<p style=”line-height: 40px;”><span style=”font-size: 26px; color: #64b902;”>Request a Refund</span></p>
<form action=”{{store url=”email/refund/submit”}}” method=”post” class=”refund_form”>
<div class=”tp_cstm row”>
<div class=”col”>
<label for=”product_name”>Product Name:</label>
<input type=”text” id=”product_name” name=”product_name” required>
</div>
<div class=”col”>
<label for=”order_number”>Order Number:</label>
<input type=”text” id=”order_number” name=”order_number” required>
</div>
<div class=”col”>
<label for=”date_of_purchase”>Date of Purchase:</label>
<input type=”date” id=”date_of_purchase” name=”date_of_purchase” required>
</div>
</div>
<div class=”tp_cstm row”>
<div class=”col”>
<label for=”product_name”>Product Name:</label>
<input type=”text” id=”product_name” name=”product_name” required>
</div>
<div class=”col”>
<label for=”order_number”>Order Number:</label>
<input type=”text” id=”order_number” name=”order_number” required>
</div>
<div class=”col”>
<label for=”date_of_purchase”>Date of Purchase:</label>
<input type=”date” id=”date_of_purchase” name=”date_of_purchase” required>
</div>
</div>
<div class=”btm_cstm”>
<label for=”Reason_for_requeste”>Reason for request</label>
<input type=”text” id=”Reason_for_requeste” name=”reason”><br>
<input type=”submit” value=”Submit” style=”background: #64B902;border-radius:8px;margin-top:25px;padding:15px;border:0 !important;color:white;”>
</div>
</form>
<style>
.refund_form input{background: #F2F2F2;
padding:15px;
border-radius: 8px;
}
</style>