<section class="content-block template-free-form">
<div class="grid-container">
<div class="grid-x align-middle align-center">
<div class="cell medium-12 is-card">
<div class="cell__inner">
<header class="module header align-center">
<h3>Get in touch</h3>
</header>
<div class="module form">
<div class="gf_browser_chrome gform_wrapper gravity-theme gform-theme--no-framework" data-form-theme="gravity-theme" data-form-index="0" id="gform_wrapper_1">
<form method="post" enctype="multipart/form-data" id="gform_1" action="/?gf_page=preview&id=1" data-formid="1" novalidate="">
<div class="gform-body gform_body"><div id="gform_fields_1" class="gform_fields top_label form_sublabel_below description_below"><div id="field_1_1" class="gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_1"><label class="gfield_label gform-field-label" for="input_1_1">First Name</label><div class="ginput_container ginput_container_text"><input name="input_1" id="input_1_1" type="text" value="" class="large" placeholder="Jason" aria-invalid="false"> <div data-lastpass-icon-root="true" style="position: relative !important; height: 0px !important; width: 0px !important; float: left !important;"></div></div></div><div id="field_1_2" class="gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_2"><label class="gfield_label gform-field-label" for="input_1_2">Last Name</label><div class="ginput_container ginput_container_text"><input name="input_2" id="input_1_2" type="text" value="" class="large" placeholder="Bourne" aria-invalid="false"> </div></div><div id="field_1_3" class="gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_3"><label class="gfield_label gform-field-label" for="input_1_3">Company</label><div class="ginput_container ginput_container_text"><input name="input_3" id="input_1_3" type="text" value="" class="large" placeholder="Treadstone" aria-invalid="false"> </div></div><div id="field_1_4" class="gfield gfield--type-email gfield--input-type-email gfield--width-half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_4"><label class="gfield_label gform-field-label" for="input_1_4">Email</label><div class="ginput_container ginput_container_email">
<input name="input_4" id="input_1_4" type="email" value="" class="large" placeholder="name@email.com" aria-invalid="false">
</div></div><div id="field_1_5" class="gfield gfield--type-phone gfield--input-type-phone gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_5"><label class="gfield_label gform-field-label" for="input_1_5">Phone</label><div class="ginput_container ginput_container_phone"><input name="input_5" id="input_1_5" type="tel" value="" class="large" placeholder="xxx.xxx.xxxx" aria-invalid="false"></div></div><div id="field_1_6" class="gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_6"><label class="gfield_label gform-field-label" for="input_1_6">Reason for contact...</label><div class="ginput_container ginput_container_select"><select name="input_6" id="input_1_6" class="large gfield_select" aria-invalid="false"><option value="Speak with sales" selected="selected">Speak with sales</option><option value="Second Choice">Second Choice</option><option value="Third Choice">Third Choice</option></select></div></div><fieldset id="field_1_7" class="gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_7"><legend class="gfield_label gform-field-label gfield_label_before_complex">Selling through (select all that apply)</legend><div class="ginput_container ginput_container_checkbox"><div class="gfield_checkbox" id="input_1_7"><div class="gchoice gchoice_1_7_1">
<input class="gfield-choice-input" name="input_7.1" type="checkbox" value="Amazon Vendor Central (VC)" id="choice_1_7_1">
<label for="choice_1_7_1" id="label_1_7_1" class="gform-field-label gform-field-label--type-inline">Amazon Vendor Central (VC)</label>
</div><div class="gchoice gchoice_1_7_2">
<input class="gfield-choice-input" name="input_7.2" type="checkbox" value="Aazon Seller Central (SC)" id="choice_1_7_2">
<label for="choice_1_7_2" id="label_1_7_2" class="gform-field-label gform-field-label--type-inline">Aazon Seller Central (SC)</label>
</div><div class="gchoice gchoice_1_7_3">
<input class="gfield-choice-input" name="input_7.3" type="checkbox" value="Not yet selling on Amazon" id="choice_1_7_3">
<label for="choice_1_7_3" id="label_1_7_3" class="gform-field-label gform-field-label--type-inline">Not yet selling on Amazon</label>
</div></div></div></fieldset><div id="field_1_8" class="gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_8"><label class="gfield_label gform-field-label" for="input_1_8">Brand(s) selling on Amazon</label><div class="ginput_container ginput_container_text"><input name="input_8" id="input_1_8" type="text" value="" class="large" aria-invalid="false"> </div></div><div id="field_1_9" class="gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_9"><label class="gfield_label gform-field-label" for="input_1_9">Primary pain points or goals...</label><div class="ginput_container ginput_container_text"><input name="input_9" id="input_1_9" type="text" value="" class="large" placeholder="Tell us your problems...." aria-invalid="false"> </div></div><div id="field_1_10" class="gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_10"><label class="gfield_label gform-field-label" for="input_1_10">Annual sales...</label><div class="ginput_container ginput_container_select"><select name="input_10" id="input_1_10" class="large gfield_select" aria-invalid="false"><option value="$ - $$" selected="selected">$ - $$</option><option value="$$ - $$$">$$ - $$$</option><option value="$$$ - $$$$">$$$ - $$$$</option><option value="$$$$ - $$$$$">$$$$ - $$$$$</option></select></div></div><div id="field_1_11" class="gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_1_11">By providing this information, you agree that we may process your personal data in accordance with our Privacy Statement.</div></div></div>
<div class="gform_footer top_label"> <button id="gform_submit_button_1" class="gform_button button">Submit</button>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
</div>
</section>