<form class="js-contact-form">
    <div class="form-wrap">
      <div class="form-group">
        <label for="name">First Name*</label>
        <input type="text" name="firstName" id="name" required>
      </div>
      <div class="form-group">
        <label for="surname">Last Name*</label>
        <input type="text" name="lastName" id="surname" required>
      </div>
      <div class="form-group">
        <label for="email">Business Email*</label>
        <input type="email" name="email" id="email" required>
      </div>
      <div class="form-group">
        <label for="company">Company*</label>
        <input type="text" name="company" id="company" required>
      </div>
      <div class="form-group">
        <label for="job-title">Job title*</label>
        <input type="text" name="jobTitle" id="job-title" required>
      </div>
      <div class="form-group">
        <label for="country">Country*</label>
        <select name="country" id="country" required>

        <option disabled selected value></option>
        <option value='Andorra'>Andorra</option>
        <option value='United Arab Emirates'>United Arab Emirates</option>
        <option value='Afghanistan'>Afghanistan</option>
        <option value='Antigua and Barbuda'>Antigua and Barbuda</option>
        <option value='Anguilla'>Anguilla</option>
        <option value='Albania'>Albania</option>
        <option value='Armenia'>Armenia</option>
        <option value='Angola'>Angola</option>
        <option value='Antarctica'>Antarctica</option>
        <option value='Argentina'>Argentina</option>
        <option value='Austria'>Austria</option>
        <option value='Australia'>Australia</option>
        <option value='Aruba'>Aruba</option>
        <option value='Aland Islands'>Aland Islands</option>
        <option value='Azerbaijan'>Azerbaijan</option>
        <option value='Bosnia and Herzegovina'>Bosnia and Herzegovina</option>
        <option value='Barbados'>Barbados</option>
        <option value='Bangladesh'>Bangladesh</option>
        <option value='Belgium'>Belgium</option>
        <option value='Burkina Faso'>Burkina Faso</option>
        <option value='Bulgaria'>Bulgaria</option>
        <option value='Bahrain'>Bahrain</option>
        <option value='Burundi'>Burundi</option>
        <option value='Benin'>Benin</option>
        <option value='Saint Barthélemy'>Saint Barthélemy</option>
        <option value='Bermuda'>Bermuda</option>
        <option value='Brunei Darussalam'>Brunei Darussalam</option>
        <option value='Bolivia'>Bolivia</option>
        <option value='Antilles (am)'>Antilles (am)</option>
        <option value='Brazil'>Brazil</option>
        <option value='Bahamas'>Bahamas</option>
        <option value='Bhutan'>Bhutan</option>
        <option value='Bouvet Island'>Bouvet Island</option>
        <option value='Botswana'>Botswana</option>
        <option value='Belarus'>Belarus</option>
        <option value='Belize'>Belize</option>
        <option value='Canada'>Canada</option>
        <option value='Cocos (Keeling) Islands'>Cocos (Keeling) Islands</option>
        <option value='Democratic Republic of the Congo'>Democratic Republic of the Congo</option>
        <option value='Central African Republic'>Central African Republic</option>
        <option value='Republic of the Congo'>Republic of the Congo</option>
        <option value='Switzerland'>Switzerland</option>
        <option value='Cote d'Ivoire'>Cote d'Ivoire</option>
        <option value='Cook Islands'>Cook Islands</option>
        <option value='Chile'>Chile</option>
        <option value='Cameroon'>Cameroon</option>
        <option value='China'>China</option>
        <option value='Colombia'>Colombia</option>
        <option value='Costa Rica'>Costa Rica</option>
        <option value='Cuba'>Cuba</option>
        <option value='Cape Verde'>Cape Verde</option>
        <option value='Curaçao'>Curaçao</option>
        <option value='Christmas Island'>Christmas Island</option>
