Gift Universe Widget

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I need help with

<div class="control-group ticket_section">
                 <label class=" required control-label cf_issue_730923-label " for="helpdesk_ticket_cf_issue_730923">Issue</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_issue_730923]" id="helpdesk_ticket_custom_field_cf_issue_730923"><option value="">...</option>
<option data-id="7000130795" value="My order hasn't yet arrived">My order hasn't yet arrived</option>
<option data-id="7000130796" value="My order arrived late">My order arrived late</option>
<option data-id="7000130797" value="My order arrived damaged">My order arrived damaged</option>
<option data-id="7000130798" value="Only part of my order arrived">Only part of my order arrived</option>
<option data-id="7000140961" value="I haven't received my tracking number">I haven't received my tracking number</option>
<option data-id="7000130799" value="Other delivery questions">Other delivery questions</option></select>
            </div> 
                </div>
      <div class="control-group ticket_section">
                 <label class=" required control-label cf_delivery_order_number_730923-label " for="helpdesk_ticket_cf_delivery_order_number_730923">Order or receipt number (or 'UNKNOWN')</label>
            <div class="controls   ">
              <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_delivery_order_number_730923]" id="helpdesk_ticket_custom_field_cf_delivery_order_number_730923" />
            </div> 
                </div>

<div class="control-group ticket_section">
                 <label class="  control-label cf_i_made_the_purchase_730923-label " for="helpdesk_ticket_cf_i_made_the_purchase_730923">I made the purchase</label>
            <div class="controls   ">
              <select class="  dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_i_made_the_purchase_730923]" id="helpdesk_ticket_custom_field_cf_i_made_the_purchase_730923"><option value="">...</option>
<option data-id="7000130793" value="Online">Online</option>
<option data-id="7000130792" value="In a store">In a store</option></select>
            </div> 
                </div>
      <div class="control-group ticket_section">
                 <label class=" required control-label cf_order_number_730923-label " for="helpdesk_ticket_cf_order_number_730923">Order Number</label>
            <div class="controls   ">
              <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_order_number_730923]" id="helpdesk_ticket_custom_field_cf_order_number_730923" />
            </div> 
                </div>
      <div class="control-group ticket_section">
                 <label class=" required control-label cf_desired_action_730923-label " for="helpdesk_ticket_cf_desired_action_730923">Desired action</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_desired_action_730923]" id="helpdesk_ticket_custom_field_cf_desired_action_730923"><option value="">...</option>
<option data-id="7000130782" value="Refund">Refund</option>
<option data-id="7000130783" value="Exchange">Exchange</option></select>
            </div> 
                </div>
      <div class="control-group ticket_section">
                 <label class=" required control-label cf_reason_for_return_730923-label " for="helpdesk_ticket_cf_reason_for_return_730923">Reason for return</label>
            <div class="controls   ">
              <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_reason_for_return_730923]" id="helpdesk_ticket_custom_field_cf_reason_for_return_730923"><option value="">...</option>
<option data-id="7000130784" value="Unwanted">Unwanted</option>
<option data-id="7000130787" value="Faulty">Faulty</option>
<option data-id="7000130786" value="Damaged">Damaged</option>
<option data-id="7000130785" value="Arrived too late">Arrived too late</option>
<option data-id="7000130789" value="Quality issue">Quality issue</option>
<option data-id="7000130790" value="Wrong item ordered">Wrong item ordered</option>
<option data-id="7000130791" value="Wrong item received">Wrong item received</option>
<option data-id="7000130788" value="Other">Other</option></select>
            </div> 
                </div>
      <div class="control-group ticket_section">
                 <label class=" required control-label cf_items_to_be_returned_one_per_line_730923-label " for="helpdesk_ticket_cf_items_to_be_returned_one_per_line_730923">Item(s) to be returned, one per line</label>
            <div class="controls   ">
              <textarea class=" required paragraph section_field span12" rows="6" placeholder="" name="helpdesk_ticket[custom_field][cf_items_to_be_returned_one_per_line_730923]" id="helpdesk_ticket_custom_field_cf_items_to_be_returned_one_per_line_730923">
</textarea>
            </div> 
                </div>

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