88 lines
2.2 KiB
HTML
88 lines
2.2 KiB
HTML
---
|
|
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>
|