Our Journal

Seedlip

Trade Marketing

    <!-- Form elements go here: Style as you wish -->
    
    <table>
    	<tr>
    		<th>Email address</th>
    		<td>
    			<input name="ue" type="text" value="" />
    		</td>
    	</tr>
    	<tr>
    		<th>First name</th>
    		<td>
    			<input name="firstname" type="text" value="" />
    		</td>
    	</tr>
    	<tr>
    		<th>Last name</th>
    		<td>
    			<input name="lastname" type="text" value="" />
    		</td>
    	</tr>
    	<tr>
    		<th>City Of Residence</th>
    		<td>
    			<input name="properties.city_of_residence" type="text" value="" />
    		</td>
    	</tr>
    </table>
    <input type="submit" value="Submit form" style="padding: 5px 20px;" name="submit" />
    
    <!-- End of form elements -->