[form] 
[fieldset name="fieldset1"]
[field name="mylistvalue" type="list" default="" label="Service Required" description =""] 
[option value="Regular Cleaning"]Regular Cleaning[/option] 
[option value="Spring Cleaning"]Spring Cleaning[/option] 
[option value="Occupational Cleaning"]Occupational Cleaning[/option] 
[option value="Window Cleaning"]Window Cleaning[/option] 
[option value="Carpet and Upholstery Cleaning"]Carpet and Upholstery  Cleaning[/option] 
[option value="Other Cleaning"]Other Cleaning[/option] [/field] 
[field name="mycalendar " type="calendar" default="15-04-2015 " label="Service Date" description="" format="%d-%m-%Y " /] 
[field name="cleaning_kit" type="checkbox" label="Cleaning Kit" description ="Cleaning Kit" value="0" /] 
[field name="carpet_machine" type="checkbox" label="Carpet Cleaning" description ="Carpet Cleaning" value="1 " /] 
[field name="laminate_floors " type="checkbox" label="Laminate/Wooden Floors" description ="Laminate/Wooden Floors" value="1" /] 
[field name="name" label="Name" type="text" size ="50" required ="true" /] 
[field name="email" label="Email" type="email" size ="50" required ="true" validate ="email" /] 
[field name="cell" label="Cell No." type="text" size ="50" /] 
[field name="address" label="Service Address" type="textarea" cols ="50" rows ="5" required ="true" /] 
[field name="message" label="NOTE : Please give us more information about the size of the house (e.g. bedrooms, bathrooms, study, etc) and the details of the required service" type="textarea" cols ="50" rows ="10" required ="false" /] 
[/fieldset] 
[/form]