---
title: Contact Me
cardImage: venice-mailbox
motto: Contact Me
---

<form
  class="form-horizontal"
  action="https://usebasin.com/f/787df7bfd22e"
  method="post"
>
  <fieldset>
    <legend>Contact Me</legend>
    <input type="hidden" name="_gotcha" />
    <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>