Contact

[form method="post" action="#Form"]

[messages class="MessageArea"]

[select name="address" label="Title" options="|Mr.|Ms." required="true" validate="trim|required|xss_clean"]

[text name="firstname" label="First Name" validate="trim|xss_clean"]

[text name="lastname" label="Last Name" required="true" validate="trim|required|xss_clean"]

[email name="email" label="E-Mail" required="true" validate="trim|required|xss_clean"]

[text name="street" label="Street / Street No." validate="trim|xss_clean"]

[text name="zip_ciy" label="Zip-Code / City" validate="trim|xss_clean"]

[text name="company" label="Company" validate="trim|xss_clean"]

[text name="phone" label="Phone (for possible queries)" validate="trim|xss_clean"]

[textarea name="message" label="Message" label-email="Message" validate="trim|xss_clean"]

[checkbox name="privacy-accepted" value="yes" label-email="Privacy notice accepted" label="I have read the {{{link}}}Privacy Statement{{{/link}}} and accepted" label-right="true" required="true" validate="trim|required|xss_clean" replace-link="en/privacy-statement"]

[success]

Thank you $address $lastname for your enquiry.

[/success]

[option recipient-email="info@eas-tb.de" recipient-name="Enquiry - EAS Technischer Brandschutz GmbH"]

[option sender-email="$email" sender-name="$firstname $lastname"]

[option subject="$firstname $lastname - Enquiry"]

[option confirmation-template="confirmation-default-en"]

[/form]