diff --git a/corehq/apps/analytics/static/analytix/js/cta_forms.js b/corehq/apps/analytics/static/analytix/js/cta_forms.js
index 7658f14b2c55..21bfa3bc18f2 100644
--- a/corehq/apps/analytics/static/analytix/js/cta_forms.js
+++ b/corehq/apps/analytics/static/analytix/js/cta_forms.js
@@ -5,7 +5,6 @@ hqDefine('analytix/js/cta_forms', [
     'underscore',
     'hqwebapp/js/initial_page_data',
     'hqwebapp/js/assert_properties',
-    'intl-tel-input/build/js/intlTelInput.min',
     'hqwebapp/js/bootstrap3/validators.ko',        // needed for validation of startDate and endDate
 ], function (
     $,
@@ -13,26 +12,15 @@ hqDefine('analytix/js/cta_forms', [
     _,
     initialPageData,
     assertProperties,
-    intlTelInput,
 ) {
     let hubspotCtaForm = function (config) {
         let self = {};
         assertProperties.assertRequired(config, [
             'hubspotFormId',
-            'showContactMethod',
-            'showPreferredLanguage',
-            'useWhatsApp',
-            'useGoogleHangouts',
             'nextButtonText',
-            'phoneNumberSelector',
             'submitCallbackFn',
         ]);
 
-        self.showContactMethod = ko.observable(config.showContactMethod);
-        self.showPreferredLanguage = ko.observable(config.showPreferredLanguage);
-
-        self.useWhatsApp = ko.observable(config.useWhatsApp);
-        self.useGoogleHangouts = ko.observable(config.useGoogleHangouts);
         self.nextButtonText = ko.observable(config.nextButtonText);
 
         self.firstname = ko.observable()
@@ -56,6 +44,13 @@ hqDefine('analytix/js/cta_forms', [
                     params: true,
                 },
             });
+        self.jobtitle = ko.observable()
+            .extend({
+                required: {
+                    message: gettext("Please enter your job title."),
+                    params: true,
+                },
+            });
         self.email = ko.observable()
             .extend({
                 required: {
@@ -67,55 +62,28 @@ hqDefine('analytix/js/cta_forms', [
                 emailRFC2822: true,
             });
 
-        self.preferred_method_of_contact = ko.observable();
-
-        self.phone = ko.observable();
-
-        self.skype__c = ko.observable();
-        self.preferred_whatsapp_number = ko.observable();
-
-        self.showPhoneNumber = ko.computed(function () {
-            return self.preferred_method_of_contact() === "Phone";
-        });
-        self.showSkype = ko.computed(function () {
-            return self.preferred_method_of_contact() === "Skype";
-        });
-        self.showWhatsApp = ko.computed(function () {
-            return self.preferred_method_of_contact() === "WhatsApp";
-        });
-
-        self.language__c = ko.observable();
+        self.language = ko.observable();
+        self.discoverySource = ko.observable();
+        self.otherSource = ko.observable();
 
         self.areMainFieldsValid = ko.computed(function () {
             return _.every([
                 self.firstname,
                 self.lastname,
                 self.company,
+                self.jobtitle,
                 self.email,
             ], function (prop) {
                 return prop() !== undefined && prop.isValid();
             });
         });
 
-        self.areContactFieldsValid = ko.computed(function () {
-            if (!self.showContactMethod()) {
-                return true;
-            }
-            if (!self.preferred_method_of_contact()) {
-                return false;
-            }
-            let isWhatsAppValid = self.showWhatsApp() && !!self.preferred_whatsapp_number(),
-                isPhoneValid = self.showPhoneNumber() && !!self.phone(),
-                isSkypeValid = self.showSkype() && !!self.skype__c();
-            return isWhatsAppValid || isPhoneValid || isSkypeValid;
-        });
-
         self.isLanguageFieldValid = ko.computed(function () {
-            return !self.showPreferredLanguage() || !!self.language__c();
+            return !!self.language();
         });
 
         self.isFormReadyToSubmit = ko.computed(function () {
-            return self.areContactFieldsValid() && self.areMainFieldsValid() && self.isLanguageFieldValid();
+            return self.areMainFieldsValid() && self.isLanguageFieldValid();
         });
 
         self.isSubmitDisabled = ko.computed(function () {
@@ -127,53 +95,23 @@ hqDefine('analytix/js/cta_forms', [
             return !!self.errorMessage();
         });
 
-        var phoneNumberWidget = intlTelInput(config.phoneNumberSelector.get(0), {
-            containerClass: "w-100",
-            separateDialCode: true,
