[{“name”:”first_name”,”label”:”Full Name”,”id”:”first_name”,”class”:”first_name”,”required”:”1″,”type”:”text”,”options”:””},{“name”:”company_name”,”label”:”Company Name “,”id”:”company_name”,”class”:”company_name”,”required”:”0″,”type”:”text”,”options”:””},{“name”:”email”,”label”:”Email”,”id”:”email”,”class”:”email”,”required”:”1″,”type”:”email”,”options”:””},{“name”:”suburb”,”label”:”City”,”id”:”suburb”,”class”:”suburb”,”required”:”1″,”type”:”text”,”options”:””},{“name”:”post_code”,”label”:”State”,”id”:”post_code”,”class”:”post_codee”,”required”:”0″,”type”:”select”,”options”:”Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin,Wyoming”},{“name”:”customer_note”,”label”:”Message: Hi Kandila Blinds Team, I am reaching out because…”,”id”:”customer_note”,”class”:”customer_note”,”required”:”0″,”type”:”textarea”,”options”:””}]