        <option value='Cyprus'>Cyprus</option>
        <option value='Czech Republic'>Czech Republic</option>
        <option value='Germany'>Germany</option>
        <option value='Djibouti'>Djibouti</option>
        <option value='Denmark'>Denmark</option>
        <option value='Dominica'>Dominica</option>
        <option value='Dominican Republic'>Dominican Republic</option>
        <option value='Algeria'>Algeria</option>
        <option value='Ecuador'>Ecuador</option>
        <option value='Estonia'>Estonia</option>
        <option value='Egypt'>Egypt</option>
        <option value='Western Sahara'>Western Sahara</option>
        <option value='Eritrea'>Eritrea</option>
        <option value='Spain'>Spain</option>
        <option value='Ethiopia'>Ethiopia</option>
        <option value='Finland'>Finland</option>
        <option value='Fiji'>Fiji</option>
        <option value='Falkland Islands'>Falkland Islands</option>
        <option value='Faroe Islands'>Faroe Islands</option>
        <option value='France'>France</option>
        <option value='Gabon'>Gabon</option>
        <option value='United Kingdom'>United Kingdom</option>
        <option value='Grenada'>Grenada</option>
        <option value='Georgia'>Georgia</option>
        <option value='French Guiana'>French Guiana</option>
        <option value='Guernsey'>Guernsey</option>
        <option value='Ghana'>Ghana</option>
        <option value='Gibraltar'>Gibraltar</option>
        <option value='Greenland'>Greenland</option>
        <option value='Gambia'>Gambia</option>
        <option value='Guinea'>Guinea</option>
        <option value='Guadeloupe'>Guadeloupe</option>
        <option value='Equatorial Guinea'>Equatorial Guinea</option>
        <option value='Greece'>Greece</option>
        <option value='South Sandwich Islands'>South Sandwich Islands</option>
        <option value='Guatemala'>Guatemala</option>
        <option value='Guinea-Bissau'>Guinea-Bissau</option>
        <option value='Guyana'>Guyana</option>
        <option value='Heard Island and McDonald Islands'>Heard Island and McDonald Islands</option>
        <option value='Honduras'>Honduras</option>
        <option value='Croatia'>Croatia</option>
        <option value='Haiti'>Haiti</option>
        <option value='Hungary'>Hungary</option>
        <option value='Indonesia'>Indonesia</option>
        <option value='Ireland'>Ireland</option>
        <option value='Israel'>Israel</option>
        <option value='Isle of Man'>Isle of Man</option>
        <option value='India'>India</option>
        <option value='British Indian Ocean Territory'>British Indian Ocean Territory</option>
        <option value='Iraq'>Iraq</option>
        <option value='Iran'>Iran</option>
        <option value='Iceland'>Iceland</option>
        <option value='Italy'>Italy</option>
        <option value='Jersey'>Jersey</option>
        <option value='Jamaica'>Jamaica</option>
        <option value='Jordan'>Jordan</option>
        <option value='Japan'>Japan</option>
        <option value='Kenya'>Kenya</option>
        <option value='Kyrgyzstan'>Kyrgyzstan</option>
        <option value='Cambodia'>Cambodia</option>
        <option value='Kiribati'>Kiribati</option>
        <option value='Comoros'>Comoros</option>
        <option value='Saint Kitts and Nevis'>Saint Kitts and Nevis</option>
        <option value='North Korea'>North Korea</option>
        <option value='South Korea'>South Korea</option>
        <option value='Kuwait'>Kuwait</option>
        <option value='Cayman Islands'>Cayman Islands</option>
        <option value='Kazakhstan'>Kazakhstan</option>
        <option value='Laos'>Laos</option>
        <option value='Lebanon'>Lebanon</option>
        <option value='Saint Lucia'>Saint Lucia</option>
        <option value='Liechtenstein'>Liechtenstein</option>
        <option value='Sri Lanka'>Sri Lanka</option>
        <option value='Liberia'>Liberia</option>