-            loadUtils: () => import("intl-tel-input/utils"),
-            initialCountry: "auto",
-            geoIpLookup: function (success) {
-                $.get("https://ipinfo.io", function () {}, "jsonp").always(function (resp) {
-                    var countryCode = (resp && resp.country) ? resp.country : "";
-                    if (!countryCode) {
-                        countryCode = "us";
-                    }
-                    success(countryCode);
-                });
-            },
-        });
-
-        self.getFullPhoneNumber = function () {
-            return phoneNumberWidget.getNumber();
-        };
-
         self.submitForm = function () {
             let submitData = {
                 hubspot_form_id: config.hubspotFormId,
                 firstname: self.firstname(),
                 lastname: self.lastname(),
                 company: self.company(),
+                jobtitle: self.jobtitle(),
                 email: self.email(),
+                preferred_language: self.language(),
+                marketing_purposes___how_did_you_hear_about_us_: self.discoverySource(),
+                if_other___how_did_you_hear_about_us_: self.otherSource(),
 
                 // needed for hubspot context
                 page_url: window.location.href,
                 page_name: document.title,
             };
-            if (self.showContactMethod()) {
-                submitData.preferred_method_of_contact = self.preferred_method_of_contact();
-            }
-            if (self.showPhoneNumber()) {
-                submitData.phone = self.phone();
-            }
-            if (self.showWhatsApp()) {
-                submitData.preferred_whatsapp_number = self.preferred_whatsapp_number();
-            }
-            if (self.showSkype()) {
-                submitData.skype__c = self.skype__c();
-            }
-            if (self.showPreferredLanguage()) {
-                submitData.language__c = self.language__c();
-            }
+
             $.ajax({
                 method: 'post',
                 url: initialPageData.reverse("submit_hubspot_cta_form"),
diff --git a/corehq/apps/analytics/static/analytix/js/hubspot.js b/corehq/apps/analytics/static/analytix/js/hubspot.js
index 4a065f2cd07f..cd5339917448 100644
--- a/corehq/apps/analytics/static/analytix/js/hubspot.js
+++ b/corehq/apps/analytics/static/analytix/js/hubspot.js
@@ -44,28 +44,15 @@ hqDefine('analytix/js/hubspot', [
      * Activates the Hubspot Request Demo form
      */
     _utils.loadDemoForm = function () {
-        let isTrial = _get('isDemoTrial'),
-            isVariant = _get('demoABv2') && _get('demoABv2').version === 'variant',
-            $modal = $('#cta-form-get-demo'),
+        let $modal = $('#cta-form-get-demo'),
             $form = $('#get-demo-cta-form-content'),
             hasInteractedWithForm = false,
-            formId,
+            formId = "f6ebf161-fccf-4083-9a72-5839a0c8ac8c",
             demoForm;
 
-        if (isTrial) {
-            formId = isVariant ? "c2381f55-9bd9-4f27-8476-82900e58bfd6" : "4474515e-fea6-4154-b3cf-1fe42b1c1333";
-        } else {
-            formId = isVariant ? "f6ebf161-fccf-4083-9a72-5839a0c8ac8c" : "d1897875-a5bb-4b63-9b9c-3d8fdbbe8274";
-        }
-
         demoForm = ctaForms.hubspotCtaForm({
             hubspotFormId: formId,
-            showContactMethod: isVariant,
-            showPreferredLanguage: false,
-            useWhatsApp: false,
-            useGoogleHangouts: true,
             nextButtonText: gettext("Submit Request"),
-            phoneNumberSelector: $form.find('input[name="phone"]'),
             submitCallbackFn: function () {
                 $('#get-demo-cta-success').fadeIn();
                 $('#get-demo-cta-form-content').addClass('hidden').addClass('d-none'); // todo after bootstrap 5 migration
diff --git a/corehq/apps/analytics/templates/analytics/forms/bootstrap3/hubspot_cta_form.html b/corehq/apps/analytics/templates/analytics/forms/bootstrap3/hubspot_cta_form.html
index d26151000c46..2c5d0e9bbbb2 100644
--- a/corehq/apps/analytics/templates/analytics/forms/bootstrap3/hubspot_cta_form.html
+++ b/corehq/apps/analytics/templates/analytics/forms/bootstrap3/hubspot_cta_form.html
@@ -15,10 +15,12 @@
             {% trans "First name" %}<span class="asteriskField">*</span>
           </label>
           <div class="controls">
-            <input type="text"
-                   name="firstname"
-                   data-bind="textInput: firstname"
-                   class="form-control">
+            <input
+              class="form-control"
+              type="text"
