[md-form]
    [md-select label="Title"]

    [/md-select]
    [md-text label="Name"]

    [/md-text]
    [md-text label="Contact No"]

    [/md-text]
    [md-text label="Email"]

    [/md-text]
    [md-select label="Country"]

    [/md-select]
    [md-checkbox label="Please select 1 or more options on the topic that you are enquiring"]
    Metabolic Health Programme™ES-TriGUARD™Enerbolis™Protecmin™ProMDR100™Tri-phyll ELIXIR™EuphoMAX™
    [/md-checkbox]
    [md-textarea label="Address"]

    [/md-textarea]
    [md-textarea label="Please state your enquiry"]

    [/md-textarea]

    [md-submit]

    [/md-submit]

    [/md-form]