survey-form.tpl.html

<!-- Title -->
<p class="wfm-step-row">Please register details</p>

<!-- Two field form -->
<div class="wfm-step-row" class="form-group" ng-form name="stepForm">

  <md-input-container class="md-block" flex-gt-sm>
    <label>E.g. First Name</label>
    <!-- Customise change ng-model ctrl.model to own variable -->
    <input type="text" id="title" name="title" ng-model="ctrl.model.firstName" required>
  </md-input-container>

  <md-input-container class="md-block" flex-gt-sm>
    <label>E.g. Last Name </label>
    <input type="text" id="title" name="title" ng-model="ctrl.model.lastName" required>
  </md-input-container>
  
</div>

<md-divider></md-divider>

<!-- Back and Continue Buttons-->
<div class="workflow-actions md-padding md-whiteframe-z4">
  <md-button class="md-primary md-hue-1" ng-click="ctrl.back($event)">Back</md-button>
  <md-button class="md-primary" ng-disabled="stepForm.$invalid || stepForm.$pristine" ng-click="ctrl.done($event)">Continue</md-button>
</div>
<!-- workflow-actions-->