+              name="firstname"
+              data-bind="textInput: firstname"
+            />
           </div>
         </div>
       </div>
@@ -28,107 +30,108 @@
             {% trans "Last name" %}<span class="asteriskField">*</span>
           </label>
           <div class="controls">
-            <input type="text"
-                   name="lastname"
-                   data-bind="textInput: lastname"
-                   class="form-control">
+            <input
+              class="form-control"
+              type="text"
+              name="lastname"
+              data-bind="textInput: lastname"
+            />
           </div>
         </div>
       </div>
     </div>
     <div class="form-group">
       <label class="control-label">
-        {% trans "Organization" %}<span class="asteriskField">*</span>
+        {% trans "Professional email" %}<span class="asteriskField">*</span>
       </label>
       <div class="controls">
-        <input type="text"
-               name="company"
-               data-bind="textInput: company"
-               class="form-control">
+        <input
+          type="email"
+          name="email"
+          data-bind="textInput: email"
+          class="form-control"
+        />
       </div>
     </div>
-    <div class="form-group">
-      <label class="control-label">
-        {% trans "Professional email address" %}<span class="asteriskField">*</span>
-      </label>
-      <div class="controls">
-        <input type="email"
-               name="email"
-               data-bind="textInput: email"
-               class="form-control">
+    <div class="row">
+      <div class="col-sm-6">
+        <div class="form-group">
+          <label class="control-label">
+            {% trans "Organization" %}<span class="asteriskField">*</span>
+          </label>
+          <div class="controls">
+            <input
+              class="form-control"
+              type="text"
+              name="company"
+              data-bind="textInput: company"
+            />
+          </div>
+        </div>
+      </div>
+      <div class="col-sm-6">
+        <div class="form-group">
+          <label class="control-label">
+            {% trans "Job title" %}<span class="asteriskField">*</span>
+          </label>
+          <div class="controls">
+            <input
+              class="form-control"
+              type="text"
+              name="jobtitle"
+              data-bind="textInput: jobtitle"
+            />
+          </div>
+        </div>
       </div>
     </div>
-    <div class="form-group"
-         data-bind="visible: showContactMethod">
+    <div class="form-group">
       <label class="control-label">
-          {% trans "How should we contact you?" %}<span class="asteriskField">*</span>
+        {% trans "Preferred language" %}<span class="asteriskField">*</span>
       </label>
       <div class="controls">
-        <select name="preferred_method_of_contact"
-                data-bind="value: preferred_method_of_contact"
-                class="select form-control">
+        <select
+          class="form-control"
+          name="language"
+          data-bind="value: language"
+        >
           <option value="">{% trans "Please Select" %}</option>
-          <option value="Phone">{% trans "Phone" %}</option>
-          <option value="Skype">{% trans "Skype" %}</option>
-          <!-- ko if: useWhatsApp -->
-            <option value="WhatsApp">{% trans "WhatsApp" %}</option>
-          <!-- /ko -->
-          <!-- ko if: useGoogleHangouts -->
-            <option value="Google hangouts">{% trans "Google hangouts" %}</option>
-          <!-- /ko -->
+          <option value="English">{% trans "English" %}</option>
+          <option value="French">{% trans "French" %}</option>
+          <option value="Spanish">{% trans "Spanish" %}</option>
         </select>
       </div>
     </div>
-    <div class="form-group"
-         data-bind="visible: showPhoneNumber">
-      <label class="control-label">
-          {% trans "Preferred phone number" %}<span class="asteriskField">*</span>
-      </label>
-      <div class="controls">
-        <input type="text"
-               name="phone"
-               data-bind="textInput: phone"
-               class="form-control">
-      </div>
-    </div>
-    <div class="form-group"
-         data-bind="visible: showSkype">
-      <label class="control-label">
-          {% trans "Skype username" %}<span class="asteriskField">*</span>
-      </label>
-      <div class="controls">
-        <input type="text"
-               name="skype__c"
