<p><label for="wbk-name">Name *</label>[text* wbk-name class:wbk-text id:wbk-customer_name]</p><p><label for="wbk-address">Appointment Address</label>[textarea* wbk-address class:wbk-textarea id:wbk-customer_address]</p><p><label for="wbk-email">Email *</label>[text* wbk-email class:wbk-text id:wbk-customer_email]</p><p><label for="wbk-phone">Phone *</label>[text* wbk-phone class:wbk-text  id:wbk-customer_phone]</p><p><label for="wbk-comment">Comment</label>[textarea wbk-comment class:wbk-textarea id:wbk-customer_desc]</p>