gistfile1.html

        
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<div class="moonray_form_field_wrapper"><label class="moonray_fieldname mr_firstname" for="firstname">First Name</label><input type="text" name="firstname" value="" class="moonray_input  text" size="30"/></div><div class="moonray_form_field_wrapper"><label class="moonray_fieldname mr_lastname" for="lastname">Last Name</label><input type="text" name="lastname" value="" class="moonray_input  text" size="30"/></div><div class="moonray_form_field_wrapper"><label class="moonray_fieldname mr_email" for="email">E-Mail<span class="moonray_required">*</span></label><input type="text" name="email" value="" class="moonray_input required text" size="30"/></div><div class="moonray_form_field_wrapper"><label class="moonray_fieldname mr_address" for="address">Address</label><input type="text" name="address" value="" class="moonray_input  text" size="30"/></div><div class="moonray_form_field_wrapper"><label class="moonray_fieldname mr_address2" for="address2">Address 2</label><input type="text" name="address2" value="" class="moonray_input  text" size="30"/></div><div class="moonray_form_field_wrapper"><label class="moonray_fieldname mr_city" for="city">City</label><input type="text" name="city" value="" class="moonray_input  text" size="30"/></div><div class="moonray_form_field_wrapper"><label class="moonray_fieldname mr_state" for="state">State</label><select name="state" class="moonray_input "><option value=''></option><option value='AL'>Alabama</option><option value='AK'>Alaska</option><option value='AZ'>Arizona</option><option value='AR'>Arkansas</option><option value='CA'>California</option><option value='CO'>Colorado</option><option value='CT'>Connecticut</option><option value='DE'>Delaware</option><option value='DC'>D.C.</option><option value='FL'>Florida</option><option value='GA'>Georgia</option><option value='HI'>Hawaii</option><option value='ID'>Idaho</option><option value='IL'>Illinois</option><option value='IN'>Indiana</option><option 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label="yyyy"/></div><div class="moonray_form_field_wrapper"><label class="moonray_fieldname mr_UltraRepsS_206" for="UltraRepsS_206">Ultra Reps Sample Date</label><input style="width:30px" type="text" name="merge_UltraRepsS_206_1" maxlength="2" size="2" value="mm"  class="moonray_input  moonray_input_date_month" label="mm"/> <span class="moonray_spacer">-</span> <input style="width:30px" type="text" name="merge_UltraRepsS_206_2" maxlength="2" size="2" value="dd"  label="dd" class="moonray_input moonray_input_date_day "/> <span class="moonray_spacer">-</span> <input style="width:40px" type="text" name="merge_UltraRepsS_206_3" maxlength="4" size="4" value="yyyy"  class="moonray_input moonray_input_date_year " label="yyyy"/></div><div class="moonray_form_field_wrapper"><label class="moonray_fieldname mr_SocialShar_213" for="SocialShar_213">Social Sharing URL</label><input type="text" name="SocialShar_213" value="" class="moonray_input  text" size="30"/></div><div class="moonray_form_field_wrapper"><label class="moonray_fieldname mr_SocialShar_214" for="SocialShar_214">Social Sharing Tracking URL</label><input type="text" name="SocialShar_214" value="" class="moonray_input  text" size="30"/></div>

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