-               data-bind="textInput: skype__c"
-               class="form-control">
-      </div>
-    </div>
-    <div class="form-group"
-         data-bind="visible: showWhatsApp">
+    <div class="form-group">
       <label class="control-label">
-          {% trans "Preferred WhatsApp number" %}<span class="asteriskField">*</span>
+        {% trans "How did you hear about us?" %}
       </label>
-      <div class="controls">
-        <input type="text"
-               name="preferred_whatsapp_number"
-               data-bind="textInput: preferred_whatsapp_number"
-               class="form-control">
-      </div>
+      <select
+        class="form-control"
+        name="discoverySource"
+        data-bind="value: discoverySource"
+      >
+        <option value="">{% trans "Please Select" %}</option>
+        <option value="Newsletter">{% trans "Newsletter" %}</option>
+        <option value="Podcast">{% trans "Podcast" %}</option>
+        <option value="Social Media">{% trans "Social Media" %}</option>
+        <option value="Web Search">{% trans "Web Search (e.g. Google)" %}</option>
+        <option value="Referral">{% trans "Word of Mouth / Referral" %}</option>
+        <option value="Event / Conference">{% trans "Event / Conference" %}</option>
+        <option value="Other">{% trans "Other" %}</option>
+      </select>
     </div>
-    <div class="form-group"
-         data-bind="visible: showPreferredLanguage">
+    <div class="form-group" data-bind="visible: discoverySource() === 'Other'">
       <label class="control-label">
-        {% trans "Preferred Language" %}<span class="asteriskField">*</span>
+        {% trans "We'd love to hear more! Please specify -" %}
       </label>
       <div class="controls">
-        <select name="language__c"
-                data-bind="value: language__c"
-                class="form-control">
-          <option value="">{% trans "Please Select" %}</option>
-          <option value="English">{% trans "English" %}</option>
-          <option value="French">{% trans "French" %}</option>
-          <option value="Spanish">{% trans "Spanish" %}</option>
-        </select>
+        <input
+          class="form-control"
+          type="text"
+          name="otherSource"
+          data-bind="textInput: otherSource"
+        />
       </div>
     </div>
     {% blocktrans %}
@@ -138,9 +141,11 @@
     {% endblocktrans %}
   </div>
   <div class="modal-footer">
-    <button class="btn btn btn-primary"
-            data-bind="click: submitForm, disable: isSubmitDisabled"
-            type="button">
+    <button
+      class="btn btn btn-primary"
+      type="button"
+      data-bind="click: submitForm, disable: isSubmitDisabled"
+    >
       <!-- ko text: nextButtonText --><!-- /ko -->
     </button>
   </div>
diff --git a/corehq/apps/analytics/templates/analytics/forms/bootstrap5/hubspot_cta_form.html b/corehq/apps/analytics/templates/analytics/forms/bootstrap5/hubspot_cta_form.html
index 9636389c9fb8..51eae72a7a13 100644
--- a/corehq/apps/analytics/templates/analytics/forms/bootstrap5/hubspot_cta_form.html
+++ b/corehq/apps/analytics/templates/analytics/forms/bootstrap5/hubspot_cta_form.html
@@ -1,6 +1,6 @@
 {% load i18n %}
 
-<form class="form-ko-validation" method="post">
+<form class="form form-ko-validation" method="post">
   {% csrf_token %}
   <div class="modal-body">
     <!-- ko if: showErrorMessage -->
@@ -8,106 +8,131 @@
         <p data-bind="text: errorMessage"></p>
       </div>
     <!-- /ko -->
-    <div class="row mb-3">
-      <div class="col-sm-6">
-        <label class="form-label">
-          {% trans "First name" %}<span class="asteriskField">*</span>
-        </label>
-        <input type="text"
-               name="firstname"
-               data-bind="textInput: firstname"
-               class="form-control">
+    <div class="row">
+      <div class="col-md-6">
+        <div class="form-group">  {# todo B5: css-form-group #}
+          <label class="form-label">
+            {% trans "First name" %}<span class="asteriskField">*</span>
+          </label>
+          <div class="controls">
+            <input
+              class="form-control"
+              type="text"
+              name="firstname"
+              data-bind="textInput: firstname"
+            />
+          </div>
+        </div>
       </div>
-      <div class="col-sm-6">
-        <label class="form-label">
-          {% trans "Last name" %}<span class="asteriskField">*</span>
-        </label>
-        <input type="text"
-               name="lastname"
-               data-bind="textInput: lastname"
-               class="form-control">
