Form Example

Text box: Full Name

Text box with watermark: Phone Number

Text area: Do you have any questions or comments?

Radio button: Have you purchased from us before?

 Yes   No

Checkbox: Do you have any pets? Check all that apply

 Dog             Cat        Fish        Other

Dropdown list - custom: In which region do you live?

Please select... East Coast USA Midwest USA New England West Coast USA Alaska Hawaii

Dropdown list - states: State of residence

Please select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia 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

Single select list: Which city are you most interested in visiting?

Tokyo Rio de Janeiro Paris Montreal Sydney   Required 

Multiple select list: Which of these zoo animals would you visit? Press and hold the Control key on your keyboard to select more than one item

Lions Tigers Bears Elephants Giraffes

Upload picture: Select this option to upload a picture

  Please upload only images   Required 

Upload file: Select this option to upload a file

  Please upload only allowed file types (eps)   Required 

Email copy: Enter an email address if you would like copy of this form

  Please enter a valid email address 

Button - reset: Click this button to clear the form and start over

Button - submit: Click this button to submit the form

Thank you message: (This appears automatically after the form is submitted)