---
title: Contact Me
cardImage: venice-mailbox
cardImageDescription:
  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.
motto: Contact Me
description: Contact form to get ahold of me
date: 2023-07-01
menu:
  main:
    name: Contact
    params:
      icon: file-signature
    weight: 1
fa-thumbnail: file-signature
validation: true
---

<form action="https://usebasin.com/f/787df7bfd22e" method="post">
  <fieldset>
    <legend>Contact Me</legend>
    <input type="hidden" name="_gotcha" />
    <label for="name">Name</label>
    <input
      type="text"
      class="form-control"
      id="name"
      name="name"
      placeholder="Jay Lush"
      required
    />
    <label for="email">Email</label>
    <input
      type="email"
      class="form-control"
      id="email"
      name="email"
      placeholder="jlush@iastate.edu"
      required
    />
    <label for="phone">Phone number</label>
    <input
      type="tel"
      class="form-control"
      id="phone"
      name="phone"
      placeholder="(515) 294-2160"
    />
    <label for="subject">Subject</label>
    <input
      type="text"
      class="form-control"
      id="subject"
      name="subject"
      placeholder="Beef genetics"
      required
    />
    <label for="message">Message</label>
    <textarea
      rows="5"
      class="form-control font-sans"
      id="message"
      name="body"
      required
      style="min-height: 72pt;"
    ></textarea>
    <button type="reset" class="btn btn-default">Cancel</button>
    <button type="submit" class="btn btn-primary pageclip-form__submit">
      <span>Submit</span>
    </button>
  </fieldset>
</form>