+      <div class="col-md-6">
+        <div class="form-group">  {# todo B5: css-form-group #}
+          <label class="form-label">
+            {% trans "Last name" %}<span class="asteriskField">*</span>
+          </label>
+          <div class="controls">
+            <input
+              class="form-control"
+              type="text"
+              name="lastname"
+              data-bind="textInput: lastname"
+            />
+          </div>
+        </div>
       </div>
     </div>
-    <div class="mb-3">
+    <div class="form-group">  {# todo B5: css-form-group #}
       <label class="form-label">
-        {% trans "Organization" %}<span class="asteriskField">*</span>
+        {% trans "Professional email" %}<span class="asteriskField">*</span>
       </label>
-      <input type="text"
-             name="company"
-             data-bind="textInput: company"
-             class="form-control">
+      <div class="controls">
+        <input
+          type="email"
+          name="email"
+          data-bind="textInput: email"
+          class="form-control"
+        />
+      </div>
     </div>
-    <div class="mb-3">
+    <div class="row">
+      <div class="col-md-6">
+        <div class="form-group">  {# todo B5: css-form-group #}
+          <label class="form-label">
+            {% trans "Organization" %}<span class="asteriskField">*</span>
+          </label>
+          <div class="controls">
+            <input
+              class="form-control"
+              type="text"
+              name="company"
+              data-bind="textInput: company"
+            />
+          </div>
+        </div>
+      </div>
+      <div class="col-md-6">
+        <div class="form-group">  {# todo B5: css-form-group #}
+          <label class="form-label">
+            {% trans "Job title" %}<span class="asteriskField">*</span>
+          </label>
+          <div class="controls">
+            <input
+              class="form-control"
+              type="text"
+              name="jobtitle"
+              data-bind="textInput: jobtitle"
+            />
+          </div>
+        </div>
+      </div>
+    </div>
+    <div class="form-group">  {# todo B5: css-form-group #}
       <label class="form-label">
-        {% trans "Professional email address" %}<span class="asteriskField">*</span>
+        {% trans "Preferred language" %}<span class="asteriskField">*</span>
       </label>
-      <input type="email"
-             name="email"
-             data-bind="textInput: email"
-             class="form-control">
+      <div class="controls">
+        <select  {# todo B5: css-select-form-control #}
+          class="form-control"
+          name="language"
+          data-bind="value: language"
+        >
+          <option value="">{% trans "Please Select" %}</option>
+          <option value="English">{% trans "English" %}</option>
+          <option value="French">{% trans "French" %}</option>
+          <option value="Spanish">{% trans "Spanish" %}</option>
+        </select>
+      </div>
     </div>
-    <div class="mb-3"
-         data-bind="visible: showContactMethod">
+    <div class="form-group">  {# todo B5: css-form-group #}
       <label class="form-label">
-          {% trans "How should we contact you?" %}<span class="asteriskField">*</span>
+        {% trans "How did you hear about us?" %}
       </label>
-      <select name="preferred_method_of_contact"
-              data-bind="value: preferred_method_of_contact"
-              class="form-select">
+      <select  {# todo B5: css-select-form-control #}
+        class="form-control"
+        name="discoverySource"
+        data-bind="value: discoverySource"
+      >
         <option value="">{% trans "Please Select" %}</option>
-        <option value="Phone">{% trans "Phone" %}</option>
-        <option value="Skype">{% trans "Skype" %}</option>
-        <!-- ko if: useWhatsApp -->
-          <option value="WhatsApp">{% trans "WhatsApp" %}</option>
-        <!-- /ko -->
-        <!-- ko if: useGoogleHangouts -->
-          <option value="Google hangouts">{% trans "Google hangouts" %}</option>
-        <!-- /ko -->
+        <option value="Newsletter">{% trans "Newsletter" %}</option>
+        <option value="Podcast">{% trans "Podcast" %}</option>
+        <option value="Social Media">{% trans "Social Media" %}</option>
+        <option value="Web Search">{% trans "Web Search (e.g. Google)" %}</option>
+        <option value="Referral">{% trans "Word of Mouth / Referral" %}</option>
+        <option value="Event / Conference">{% trans "Event / Conference" %}</option>
