Don't forget to change the hidden input for the recipient address at the bottom of this form.
(To do this you will need to edit the HTML).
Text input:
Email text input:
Radio buttons:
Good
Average
Poor
Checkboxes:
Checkbox one
Checkbox two
Textarea:
Select box:
(Multiple)
Option 1
Option 2
Option 3
Option 4
Option 5
Select box:
Option 1
Option 2
Option 3
Option 4
Option 5
File upload:
* = Required fields.