---
title: "Contact form with states"
canonical_url: "https://www.nutrient.io/guides/workflow-automation/form-templates/marketing/contact-form-with-states/"
md_url: "https://www.nutrient.io/guides/workflow-automation/form-templates/marketing/contact-form-with-states.md"
last_updated: "2026-05-21T20:35:01.121Z"
description: "Streamline your lead collection with our customizable contact form, compatible with Workflow Automation. The JSON file includes a US state dropdown and industry options."
---

# Contact form with states

This form can be downloaded and imported into your Workflow Automation instance. The downloadable JSON file is at the bottom of this page. For information on importing forms, refer to [this guide](https://www.nutrient.io/guides/workflow-automation/admin-guide/forms/importing-and-exporting-forms.md).

This contact form can be used to collect sales leads or any other purpose of collecting contact information. The **State** dropdown includes all US states and has values assigned by region (e.g. 1 = East Coast, 2 = Midwest, 3 = West Coast). It also includes basic list of industries for the **Industry** field.

## Form![contact form](@/assets/guides/workflow-automation/files/1761/contact-form-states.700x0-is.png)

[Download the Form](https://www.nutrient.io/assets/nutrient-media/guides/workflow-automation/files/1761/contact-form-with-states.json)
---

## Related pages

- [Collateral request form](/guides/workflow-automation/form-templates/marketing/collateral-request-form.md)
- [Marketing](/guides/workflow-automation/form-templates/marketing.md)