sample

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<!-- NOTE: Please add the following <META> element to your page <HEAD>. -->
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<!-- character set of your HTML page. -->
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<META HTTP-EQUIV="Content-type" CONTENT="text/html; charset=UTF-8">

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<!-- NOTE: Please add the following <FORM> element to your page. -->
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<form action="https://webto.salesforce.com/servlet/servlet.WebToLead?encoding=UTF-8" method="POST">

<input type=hidden name="oid" value="00DD0000000qCF1">
<input type=hidden name="retURL" value="http://">

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<!-- NOTE: These fields are optional debugging elements. Please uncomment -->
<!-- these lines if you wish to test in debug mode. -->
<!-- <input type="hidden" name="debug" value=1> -->
<!-- <input type="hidden" name="debugEmail" -->
<!-- value="michael@stonewallhousing.org"> -->
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<label for="first_name">First Name</label><input id="first_name" maxlength="40" name="first_name" size="20" type="text" /><br>

<label for="last_name">Last Name</label><input id="last_name" maxlength="80" name="last_name" size="20" type="text" /><br>

<label for="email">Email</label><input id="email" maxlength="80" name="email" size="20" type="text" /><br>

<label for="company">Company</label><input id="company" maxlength="40" name="company" size="20" type="text" /><br>

<label for="city">City</label><input id="city" maxlength="40" name="city" size="20" type="text" /><br>

<label for="state">State/Province</label><input id="state" maxlength="20" name="state" size="20" type="text" /><br>

Web Source:<input id="00ND0000004tBNG" maxlength="255" name="00ND0000004tBNG" size="20" type="text" /><br>

Preferred Pronoun:<select id="00ND0000006C0j2" name="00ND0000006C0j2" title="Preferred Pronoun"><option value="">--None--</option><option value="He">He</option>
<option value="She">She</option>
<option value="They">They</option>
<option value="Other">Other</option>
</select><br>

Borough:<select id="00ND0000006C0jC" name="00ND0000006C0jC" title="Borough"><option value="">--None--</option><option value="Barking and Dagenham">Barking and Dagenham</option>
<option value="Barnet">Barnet</option>
<option value="Bexley">Bexley</option>
<option value="Brent">Brent</option>
<option value="Bromley">Bromley</option>
<option value="Camden">Camden</option>
<option value="City of London">City of London</option>
<option value="Croydon">Croydon</option>
<option value="Ealing">Ealing</option>
<option value="Enfield">Enfield</option>
<option value="Greenwich">Greenwich</option>
<option value="Hackney">Hackney</option>
<option value="Hammersmith">Hammersmith</option>
<option value="Haringey">Haringey</option>
<option value="Harrow">Harrow</option>
<option value="avering">avering</option>
<option value="Hillingdon">Hillingdon</option>
<option value="Hounslow I">Hounslow I</option>
<option value="slington">slington</option>
<option value="Kensington and Chelsea">Kensington and Chelsea</option>
<option value="Kingston upon Thames">Kingston upon Thames</option>
<option value="Lambeth Lewisham">Lambeth Lewisham</option>
<option value="Merton">Merton</option>
<option value="Newham">Newham</option>
<option value="Redbridge">Redbridge</option>
<option value="Richmond upon Thames">Richmond upon Thames</option>
<option value="Southwark">Southwark</option>
<option value="Sutton">Sutton</option>
<option value="Tower Hamlets">Tower Hamlets</option>
<option value="Waltham Forest">Waltham Forest</option>
<option value="Wandsworth">Wandsworth</option>
<option value="Westminster">Westminster</option>
<option value="Blank">Blank</option>
</select><br>

Language Interpreter Required:<select id="00ND0000006C0jH" name="00ND0000006C0jH" title="Language Interpreter Required"><option value="">--None--</option><option value="Yes">Yes</option>
<option value="No">No</option>
</select><br>

Date of Birth:<span class="dateInput dateOnlyInput"><input id="00ND0000006C0jM" name="00ND0000006C0jM" size="12" type="text" /></span><br>

