[text* first-name autocomplete:name placeholder "First name"]


        [text* last-name autocomplete:name placeholder "Last name"]




        [email* your-email placeholder "Email"]


          [email* confirm-email autocomplete:off placeholder "Confirm Email"]




        [text* town placeholder "Town"]


        [text* postcode placeholder "Post Code"]





        [text business-name placeholder "Company name (if applicable)"]




    Select Country

[select* your-country 
    "New Zealand"  "Afghanistan" "Albania" "Algeria" "Andorra" "Angola" 
    "Antigua and Barbuda" "Argentina" "Armenia" "Australia" 
    "Austria" "Azerbaijan" "Bahamas" "Bahrain" "Bangladesh" 
    "Barbados" "Belarus" "Belgium" "Belize" "Benin" 
    "Bhutan" "Bolivia" "Bosnia and Herzegovina" "Botswana" 
    "Brazil" "Brunei" "Bulgaria" "Burkina Faso" "Burundi" 
    "Cabo Verde" "Cambodia" "Cameroon" "Canada" "Central African Republic" 
    "Chad" "Chile" "China" "Colombia" "Comoros" 
    "Congo, Republic of the" "Congo, Democratic Republic of the" 
    "Costa Rica" "Croatia" "Cuba" "Cyprus" "Czech Republic" 
    "Denmark" "Djibouti" "Dominica" "Dominican Republic" 
    "Ecuador" "Egypt" "El Salvador" "Equatorial Guinea" 
    "Eritrea" "Estonia" "Eswatini" "Ethiopia" "Fiji" 
    "Finland" "France" "Gabon" "Gambia" "Georgia" 
    "Germany" "Ghana" "Greece" "Grenada" "Guatemala" 
    "Guinea" "Guinea-Bissau" "Guyana" "Haiti" "Honduras" 
    "Hungary" "Iceland" "India" "Indonesia" "Iran" 
    "Iraq" "Ireland" "Israel" "Italy" "Jamaica" 
    "Japan" "Jordan" "Kazakhstan" "Kenya" "Kiribati" 
    "Korea, North" "Korea, South" "Kuwait" "Kyrgyzstan" 
    "Laos" "Latvia" "Lebanon" "Lesotho" "Liberia" 
    "Libya" "Liechtenstein" "Lithuania" "Luxembourg" 
    "Madagascar" "Malawi" "Malaysia" "Maldives" "Mali" 
    "Malta" "Marshall Islands" "Mauritania" "Mauritius" 
    "Mexico" "Micronesia" "Moldova" "Monaco" "Mongolia" 
    "Montenegro" "Morocco" "Mozambique" "Myanmar" 
    "Namibia" "Nauru" "Nepal" "Netherlands" 
    "Nicaragua" "Niger" "Nigeria" "North Macedonia" 
    "Norway" "Oman" "Pakistan" "Palau" "Palestine" 
    "Panama" "Papua New Guinea" "Paraguay" "Peru" 
    "Philippines" "Poland" "Portugal" "Qatar" 
    "Romania" "Russia" "Rwanda" "Saint Kitts and Nevis" 
    "Saint Lucia" "Saint Vincent and the Grenadines" 
    "Samoa" "San Marino" "Sao Tome and Principe" 
    "Saudi Arabia" "Senegal" "Serbia" "Seychelles" 
    "Sierra Leone" "Singapore" "Slovakia" "Slovenia" 
    "Solomon Islands" "Somalia" "South Africa" 
    "South Sudan" "Spain" "Sri Lanka" "Sudan" 
    "Suriname" "Sweden" "Switzerland" "Syria" 
    "Taiwan" "Tajikistan" "Tanzania" "Thailand" 
    "Timor-Leste" "Togo" "Tonga" "Trinidad and Tobago" 
    "Tunisia" "Turkey" "Turkmenistan" "Tuvalu" 
    "Uganda" "Ukraine" "United Arab Emirates" "United Kingdom" 
    "United States" "Uruguay" "Uzbekistan" "Vanuatu" 
    "Vatican City" "Venezuela" "Vietnam" "Yemen" 
    "Zambia" "Zimbabwe" "American Samoa" "Anguilla" 
    "Aruba" "Bermuda" "British Indian Ocean Territory" 
    "British Virgin Islands" "Cayman Islands" "Christmas Island" 
    "Cocos (Keeling) Islands" "Curacao" "Falkland Islands" 
    "Faroe Islands" "French Guiana" "French Polynesia" 
    "Gibraltar" "Greenland" "Guadeloupe" "Guam" 
    "Isle of Man" "Jersey" "Montserrat" "New Caledonia" 
    "Niue" "Norfolk Island" "Northern Mariana Islands" 
    "Pitcairn Islands" "Puerto Rico" "Reunion" 
    "Saint Barthélemy" "Saint Helena" "Saint Martin" 
    "Sint Maarten" "South Georgia and the South Sandwich Islands" 
    "Svalbard and Jan Mayen" "Tokelau" "Turks and Caicos Islands" 
    "United States Virgin Islands" "Wallis and Futuna" 
    "Western Sahara" "Western Samoa" "Kosovo"]