<h1>Invoicing</h1>
<h2>Email Body</h2>



<p>Your Name (required)<br />
    [text* your-name] </p>

<p>Your Email (required)<br />
    [email* your-email] </p>
<p>Message <br />
    [textarea* your-message]
</p>


<h2 style="margin-top: 50px">Invoice Details</h2>

<p>Your Company(required)<br />
    [text* your-company] </p>

<p>Your address(required)<br />
    [text* your-address] </p>

<p>Your city(required)<br />
    [text* your-city] </p>

<p>Your province(required)<br />
    [text* your-province] </p>

<p>Your postalcode(required)<br />
    [text* your-postalcode] </p>

<p>Your phone(required)<br />
    [text* your-phone] </p>

<p>Your fax<br />
    [text your-fax] </p>

<p>Your Special Instructions<br />
  [textarea your-specialinstructions]</p>

<p>Your Sales Person(required)<br />
    [text* your-salesperson] </p>

<p>Your H.S.T. BIN(required)<br />
    [text* your-bin] </p>

<p>Your Requistioner<br />
    [text your-requistioner] </p>

<p>Send VIA<br />
[select* your-shipping "Cheque" "Direct Deposit" "Email Money Transfer"]
  </p>

<p>Your P.O. Number<br />
    [text your-ponumber] </p>

<p>Your terms(required)<br />
[select* your-terms "Due On Receipt" "Net 30" "Net 60" "Net 90"]
  </p>

<p>Your Hours(required)<br />
    [text* your-quantity] </p>

<p>Your description(required)<br />
    [text* your-description] </p>

<p>Your Unit Price(required)<br />
    [text* your-unitprice] </p>


[recaptcha]
<p>[submit "Send"]</p>