Ethnicity:<select id="00ND0000006C0jR" name="00ND0000006C0jR" title="Ethnicity"><option value="">--None--</option><option value="Asian-Asian or Asian British">Asian-Asian or Asian British</option>
<option value="Asian-Bangladeshi">Asian-Bangladeshi</option>
<option value="Asian-Chinese">Asian-Chinese</option>
<option value="Asian-Indian">Asian-Indian</option>
<option value="Asian-Other Asian background">Asian-Other Asian background</option>
<option value="Asian-Pakistani">Asian-Pakistani</option>
<option value="Black-African">Black-African</option>
<option value="Black-Black or Black British">Black-Black or Black British</option>
<option value="Black-Caribbean">Black-Caribbean</option>
<option value="Black-Other Black background">Black-Other Black background</option>
<option value="Mixed-Other mixed background">Mixed-Other mixed background</option>
<option value="Mixed-White and Black African">Mixed-White and Black African</option>
<option value="Mixed-White and Black Caribbean">Mixed-White and Black Caribbean</option>
<option value="Other background">Other background</option>
<option value="Other-Latin American">Other-Latin American</option>
<option value="Other-Middle Eastern">Other-Middle Eastern</option>
<option value="Other-Mixed Ethnicity">Other-Mixed Ethnicity</option>
<option value="Prefer not to say">Prefer not to say</option>
<option value="Unknown">Unknown</option>
<option value="White-White British">White-White British</option>
<option value="White-White Irish">White-White Irish</option>
<option value="White-White European">White-White European</option>
<option value="White-White Other">White-White Other</option>
<option value="Gypsy - Roma">Gypsy - Roma</option>
<option value="Gypsy - Traveler">Gypsy - Traveler</option>
<option value="Gypsy - Other">Gypsy - Other</option>
</select><br>

Sexuality:<select id="00ND0000006C0jW" name="00ND0000006C0jW" title="Sexuality"><option value="">--None--</option><option value="Asexual">Asexual</option>
<option value="Bisexual">Bisexual</option>
<option value="Gay">Gay</option>
<option value="Heterosexual">Heterosexual</option>
<option value="Lesbian">Lesbian</option>
<option value="Other">Other</option>
<option value="Pan-sexual">Pan-sexual</option>
<option value="Queer">Queer</option>
<option value="Questioning">Questioning</option>
</select><br>

Religion:<select id="00ND0000006C0jb" name="00ND0000006C0jb" title="Religion"><option value="">--None--</option><option value="Jewish">Jewish</option>
<option value="Agnostic">Agnostic</option>
<option value="Atheist">Atheist</option>
<option value="Baha&#39;i">Baha&#39;i</option>
<option value="Buddhist">Buddhist</option>
<option value="Christian">Christian</option>
<option value="Hindu">Hindu</option>
<option value="Humanist">Humanist</option>
<option value="Jain">Jain</option>
<option value="Muslim">Muslim</option>
<option value="None">None</option>
<option value="Other">Other</option>
<option value="Prefer not to say">Prefer not to say</option>
<option value="Rastafarian">Rastafarian</option>
<option value="Sikh">Sikh</option>
<option value="Zoroastrian">Zoroastrian</option>
</select><br>

Relationship Status:<select id="00ND0000006C0jg" name="00ND0000006C0jg" title="Relationship Status"><option value="">--None--</option><option value="Single">Single</option>
<option value="Unknown">Unknown</option>
<option value="Blank">Blank</option>
<option value="Civil P.">Civil P.</option>
<option value="Married">Married</option>
<option value="Divorced / Dissolution">Divorced / Dissolution</option>
<option value="Prefer not to say">Prefer not to say</option>
<option value="Couple / Partnered">Couple / Partnered</option>
</select><br>

Pregnancy / Childcare:<select id="00ND0000006C0jl" name="00ND0000006C0jl" title="Pregnancy / Childcare"><option value="">--None--</option><option value="No">No</option>
<option value="Not Asked">Not Asked</option>
<option value="Yes">Yes</option>
<option value="Blank">Blank</option>
</select><br>

Gender Identity:<select id="00ND0000006C0jq" name="00ND0000006C0jq" title="Gender Identity"><option value="">--None--</option><option value="Female">Female</option>
<option value="Intersex">Intersex</option>
<option value="Male">Male</option>
<option value="non-binary">non-binary</option>
<option value="other">other</option>
<option value="Queer">Queer</option>
<option value="Trans man">Trans man</option>
<option value="Trans woman">Trans woman</option>
</select><br>

Trans or Trans History?:<select id="00ND0000006C0jv" name="00ND0000006C0jv" title="Trans or Trans History?"><option value="">--None--</option><option value="Yes">Yes</option>
<option value="No">No</option>
<option value="Unsure">Unsure</option>
<option value="Prefer not to say">Prefer not to say</option>
<option value="Blank">Blank</option>
</select><br>

Disability:<select id="00ND0000006C0k5" name="00ND0000006C0k5" title="Disability"><option value="">--None--</option><option value="Yes">Yes</option>
<option value="No">No</option>
<option value="(blank)/Unknown">(blank)/Unknown</option>
<option value="Blind or visual impairment">Blind or visual impairment</option>
<option value="Not asked">Not asked</option>
<option value="Client Unsure/Prefer not to say">Client Unsure/Prefer not to say</option>
<option value="Deaf or hearing impaired">Deaf or hearing impaired</option>
<option value="Learning difficulty">Learning difficulty</option>
<option value="Mental health">Mental health</option>
<option value="Mobility">Mobility</option>
<option value="Other disability">Other disability</option>
</select><br>

<input type="submit" name="submit">

</form>