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---
title: Contact Me
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description: Contact form to get ahold of me.
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imageUrl: /img/venice-mailbox.jpg
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imageTitle: Snitch box in Venice
imageDescription: This mailbox was used for reporting public health offenses in Venice. It survived the wrath of Napoleon because it didn't look enough like a lion.
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blurImageUrl: /img/venice-mailbox_blur.jpg
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motto: Contact Me
---
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< form class = "form-horizontal pageclip-form"
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action="https://usebasin.com/f/787df7bfd22e"
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method="post">
< fieldset >
< legend > Contact Me< / legend >
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< input type = "hidden" name = "_gotcha" >
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< div class = "form-group" >
< label for = "name" class = "col-lg-2 control-label" > Name< / label >
< div class = "col-lg-10" >
< input type = "text" class = "form-control" id = "name" name = "name" placeholder = "Jay Lush" required >
< / div >
< / div >
< div class = "form-group" >
< label for = "email" class = "col-lg-2 control-label" > Email< / label >
< div class = "col-lg-10" >
< input type = "email" class = "form-control" id = "email" name = "email" placeholder = "jlush@iastate.edu" required >
< / div >
< / div >
< div class = "form-group" >
< label for = "phone" class = "col-lg-2 control-label" > Phone number< / label >
< div class = "col-lg-10" >
< input type = "tel" class = "form-control" id = "phone" name = "phone" placeholder = "(515) 294-2160" >
< / div >
< / div >
< div class = "form-group" >
< label for = "subject" class = "col-lg-2 control-label" > Subject< / label >
< div class = "col-lg-10" >
< input type = "text" class = "form-control" id = "subject" name = "subject" placeholder = "Beef genetics" required >
< / div >
< / div >
< div class = "form-group" >
< label for = "message" class = "col-lg-2 control-label" > Message< / label >
< div class = "col-lg-10" >
< textarea rows = "5" class = "form-control font-sans" id = "message" name = "body" required style = "min-height: 72pt;" > < / textarea >
< / div >
< / div >
< div class = "form-group" >
< div class = "col-lg-10 col-lg-offset-2" >
< button type = "reset" class = "btn btn-default" > Cancel< / button >
< button type = "submit" class = "btn btn-primary pageclip-form__submit" > < span > Submit< / span > < / button >
< / div >
< / div >
< / fieldset >
< / form >