{% from "./form-items/_macros.html" import button %}

<div id="form">
    <form method="post" accept-charset="UTF-8" novalidate="novalidate">
        {% include "./form-items/webform-steps.html" %}

        <div class="form-item m2d-message">
            <div class="form-item extra-spacing">
                <label> Send your message to: </label>
                <div class="form-checkboxes">
                    <div class="form-group">
                        <div class="form-item group-item">
                            <input class="form-checkbox" type="checkbox" id="id_12345" value="12345"
                                name="m2d-message.targets_selected" disabled>
                            <label class="option" for="id_12345">
                                <span>Rt Hon Mary Field MP</span>
                            </label>
                        </div>
                    </div>
                </div>
            </div>
            <div class="message-wrapper">
                <h3>Message for Rt Hon Mary Field MP</h3>
                <div>
                    <p>Dear Mrs Field,</p>
                </div>
                <div class="form-item">
                    <label for="message">Your message here</label>
                    <textarea id="message" name="m2d-message.message" rows="5"></textarea>
                </div>
                <div>
                    <p>Best regards,<br>Jane Smith</p>
                </div>
            </div>
        </div>

        {{ button("Send message", class="expanded primary button large") }}
    </form>
</div>