<div class="form-style-2"> <div class="form-style-2-heading">Provide your information</div> <form action="" method="post"> <label for="field1"><span>Name <span class="required">*</span></span><input type="text" class="input-field" name="field1" value="" /></label> <label for="field2"><span>Email <span class="required">*</span></span><input type="text" class="input-field" name="field2" value="" /></label> <label><span>Telephone</span><input type="text" class="tel-number-field" name="tel_no_1" value="" maxlength="4" />-<input type="text" class="tel-number-field" name="tel_no_2" value="" maxlength="4" />-<input type="text" class="tel-number-field" name="tel_no_3" value="" maxlength="10" /></label> <label for="field4"><span>Regarding</span><select name="field4" class="select-field"> <option value="General Question">General</option> <option value="Advertise">Advertisement</option> <option value="Partnership">Partnership</option> </select></label> <label for="field5"><span>Message <span class="required">*</span></span><textarea name="field5" class="textarea-field"></textarea></label> <label><span> </span><input type="submit" value="Submit" /></label> </form> </div>
Provide your information