        <option value='Lesotho'>Lesotho</option>
        <option value='Lithuania'>Lithuania</option>
        <option value='Luxembourg'>Luxembourg</option>
        <option value='Latvia'>Latvia</option>
        <option value='Libya'>Libya</option>
        <option value='Morocco'>Morocco</option>
        <option value='Monaco'>Monaco</option>
        <option value='Moldova'>Moldova</option>
        <option value='Montenegro'>Montenegro</option>
        <option value='Saint Martin (French part)'>Saint Martin (French part)</option>
        <option value='Madagascar'>Madagascar</option>
        <option value='Macedonia'>Macedonia</option>
        <option value='Mali'>Mali</option>
        <option value='Myanmar'>Myanmar</option>
        <option value='Mongolia'>Mongolia</option>
        <option value='Macao'>Macao</option>
        <option value='Martinique'>Martinique</option>
        <option value='Mauritania'>Mauritania</option>
        <option value='Montserrat'>Montserrat</option>
        <option value='Malta'>Malta</option>
        <option value='Mauritius'>Mauritius</option>
        <option value='Maldives'>Maldives</option>
        <option value='Malawi'>Malawi</option>
        <option value='Mexico'>Mexico</option>
        <option value='Malaysia'>Malaysia</option>
        <option value='Mozambique'>Mozambique</option>
        <option value='Namibia'>Namibia</option>
        <option value='New Caledonia'>New Caledonia</option>
        <option value='Niger'>Niger</option>
        <option value='Norfolk Island'>Norfolk Island</option>
        <option value='Nigeria'>Nigeria</option>
        <option value='Nicaragua'>Nicaragua</option>
        <option value='Netherlands'>Netherlands</option>
        <option value='Norway'>Norway</option>
        <option value='Nepal'>Nepal</option>
        <option value='Nauru'>Nauru</option>
        <option value='Niue'>Niue</option>
        <option value='New Zealand'>New Zealand</option>
        <option value='Oman'>Oman</option>
        <option value='Panama'>Panama</option>
        <option value='Peru'>Peru</option>
        <option value='French Polynesia'>French Polynesia</option>
        <option value='Papua New Guinea'>Papua New Guinea</option>
        <option value='Philippines'>Philippines</option>
        <option value='Pakistan'>Pakistan</option>
        <option value='Poland'>Poland</option>
        <option value='Saint Pierre and Miquelon'>Saint Pierre and Miquelon</option>
        <option value='Pitcairn'>Pitcairn</option>
        <option value='Palestina'>Palestina</option>
        <option value='Portugal'>Portugal</option>
        <option value='Paraguay'>Paraguay</option>
        <option value='Qatar'>Qatar</option>
        <option value='Reunion'>Reunion</option>
        <option value='Romania'>Romania</option>
        <option value='Serbia'>Serbia</option>
        <option value='Russian Federation'>Russian Federation</option>
        <option value='Rwanda'>Rwanda</option>
        <option value='Saudi Arabia'>Saudi Arabia</option>
        <option value='Solomon Islands'>Solomon Islands</option>
        <option value='Seychelles'>Seychelles</option>
        <option value='Sudan'>Sudan</option>
        <option value='Sweden'>Sweden</option>
        <option value='Singapore'>Singapore</option>
        <option value='Saint Helena'>Saint Helena</option>
        <option value='Slovenia'>Slovenia</option>
        <option value='Svalbard and Jan Mayen'>Svalbard and Jan Mayen</option>
        <option value='Slovakia'>Slovakia</option>
        <option value='Sierra Leone'>Sierra Leone</option>
        <option value='San Marino'>San Marino</option>
        <option value='Senegal'>Senegal</option>
        <option value='Somalia'>Somalia</option>
        <option value='Suriname'>Suriname</option>
        <option value='South Sudan'>South Sudan</option>
        <option value='Sao Tome and Principe'>Sao Tome and Principe</option>
        <option value='El Salvador'>El Salvador</option>