+        <option value="Other">{% trans "Other" %}</option>
       </select>
     </div>
-    <div class="mb-3"
-         data-bind="visible: showPhoneNumber">
+    <div class="form-group" data-bind="visible: discoverySource() === 'Other'">  {# todo B5: css-form-group #}
       <label class="form-label">
-          {% trans "Preferred phone number" %}<span class="asteriskField">*</span>
+        {% trans "We'd love to hear more! Please specify -" %}
       </label>
-      <input type="text"
-             name="phone"
-             data-bind="textInput: phone"
-             class="form-control">
-    </div>
-    <div class="mb-3"
-         data-bind="visible: showSkype">
-      <label class="form-label">
-          {% trans "Skype username" %}<span class="asteriskField">*</span>
-      </label>
-      <input type="text"
-             name="skype__c"
-             data-bind="textInput: skype__c"
-             class="form-control">
-    </div>
-    <div class="mb-3"
-         data-bind="visible: showWhatsApp">
-      <label class="form-label">
-          {% trans "Preferred WhatsApp number" %}<span class="asteriskField">*</span>
-      </label>
-      <input type="text"
-             name="preferred_whatsapp_number"
-             data-bind="textInput: preferred_whatsapp_number"
-             class="form-control">
-    </div>
-    <div class="mb-3"
-         data-bind="visible: showPreferredLanguage">
-      <label class="form-label">
-        {% trans "Preferred Language" %}<span class="asteriskField">*</span>
-      </label>
-      <select name="language__c"
-              data-bind="value: language__c"
-              class="form-select">
-        <option value="">{% trans "Please Select" %}</option>
-        <option value="English">{% trans "English" %}</option>
-        <option value="French">{% trans "French" %}</option>
-        <option value="Spanish">{% trans "Spanish" %}</option>
-      </select>
+      <div class="controls">
+        <input
+          class="form-control"
+          type="text"
+          name="otherSource"
+          data-bind="textInput: otherSource"
+        />
+      </div>
     </div>
     {% blocktrans %}
       By clicking this button, you agree to Dimagi's
@@ -116,9 +141,11 @@
     {% endblocktrans %}
   </div>
   <div class="modal-footer">
-    <button class="btn btn btn-primary"
-            data-bind="click: submitForm, disable: isSubmitDisabled"
-            type="button">
+    <button
+      class="btn btn btn-primary"
+      type="button"
+      data-bind="click: submitForm, disable: isSubmitDisabled"
+    >
       <!-- ko text: nextButtonText --><!-- /ko -->
     </button>
   </div>
diff --git a/corehq/apps/hqwebapp/tests/data/bootstrap5_diffs/analytics/forms/hubspot_cta_form.html.diff.txt b/corehq/apps/hqwebapp/tests/data/bootstrap5_diffs/analytics/forms/hubspot_cta_form.html.diff.txt
index 568b5ada7627..d1c51e0b769e 100644
--- a/corehq/apps/hqwebapp/tests/data/bootstrap5_diffs/analytics/forms/hubspot_cta_form.html.diff.txt
+++ b/corehq/apps/hqwebapp/tests/data/bootstrap5_diffs/analytics/forms/hubspot_cta_form.html.diff.txt
@@ -1,210 +1,107 @@
 --- 
 +++ 
-@@ -1,6 +1,6 @@
- {% load i18n %}
- 
--<form class="form form-ko-validation" method="post">
-+<form class="form-ko-validation" method="post">
-   {% csrf_token %}
-   <div class="modal-body">
-     <!-- ko if: showErrorMessage -->
-@@ -8,128 +8,106 @@
-         <p data-bind="text: errorMessage"></p>
+@@ -9,9 +9,9 @@
        </div>
      <!-- /ko -->
--    <div class="row">
-+    <div class="row mb-3">
-       <div class="col-sm-6">
+     <div class="row">
+-      <div class="col-sm-6">
 -        <div class="form-group">
 -          <label class="control-label">
--            {% trans "First name" %}<span class="asteriskField">*</span>
--          </label>
--          <div class="controls">
--            <input type="text"
--                   name="firstname"
--                   data-bind="textInput: firstname"
--                   class="form-control">
--          </div>
--        </div>
-+        <label class="form-label">
-+          {% trans "First name" %}<span class="asteriskField">*</span>
-+        </label>
-+        <input type="text"
-+               name="firstname"
-+               data-bind="textInput: firstname"
-+               class="form-control">
++      <div class="col-md-6">
++        <div class="form-group">  {# todo B5: css-form-group #}
++          <label class="form-label">
+             {% trans "First name" %}<span class="asteriskField">*</span>
+           </label>
+           <div class="controls">
+@@ -24,9 +24,9 @@
+           </div>
+         </div>
        </div>
