[md-form class="wmform"]
[md-text label="Name"] [/md-text]
[md-text label="Email"] [/md-text]
[md-text label="Phone Number"] [/md-text]
[md-checkbox label="Preferred Method of Communication"] EmailCallText [/md-checkbox]
[md-text label="Website"] [/md-text]
[md-checkbox* label="Register as"] AlliancePartnerCommunity ChampionGirls AmbassadorNot Sure [/md-checkbox]
[md-text label="Comment"] [/md-text]
[md-submit] [/md-submit]
[/md-form]
