JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
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I checked your form and I'm assuming that you have a problem with receiving information from this form. That's because you didn't create Notifier for your form, but only Autoresponder. You can follow this guide on how to create Notifiers.
If you have any further questions or had something else in mind please let us know.