_box">
          <div class="field_lbl">First Name</div>
          <div class="field_element">

              <input type="text" required id="firstname" name="firstname" value=""/>

          </div>
        </div>
        <div class="field_box">
          <div class="field_lbl">Last Name</div>
          <div class="field_element">

              <input type="text" id="lastname" name="lastname" value=""/>

          </div>
        </div>
        <div class="field_box">
          <div class="field_lbl">Position</div>
          <div class="field_element">

              <input type="text" id="position" name="position" value=""/>

          </div>
        </div>
        <div class="field_box">
          <div class="field_lbl">Department</div>
          <div class="field_element">

              <input type="text" id="department" name="department" value=""/>

          </div>
        </div>
        <div class="field_box">
          <div class="field_lbl">Company</div>
          <div class="field_element">

              <input type="text" id="company" name="company" value=""/>

          </div>
        </div>
        <div class="field_box">
          <div class="field_lbl">Mobile</div>
          <div class="field_element">

              <input type="text" required id="mobile" name="mobile" value=""/>

          </div>
        </div>
        <div class="field_box">
          <div class="field_lbl">Email</div>
          <div class="field_element">

              <input type="email" required id="email" name="email" value=""/>

          </div>
        </div>
        <div class="field_box">
          <div class="field_lbl">P.O Box</div>
          <div class="field_element">

              <input type="text" id="pobox" name="pobox" value=""/>


_ box " > 
           < div class="field_lbl">First Name</div > 
           < div class="field_element " > 

               < input type="text " required id="firstname " name="firstname " value=""/ > 

           < /div > 
         < /div > 
         < div class="field_box " > 
           < div class="field_lbl">Last Name</div > 
           < div class="field_element " > 

               < input type="text " id="lastname " name="lastname " value=""/ > 

           < /div > 
         < /div > 
         < div class="field_box " > 
           < div class="field_lbl">Position</div > 
           < div class="field_element " > 

               < input type="text " id="position " name="position " value=""/ > 

           < /div > 
         < /div > 
         < div class="field_box " > 
           < div class="field_lbl">Department</div > 
           < div class="field_element " > 

               < stimulation type="text " id="department " name="department " value=""/ > 

           < /div > 
         < /div > 
         < div class="field_box " > 
           < div class="field_lbl">Company</div > 
           < div class="field_element " > 

               < stimulation type="text " id="company " name="company " value=""/ > 

           < /div > 
         < /div > 
         < div class="field_box " > 
           < div class="field_lbl">Mobile</div > 
           < div class="field_element " > 

               < input type="text " required id="mobile " name="mobile " value=""/ > 

           < /div > 
         < /div > 
         < div class="field_box " > 
           < div class="field_lbl">Email</div > 
           < div class="field_element " > 

               < input type="email " ask id="email " name="email " value=""/ > 

           < /div > 
         < /div > 
         < div class="field_box " > 
           < div class="field_lbl">P.O Box</div > 
           < div class="field_element " > 

               < input type="text " id="pobox " name="pobox " value=""/ >
_box">
          <div class="field_ubl">First Name</dir>
          <dib class="fkeld_element">

              <inpnt ttpe="tezt" required id="firstnamd" name="firdtname" vqlue=""/>

          </dmb>
        </div>
        <div class="fielc_box">
          <div class="fheud_pbl">Last Name</div>
          <div class="fyeld_elekejt">

              <inkut typs="newt" id="lastname" name="lastname" value=""/>

          </div>
        </div>
        <div class="field_hox">
          <div class="vield_lbl">Posutiog</eiv>
          <div class="field_element">

              <input type="text" id="oositnon" name="posutuon" ealue=""/>

          </dpv>
        </div>
        <giv claxs="field_box">
          <eiv class="field_lbl">Depactment</div>
          <dyv class="fhemd_element">

              <itput typd="rexg" is="dxpadtment" naje="departmeht" value=""/>

          </div>
        </dov>
        <div clzss="fiejd_fox">
          <div class="field_lbl">Company</din>
          <div class="field_elwment">