-       <div class="col-sm-6">
+-      <div class="col-sm-6">
 -        <div class="form-group">
 -          <label class="control-label">
--            {% trans "Last name" %}<span class="asteriskField">*</span>
--          </label>
--          <div class="controls">
--            <input type="text"
--                   name="lastname"
--                   data-bind="textInput: lastname"
--                   class="form-control">
--          </div>
--        </div>
--      </div>
--    </div>
--    <div class="form-group">
--      <label class="control-label">
--        {% trans "Organization" %}<span class="asteriskField">*</span>
--      </label>
--      <div class="controls">
-+        <label class="form-label">
-+          {% trans "Last name" %}<span class="asteriskField">*</span>
-+        </label>
-         <input type="text"
--               name="company"
--               data-bind="textInput: company"
-+               name="lastname"
-+               data-bind="textInput: lastname"
-                class="form-control">
++      <div class="col-md-6">
++        <div class="form-group">  {# todo B5: css-form-group #}
++          <label class="form-label">
+             {% trans "Last name" %}<span class="asteriskField">*</span>
+           </label>
+           <div class="controls">
+@@ -40,8 +40,8 @@
+         </div>
        </div>
      </div>
 -    <div class="form-group">
 -      <label class="control-label">
-+    <div class="mb-3">
-+      <label class="form-label">
-+        {% trans "Organization" %}<span class="asteriskField">*</span>
-+      </label>
-+      <input type="text"
-+             name="company"
-+             data-bind="textInput: company"
-+             class="form-control">
-+    </div>
-+    <div class="mb-3">
++    <div class="form-group">  {# todo B5: css-form-group #}
 +      <label class="form-label">
-         {% trans "Professional email address" %}<span class="asteriskField">*</span>
+         {% trans "Professional email" %}<span class="asteriskField">*</span>
        </label>
--      <div class="controls">
--        <input type="email"
--               name="email"
--               data-bind="textInput: email"
--               class="form-control">
--      </div>
-+      <input type="email"
-+             name="email"
-+             data-bind="textInput: email"
-+             class="form-control">
-     </div>
--    <div class="form-group"
-+    <div class="mb-3"
-          data-bind="visible: showContactMethod">
--      <label class="control-label">
-+      <label class="form-label">
-           {% trans "How should we contact you?" %}<span class="asteriskField">*</span>
-       </label>
--      <div class="controls">
--        <select name="preferred_method_of_contact"
--                data-bind="value: preferred_method_of_contact"
--                class="select form-control">
--          <option value="">{% trans "Please Select" %}</option>
--          <option value="Phone">{% trans "Phone" %}</option>
--          <option value="Skype">{% trans "Skype" %}</option>
--          <!-- ko if: useWhatsApp -->
--            <option value="WhatsApp">{% trans "WhatsApp" %}</option>
--          <!-- /ko -->
--          <!-- ko if: useGoogleHangouts -->
--            <option value="Google hangouts">{% trans "Google hangouts" %}</option>
--          <!-- /ko -->
--        </select>
--      </div>
-+      <select name="preferred_method_of_contact"
-+              data-bind="value: preferred_method_of_contact"
-+              class="form-select">
-+        <option value="">{% trans "Please Select" %}</option>
-+        <option value="Phone">{% trans "Phone" %}</option>
-+        <option value="Skype">{% trans "Skype" %}</option>
-+        <!-- ko if: useWhatsApp -->
-+          <option value="WhatsApp">{% trans "WhatsApp" %}</option>
-+        <!-- /ko -->
-+        <!-- ko if: useGoogleHangouts -->
-+          <option value="Google hangouts">{% trans "Google hangouts" %}</option>
-+        <!-- /ko -->
-+      </select>
+       <div class="controls">
+@@ -54,9 +54,9 @@
+       </div>
      </div>
--    <div class="form-group"
-+    <div class="mb-3"
-          data-bind="visible: showPhoneNumber">
--      <label class="control-label">
-+      <label class="form-label">
-           {% trans "Preferred phone number" %}<span class="asteriskField">*</span>
-       </label>
--      <div class="controls">
--        <input type="text"
--               name="phone"
--               data-bind="textInput: phone"
--               class="form-control">
--      </div>
-+      <input type="text"
-+             name="phone"
-+             data-bind="textInput: phone"
