lete="family-name" required>
                      </div>
                      <div class="col-6 mb-3">
                        <label class="col-form-label" for="email">Email Address <span class="text-danger text-small">*</span>
                        </label>
                        <input type="email" class="form-control" id="email" name="email" value="" autocomplete="email" required>
                      </div>
                      <!--                    
							<div class="col-6 mb-3">
								<la