---
title: Contact Me
description: Contact form to get ahold of me.
imageUrl: /img/venice-mailbox.jpg
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.
blurImageUrl: /img/venice-mailbox_blur.jpg
motto: Contact Me
---

<form class="form-horizontal pageclip-form"
    action="https://send.pageclip.co/xn1OfLsjWvXGIiKwsZinza5uZpXX7g9z/millironx-contact-form"
    method="post">
    <fieldset>
        <legend>Contact Me</legend>
        <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>