<div class="control-group ticket_section"> <label class=" required control-label cf_order_number_current_owner_1546960-label " for="helpdesk_ticket_cf_order_number_current_owner_1546960">Order Number</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_order_number_current_owner_1546960]" id="helpdesk_ticket_custom_field_cf_order_number_current_owner_1546960" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_order_number_1546960-label " for="helpdesk_ticket_cf_order_number_1546960">Order Number</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_order_number_1546960]" id="helpdesk_ticket_custom_field_cf_order_number_1546960" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_topic_1546960-label " for="helpdesk_ticket_cf_topic_1546960">Topic</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_topic_1546960]" id="helpdesk_ticket_custom_field_cf_topic_1546960"><option value="">...</option> <option data-id="65000216236" value="Ebike Sizing">Ebike Sizing</option> <option data-id="65000216237" value="Questions about Models">Questions about Models</option> <option data-id="65000216238" value="Care and Service Options">Care and Service Options</option> <option data-id="65000216239" value="Product Availablity">Product Availablity</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_type_of_concern_1546960-label " for="helpdesk_ticket_cf_type_of_concern_1546960">Type of Concern</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type_of_concern_1546960]" id="helpdesk_ticket_custom_field_cf_type_of_concern_1546960"><option value="">...</option> <option data-id="65000216240" value="Assembly Issue">Assembly Issue</option> <option data-id="65000216241" value="Motor power/ Battery related">Motor power/ Battery related</option> <option data-id="65000216242" value="Error Code">Error Code</option> <option data-id="65000216243" value="Mechanical Issue (brake, shifting, wheels, etc.)">Mechanical Issue (brake, shifting, wheels, etc.)</option> <option data-id="65000216244" value="Need to Purchase Parts">Need to Purchase Parts</option> <option data-id="65000216245" value="Other">Other</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_sales_model702191_1546960-label " for="helpdesk_ticket_cf_sales_model702191_1546960">Model</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_sales_model702191_1546960]" id="helpdesk_ticket_custom_field_cf_sales_model702191_1546960"><option value="">...</option> <option data-id="65000217873" value="P E N D I N G">P E N D I N G</option> <option data-id="65000211560" value="700 Series">700 Series</option> <option data-id="65000211561" value="Cafe Cruiser">Cafe Cruiser</option> <option data-id="65000214379" value="CF Racer 1 Gravel">CF Racer 1 Gravel</option> <option data-id="65000214380" value="CF Racer 1 Road">CF Racer 1 Road</option> <option data-id="65000214402" value="LMT'D V2">LMT'D V2</option> <option data-id="65000211563" value="Portola">Portola</option> <option data-id="65000211570" value="Turris">Turris</option> <option data-id="65000217481" value="Vorsa">Vorsa</option> <option data-id="65000211564" value="Prodigy XC">Prodigy XC</option> <option data-id="65000211565" value="Prodigy V2">Prodigy V2</option> <option data-id="65000211566" value="Revv 1 - DRT">Revv 1 - DRT</option> <option data-id="65000217871" value="Revv 1 - HT">Revv 1 - HT</option> <option data-id="65000217872" value="Revv 1 - FS">Revv 1 - FS</option> <option data-id="65000215907" value="Roadster V3">Roadster V3</option> <option data-id="65000211571" value="Accessories">Accessories</option> <option data-id="65000215908" value="500 Series (Discontinued)">500 Series (Discontinued)</option> <option data-id="65000215909" value="Core-5 (Discontinued)">Core-5 (Discontinued)</option> <option data-id="65000215910" value="LMT'D (Discontinued)">LMT'D (Discontinued)</option> <option data-id="65000215911" value="Prodigy (Discontinued)">Prodigy (Discontinued)</option> <option data-id="65000211567" value="Rift (Discontinued)">Rift (Discontinued)</option> <option data-id="65000215912" value="Roadster Ghost (Discontinued)">Roadster Ghost (Discontinued)</option> <option data-id="65000211569" value="Roadster V2 Gravel (Discontinued)">Roadster V2 Gravel (Discontinued)</option> <option data-id="65000211568" value="Roadster V2 (Discontinued)">Roadster V2 (Discontinued)</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_order_number893758_1546960-label " for="helpdesk_ticket_cf_order_number893758_1546960">Order Number</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_order_number893758_1546960]" id="helpdesk_ticket_custom_field_cf_order_number893758_1546960" /> </div> </div> <div class="control-group ticket_section"> <label class=" required control-label cf_serial_number_1546960-label " for="helpdesk_ticket_cf_serial_number_1546960">Serial Number</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_serial_number_1546960]" id="helpdesk_ticket_custom_field_cf_serial_number_1546960" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_mileage_1546960-label " for="helpdesk_ticket_cf_mileage_1546960">Mileage</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_mileage_1546960]" id="helpdesk_ticket_custom_field_cf_mileage_1546960" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_type_1546960-label " for="helpdesk_ticket_cf_type_1546960">Type</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type_1546960]" id="helpdesk_ticket_custom_field_cf_type_1546960"><option value="">...</option> <option data-id="65000216246" value="Need help seeking a qualified bike">Need help seeking a qualified bike</option> <option data-id="65000216247" value="I'm ready to redeem my voucher">I'm ready to redeem my voucher</option> <option data-id="65000216248" value="Other">Other</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_type851739_1546960-label " for="helpdesk_ticket_cf_type851739_1546960">Question</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type851739_1546960]" id="helpdesk_ticket_custom_field_cf_type851739_1546960"><option value="">...</option> <option data-id="65000217171" value="Need help seeking a qualified bike">Need help seeking a qualified bike</option> <option data-id="65000217172" value="I'm ready to redeem my voucher">I'm ready to redeem my voucher</option> <option data-id="65000217173" value="Other Question">Other Question</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" required control-label cf_model791907_1546960-label " for="helpdesk_ticket_cf_model791907_1546960">Model you wish to purchase</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_model791907_1546960]" id="helpdesk_ticket_custom_field_cf_model791907_1546960"><option value="">...</option> <option data-id="65000214865" value="T B D">T B D</option> <option data-id="65000214862" value="Portola">Portola</option> <option data-id="65000214863" value="Vorsa">Vorsa</option> <option data-id="65000214864" value="Roadster V3">Roadster V3</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" required control-label cf_shipping_address813142_1546960-label " for="helpdesk_ticket_cf_shipping_address813142_1546960">Shipping Address</label> <div class="controls "> <textarea class=" required paragraph section_field span12" rows="6" placeholder="" name="helpdesk_ticket[custom_field][cf_shipping_address813142_1546960]" id="helpdesk_ticket_custom_field_cf_shipping_address813142_1546960"> </textarea> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_billing_address27772_1546960-label " for="helpdesk_ticket_cf_billing_address27772_1546960">Billing Address (If different from shipping)</label> <div class="controls "> <textarea class=" paragraph section_field span12" rows="6" placeholder="" name="helpdesk_ticket[custom_field][cf_billing_address27772_1546960]" id="helpdesk_ticket_custom_field_cf_billing_address27772_1546960"> </textarea> </div> </div> <div class="control-group ticket_section"> <label class=" required control-label cf_colorado_id_number_1546960-label " for="helpdesk_ticket_cf_colorado_id_number_1546960">Colorado ID Number</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_colorado_id_number_1546960]" id="helpdesk_ticket_custom_field_cf_colorado_id_number_1546960" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_order_number302564_1546960-label " for="helpdesk_ticket_cf_order_number302564_1546960">Order Number</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_order_number302564_1546960]" id="helpdesk_ticket_custom_field_cf_order_number302564_1546960" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_lock_core_number_1546960-label " for="helpdesk_ticket_cf_lock_core_number_1546960">Lock Core Number</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_lock_core_number_1546960]" id="helpdesk_ticket_custom_field_cf_lock_core_number_1546960" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_type312221_1546960-label " for="helpdesk_ticket_cf_type312221_1546960">What best describes you</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_type312221_1546960]" id="helpdesk_ticket_custom_field_cf_type312221_1546960"><option value="">...</option> <option data-id="65000216249" value="Bike shop looking to sell R1U">Bike shop looking to sell R1U</option> <option data-id="65000216250" value="Current or future Affiliate looking for information">Current or future Affiliate looking for information</option> <option data-id="65000216251" value="Content Creator looking for information">Content Creator looking for information</option></select> </div> </div>