"Contact Us form"
Bootstrap 3.3.0 Snippet by prakash044

<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <div class="container-fluid"> <div class="row-fluid" > <div class="col-md-offset-4 col-md-4" id="box"> <h2>Contact Us!</h2> <hr> <form class="form-horizontal" action=" " method="" id="contact_form"> <fieldset> <!-- Form Name --> <!-- Text input--> <div class="form-group"> <div class="col-md-12"> <div class="input-group"> <span class="input-group-addon"><i class="glyphicon glyphicon-user"></i></span> <input name="first_name" placeholder="Name" class="form-control" type="text"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <div class="col-md-12"> <div class="input-group"> <span class="input-group-addon"><i class="glyphicon glyphicon-envelope"></i></span> <input name="email" placeholder="E-Mail Address" class="form-control" type="text"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <div class="col-md-12"> <div class="input-group"> <span class="input-group-addon"><i class="glyphicon glyphicon-earphone"></i></span> <input name="phone" placeholder="(005)501-120101" class="form-control" type="text"> </div> </div> </div> <!-- Text input--> <div class="form-group"> <div class="col-md-12 inputGroupContainer"> <div class="input-group"> <span class="input-group-addon"><i class="glyphicon glyphicon-pencil"></i></span> <textarea class="form-control" name="comment" placeholder="Message"></textarea> </div> </div> </div> <div class="form-group"> <div class="col-md-12"> <button type="submit" class="btn btn-warning pull-right">Send <span class="glyphicon glyphicon-send"></span></button> </div> </div> </fieldset> </form> </div> </div>
body{ background-image: linear-gradient(#79a06d, #79a06d); } #box{ border: 1px solid rgb(200, 200, 200); box-shadow: rgba(0, 0, 0, 0.1) 0px 5px 5px 2px; background: rgba(200, 200, 200, 0.1); border-radius: 4px; top:50px; } h2{ text-align:center; color:#fff; }

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