[full_width]Your information:[/full_width]
    [one_half padding="0 10px 0 0"][/one_half][one_half_last][/one_half_last]
    [one_half padding="0 10px 0 0"][/one_half][one_half_last][/one_half_last]
    [one_half padding="-10px 10px 0 0"][/one_half][one_half_last][/one_half_last]

    [full_width]Supplier/factory information:[/full_width]
    [one_half padding="0 10px 0 0"] [/one_half][one_half_last] [/one_half_last]
    [one_half padding="0 10px 0 0"] [/one_half][one_half_last] [/one_half_last]
    [one_half padding="0 10px 0 0"] [/one_half][one_half_last] [/one_half_last]
    [one_half padding="0 10px 0 0"] [/one_half]

    [full_width]Choose the service type:[/full_width]
    [two_third padding="0 10px 0 0"] [/two_third][one_third_last] [/one_third_last]

    [full_width]Your comments/remarks:[/full_width]
    [full_width][/full_width]

    [full_width][/full_width]

    [full_width][/full_width]