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<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>Form 237B/c2 - Lemon Cheesecake Bars Request</title>
</head>
<body>
    <h1>Lemon Cheesecake Bars Request</h1>
    <form name="form237Bc2" action="/submit-request" method="POST">
        <label for="name">Full Name:</label><br>
        <input type="text" id="name" name="name" required><br><br>

        <label for="email">Email Address:</label><br>
        <input type="email" id="email" name="email" required><br><br>

        <label for="quantity">Number of Lemon Cheesecake Bars:</label><br>
        <input type="number" id="quantity" name="quantity" min="1" required><br><br>

        <label for="delivery-date">Preferred Delivery Date:</label><br>
        <input type="date" id="delivery-date" name="delivery_date" required><br><br>

        <label for="special-request">Special Requests or Dietary Restrictions:</label><br>
        <textarea id="special-request" name="special_request" rows="4" cols="50"></textarea><br><br>

        <button type="submit">Submit Request</button>
    </form>
</body>
</html>
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