        <option value='Sint Maarten (Dutch part)'>Sint Maarten (Dutch part)</option>
        <option value='Syria'>Syria</option>
        <option value='Swaziland'>Swaziland</option>
        <option value='Turks and Caicos Islands'>Turks and Caicos Islands</option>
        <option value='Chad'>Chad</option>
        <option value='French Southern Territories'>French Southern Territories</option>
        <option value='Togo'>Togo</option>
        <option value='Thailand'>Thailand</option>
        <option value='Tajikistan'>Tajikistan</option>
        <option value='Tokelau'>Tokelau</option>
        <option value='Timor-Leste'>Timor-Leste</option>
        <option value='Turkmenistan'>Turkmenistan</option>
        <option value='Tunisia'>Tunisia</option>
        <option value='Tonga'>Tonga</option>
        <option value='Turkey'>Turkey</option>
        <option value='Trinidad and Tobago'>Trinidad and Tobago</option>
        <option value='Tuvalu'>Tuvalu</option>
        <option value='Taiwan'>Taiwan</option>
        <option value='Tanzania'>Tanzania</option>
        <option value='Ukraine'>Ukraine</option>
        <option value='Uganda'>Uganda</option>
        <option value='United States'>United States</option>
        <option value='Uruguay'>Uruguay</option>
        <option value='Uzbekistan'>Uzbekistan</option>
        <option value='Vatican City'>Vatican City</option>
        <option value='Saint Vincent and the Grenadines'>Saint Vincent and the Grenadines</option>
        <option value='Venezuela'>Venezuela</option>
        <option value='Virgin Islands, British'>Virgin Islands, British</option>
        <option value='Vietnam'>Vietnam</option>
        <option value='Vanuatu'>Vanuatu</option>
        <option value='Wallis and Futuna'>Wallis and Futuna</option>
        <option value='Samoa'>Samoa</option>
        <option value='Yemen'>Yemen</option>
        <option value='Mayotte'>Mayotte</option>
        <option value='South Africa'>South Africa</option>
        <option value='Zambia'>Zambia</option>
        <option value='Zimbabwe'>Zimbabwe</option>


        </select>
      </div>

      <div class="form-group full-width">
        <label for="message">Your message*</label>
        <textarea name="message" id="Comments" cols="30" rows="10" required></textarea>
      </div>
      <div class="form-group full-width">
        <div class="checkbox-styled">
          <label for="terms" class="" required>
            I accept Linde Engineering's <a href="{{ data_protection_page_link }} "> Data Protection</a> terms and its <a href="{{ terms_page_link }} ">Terms and Conditions of Use</a>.*
            <input name="terms" type="checkbox" id="terms" value="Yes" required>
            <span class="checkmark"></span>
          </label>
        </div>
      </div>
      <div class="form-group full-width">
        <div class="checkbox-styled">
          <label for="newsletter" class="">
            I would like to sign up for the Linde Virtual Academy newsletter
            <input name="newsletterSuccessStories" type="checkbox" id="newsletter" value="Yes">
            <span class="checkmark"></span>
          </label>
        </div>
      </div>
      <div class="btn-left">
        <button type="submit" class="btn btn--gradient js-contact-form-submit" >Send</button>
      </div>
      <div class="form-feedback">
        <div class="loading-animation u-hidden js-contact-form-loading">
          <div class="loading-animation__circle"></div>
          <div class="loading-animation__circle"></div>
          <div class="loading-animation__circle"></div>
          <div class="loading-animation__circle"></div>
        </div>
        <p class="form-feedback__text success js-contact-form-feedback" data-thank-you-link="{{ thank_you_page_link }}">Thank you for reaching out! We'll get back to you soon!</p>
        <p class="form-feedback__text form-feedback__text--error error js-contact-form-feedback"></p>
      </div>
    </div>
  </form>