Thank You, Oritzio!
The form code is below. I haven’t tried it with another theme.
<p><label for=”your-name”>Your Name (required)</label><br />
[text* your-name] </p>
<p><label for=”your-email”>Your Email (required)</label><br />
[email* your-email] </p>
<p><label for=”your-location”>Your Location (country and city)</label><br />
[text your-location] </p>
<p><label for=”attached-image”>Attach your photo (optional)</label><br />
[file attached-image limit:6mb filetypes:gif|png|jpg|jpeg] </p>
<p><label for=”your-video-url”>If you recorded a video testimonial, paste the youtube link here (optional)</label><br />
[text your-video-url] </p>
<p><label for=”your-testimonial”>Your Testimonial</label><br />
[textarea your-testimonial] </p>
<p>[checkbox use-everything exclusive] <label for=”use-everything”>Yes, you can use my testimonial with my name, location and picture</label></p>
<p><label for=”use-testimonial-only”>Yes, you can use my testimonial <i>without</i> my name, picture,location</label><br />
[checkbox use-testimonial-only exclusive] </p>
<p><label for=”internal-use-only”>For the RSF team only, not for public posting</label><br />
[checkbox internal-use-only exclusive] </p>
<p><label for=”contact-me”>Please contact me if you use my testimonial</label><br />
[checkbox contact-me] </p>
<p><label for=”captcha-884″>Are you human?</label><br />
[recaptcha] <br /></p>
<p>[submit class:button class:blue-button “Submit Testimonial”]</p>