<%- # License: AGPL-3.0-or-later WITH Web-Template-Output-Additional-Permission-3.0-or-later -%> <% require_email = nil if require_email.nil? %> <% require_name = nil if require_name.nil? %>

>Name <%= require_name ? '(required)' : '' %> >

Email <%= require_email && '(required)' %> >

Phone

Address

City

State/Region

Postal Code

Country