73 lines
1.7 KiB
HTML
73 lines
1.7 KiB
HTML
---
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title: Contact Me
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cardImage: venice-mailbox
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cardImageDescription:
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This mailbox was used for reporting public health offenses in Venice. It
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survived the wrath of Napoleon because it didn't look enough like a lion.
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motto: Contact Me
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description: Contact form to get ahold of me
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date: 2023-07-01
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menu:
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main:
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name: Contact
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params:
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icon: file-signature
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weight: 1
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fa-thumbnail: file-signature
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validation: true
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---
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<form action="https://usebasin.com/f/787df7bfd22e" method="post">
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<fieldset>
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<legend>Contact Me</legend>
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<input type="hidden" name="_gotcha" />
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<label for="name">Name</label>
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<input
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type="text"
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class="form-control"
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id="name"
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name="name"
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placeholder="Jay Lush"
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required
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/>
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<label for="email">Email</label>
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<input
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type="email"
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class="form-control"
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id="email"
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name="email"
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placeholder="jlush@iastate.edu"
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required
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/>
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<label for="phone">Phone number</label>
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<input
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type="tel"
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class="form-control"
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id="phone"
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name="phone"
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placeholder="(515) 294-2160"
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/>
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<label for="subject">Subject</label>
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<input
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type="text"
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class="form-control"
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id="subject"
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name="subject"
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placeholder="Beef genetics"
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required
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/>
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<label for="message">Message</label>
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<textarea
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rows="5"
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class="form-control font-sans"
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id="message"
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name="body"
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required
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style="min-height: 72pt;"
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></textarea>
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<button type="reset" class="btn btn-default">Cancel</button>
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<button type="submit" class="btn btn-primary pageclip-form__submit">
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<span>Submit</span>
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</button>
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</fieldset>
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</form>
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