[response]
<p>Email<br />
    [email* your-email] </p>
<p>First Name<br />
    [text* first-name] </p>
<p>Last Name<br />
    [text* last-name] </p>
<p>Choose One...
[select* visitor-type "Lender" "Home Buyer" "Other"]</p>
[recaptcha]
<p>[submit "Submit"]</p>