Full Name	{Name}
Email	{Email}
Street Address	{Street-Address}
City	{City}
State	{Country}
Postcode or Zip code	{Post-Zip-Code}
Telephone	{Telephone}
Item one quantity	{Item-one-quantity}
Item two quantity	{Item-two-quantity}
Additional details	{Additional-details}
Checkbox Group	{checkbox-group-1680443024181}