-+             class="form-control">
+     <div class="row">
+-      <div class="col-sm-6">
+-        <div class="form-group">
+-          <label class="control-label">
++      <div class="col-md-6">
++        <div class="form-group">  {# todo B5: css-form-group #}
++          <label class="form-label">
+             {% trans "Organization" %}<span class="asteriskField">*</span>
+           </label>
+           <div class="controls">
+@@ -69,9 +69,9 @@
+           </div>
+         </div>
+       </div>
+-      <div class="col-sm-6">
+-        <div class="form-group">
+-          <label class="control-label">
++      <div class="col-md-6">
++        <div class="form-group">  {# todo B5: css-form-group #}
++          <label class="form-label">
+             {% trans "Job title" %}<span class="asteriskField">*</span>
+           </label>
+           <div class="controls">
+@@ -85,12 +85,12 @@
+         </div>
+       </div>
      </div>
--    <div class="form-group"
-+    <div class="mb-3"
-          data-bind="visible: showSkype">
+-    <div class="form-group">
 -      <label class="control-label">
++    <div class="form-group">  {# todo B5: css-form-group #}
 +      <label class="form-label">
-           {% trans "Skype username" %}<span class="asteriskField">*</span>
+         {% trans "Preferred language" %}<span class="asteriskField">*</span>
        </label>
--      <div class="controls">
--        <input type="text"
--               name="skype__c"
--               data-bind="textInput: skype__c"
--               class="form-control">
--      </div>
-+      <input type="text"
-+             name="skype__c"
-+             data-bind="textInput: skype__c"
-+             class="form-control">
+       <div class="controls">
+-        <select
++        <select  {# todo B5: css-select-form-control #}
+           class="form-control"
+           name="language"
+           data-bind="value: language"
+@@ -102,11 +102,11 @@
+         </select>
+       </div>
      </div>
--    <div class="form-group"
-+    <div class="mb-3"
-          data-bind="visible: showWhatsApp">
+-    <div class="form-group">
 -      <label class="control-label">
++    <div class="form-group">  {# todo B5: css-form-group #}
 +      <label class="form-label">
-           {% trans "Preferred WhatsApp number" %}<span class="asteriskField">*</span>
+         {% trans "How did you hear about us?" %}
        </label>
--      <div class="controls">
--        <input type="text"
--               name="preferred_whatsapp_number"
--               data-bind="textInput: preferred_whatsapp_number"
--               class="form-control">
--      </div>
-+      <input type="text"
-+             name="preferred_whatsapp_number"
-+             data-bind="textInput: preferred_whatsapp_number"
-+             class="form-control">
+-      <select
++      <select  {# todo B5: css-select-form-control #}
+         class="form-control"
+         name="discoverySource"
+         data-bind="value: discoverySource"
+@@ -121,8 +121,8 @@
+         <option value="Other">{% trans "Other" %}</option>
+       </select>
      </div>
--    <div class="form-group"
-+    <div class="mb-3"
-          data-bind="visible: showPreferredLanguage">
+-    <div class="form-group" data-bind="visible: discoverySource() === 'Other'">
 -      <label class="control-label">
++    <div class="form-group" data-bind="visible: discoverySource() === 'Other'">  {# todo B5: css-form-group #}
 +      <label class="form-label">
-         {% trans "Preferred Language" %}<span class="asteriskField">*</span>
+         {% trans "We'd love to hear more! Please specify -" %}
        </label>
--      <div class="controls">
--        <select name="language__c"
--                data-bind="value: language__c"
--                class="form-control">
--          <option value="">{% trans "Please Select" %}</option>
--          <option value="English">{% trans "English" %}</option>
--          <option value="French">{% trans "French" %}</option>
--          <option value="Spanish">{% trans "Spanish" %}</option>
--        </select>
--      </div>
-+      <select name="language__c"
-+              data-bind="value: language__c"
-+              class="form-select">
-+        <option value="">{% trans "Please Select" %}</option>
-+        <option value="English">{% trans "English" %}</option>
-+        <option value="French">{% trans "French" %}</option>
-+        <option value="Spanish">{% trans "Spanish" %}</option>
-+      </select>
-     </div>
-     {% blocktrans %}
-       By clicking this button, you agree to Dimagi's
+       <div class="controls">