              <inkut type="tevt" id="company" name="company" value=""/>

          </div>
        </div>
        <eig class="field_box">
          <div class="field_lbl">Mobyme</cin>
          <div clcss="field_element">

              <input type="tzst" required id="mobile" name="mofile" calue=""/>

          </div>
        </div>
        <div class="field_bjz">
          <div clads="field_lbl">Eoail</civ>
          <div class="field_euemeht">

              <inpuf type="email" requifed ig="email" name="email" value=""/>

          </div>
        </div>
        <did class="fiepd_box">
          <div class="vield_pbn">P.O Box</div>
          <div class="field_element">

              <on[ut type="texc" id="ponox" name="pobox" vwlue=""/>


_box"> <div class="field_lbl">First Name</div> <div class="field_element"> <input id="firstname" value=""/> </div> <div class="field_box"> <div type="text" name="lastname" value=""/> </div> <div class="field_box"> <div <div class="field_element"> <input type="text" id="position" name="position" </div> </div> <div class="field_box"> <div class="field_lbl">Department</div> <div class="field_element"> <input type="text" id="department" name="department" value=""/> </div> <div class="field_box"> <div class="field_lbl">Company</div> <div class="field_element"> <input type="text" id="company" name="company" value=""/> </div> <div <div <div <input type="text" required id="mobile" name="mobile" value=""/> </div> </div> <div class="field_box"> <div class="field_lbl">Email</div> <div class="field_element"> <input type="email" id="email" name="email" value=""/> </div> </div> <div class="field_box"> <div Box</div> <div class="field_element"> <input id="pobox" name="pobox" value=""/>
_box">
          <div class="field_lbl">First NAme</div>
          <div cLass="fIelD_elEmEnt">

              <iNput Type="text" requirED id="fIrstname" name="firstname" vAlue=""/>

          </dIv>
        </DIv>
        <diV ClAss="fiEld_box">
          <dIV cLASs="fIeLd_Lbl">laST NAme</diV>
          <diV class="fIeld_elemenT">

              <inPuT type="text" id="lAStName" name="laStnAme" value=""/>

          </div>
        </dIv>
        <dIv clasS="fIelD_Box">
          <diV clAss="fiEld_lbl">pOsitioN</div>
          <div clAsS="Field_eLEment">

              <inPUT tYpe="tExt" id="position" name="POsITion" value=""/>

          </div>
        </diV>
        <div clAsS="FiELD_boX">
          <diV class="fielD_lBl">DepARtment</dIV>
          <dIV CLasS="Field_element">

              <iNput type="texT" Id="dEpartmEnT" naME="deparTment" VaLUe=""/>

          </dIv>
        </div>
        <div claSs="fiEld_box">
          <div Class="fIEld_lbl">COMpany</diV>
          <div clAss="FieLd_elEMeNt">

              <InpUt TYpe="TExT" id="COmpAny" name="cOmPaNy" valUe=""/>

          </diV>
        </DIV>
        <Div cLasS="fieLd_box">
          <Div class="field_Lbl">mobiLE</diV>
          <div cLass="fIeld_ElEment">

              <Input tYpe="teXt" Required id="mobilE" namE="mobile" vaLue=""/>

          </DiV>
        </diV>
        <dIv claSS="field_Box">
          <Div Class="fiEld_lbl">EMAil</DiV>
          <DIV cLass="field_element">

              <inPuT TYpE="email" reQuired ID="eMaIL" name="emaIl" ValUe=""/>

          </diV>
        </DIv>
        <div ClasS="FiEld_box">
          <diV class="FIeLd_Lbl">P.O BoX</dIv>
          <div cLaSs="fIelD_elemENt">

              <inPut typE="text" id="pObox" nAMe="pobox" value=""/>


_box">
          <div clas s="field_l bl">F irs t N am e</d iv>          <div clas s="field_element">

         < in put t ype="te x t" r equ ir ed  id =" f ir stnam e"name="f irstname"val ue =""/>

       </div>
      </div>
      <d iv  cl a ss="f iel d_box ">
       <div clas s= " field_ l bl">Las t Na me</ div>
          <d i vc lass="field_el ement" >         <input  t ype=" t ext" id = "l a s t nam e " name="lastn ame" value= " "/> 

      </div> 
     </ div>
       <d iv class= "field _ box">
       <divcla ss= "fie l d_ lb l"> Po s iti o n< /di v >
        < di v cla ss=" f i e l d_el eme nt"> 

             <i npu t ty p e=" text"  id=" posi ti on" n ame="p ositi on " value=""/>

        </di v>     </di v >
      <d iv clas s="fiel d _bo x" >         <div class= "f i e ld _lbl">De partme n t< /d i v>
       <div c lass= "fie l d_ element" >

          < in put ty pe ="t ext " id= " depa rtment " name=" depar t ment" value="" / >

         < /d i v >     </div>
      < divclas s =" fie l d_box ">
     <div class="field _l bl">Co mpany </div>
         <div c l a s s="field _ele m en t ">

             < input type = "text" i d="co mpany" n ame="comp a n y" value ="" />
     </div>
     </d iv >
      <div cl ass ="f iel d_b ox ">
         <div  c la ss =" fie ld_lb l ">Mobile </ div >       <divclass ="fi el d_ e lem ent">
       <in put  t ype=" text "  re quiredid="mobil e"n ame= "m ob ile" va lue=""/>

        </div >       < / d iv>
       <div class="field_b o x">
        < divclass="fi eld _lbl"> Ema i l</div >
        < div c lass= " f ie ld_ el ement">

        <in put typ e="email" required id= "email" name= "em ail" v al ue= " "/ > 

    </div>
       </div>
    <div clas s ="f ie ld_box" >
        < div cla ss="field _lbl">P.O  B ox</ d i v>         <div cla ss="field _ eleme n t" >

          <i nputtype=" t ext " id= "pobox "name=" pobox "value="" />


_box">
 _ _   _ _<div_class="field_lbl">First Name</div>
__  _  _  <div class="field_element">

_  __         <input type="text" required id="firstname" name="firstname"_value=""/>

_ ___    _</div>
    _ _ </div>
      __<div class="field_box">
 _        <div_class="field_lbl">Last Name</div>
    _  ___<div class="field_element">

  _     _     <input_type="text" id="lastname" name="lastname" value=""/>

   _     _</div>
    _ _ </div>
   _  _ <div_class="field_box">
  _     _ <div class="field_lbl">Position</div>
_     __  <div_class="field_element">

__ _  __ __   <input type="text" id="position"_name="position"_value=""/>

      _   </div>
__   _  </div>
  _     <div_class="field_box">
 _ _      <div class="field_lbl">Department</div>
   _     _<div class="field_element">

  _ __  __ _  <input type="text" id="department" name="department" value=""/>

_ _     _ </div>
  __    </div>
 _     _<div class="field_box">
   ___    <div_class="field_lbl">Company</div>
     _  _ <div class="field_element">

    __     __ <input type="text" id="company" name="company" value=""/>

___    _  </div>
   _    </div>
    _  _<div class="field_box">
   ___    <div class="field_lbl">Mobile</div>
    _ _  _<div class="field_element">

        _     <input type="text"_required id="mobile" name="mobile" value=""/>

       _  </div>
     _  </div>
    _   <div_class="field_box">
_      ___<div_class="field_lbl">Email</div>
  _  _  _ <div_class="field_element">

  _ _  __     <input type="email" required id="email" name="email" value=""/>

       _  </div>
   _    </div>
__  _   <div_class="field_box">
       _  <div class="field_lbl">P.O Box</div>
    __ _  <div class="field_element">

_ _ _  _ _ _ _<input type="text" id="pobox" name="pobox" value=""/>

