<!--Mode HTML-->
<head>
<link href="https://netdna.bootstrapcdn.com/font-awesome/4.0.3/css/font-awesome.css" rel="stylesheet">
<header class="ccheader">
<h1>Form Type #03</h1>
</header>
<div class="wrapper">
<form method="post" action="url" class="ccform">
<div class="ccfield-prepend">
<span class="ccform-addon"><i class="fa fa-user fa-2x"></i></span>
<input class="ccformfield" type="text" placeholder="Full Name" required>
</div>
<div class="ccfield-prepend">
<span class="ccform-addon"><i class="fa fa-envelope fa-2x"></i></span>
<input class="ccformfield" type="text" placeholder="Email" required>
</div>
<div class="ccfield-prepend">
<span class="ccform-addon"><i class="fa fa-mobile-phone fa-2x"></i></span>
<input class="ccformfield" type="text" placeholder="Phone">
</div>
<div class="ccfield-prepend">
<span class="ccform-addon"><i class="fa fa-info fa-2x"></i></span>
<input class="ccformfield" type="text" placeholder="Subject" required>
</div>
<div class="ccfield-prepend">
<span class="ccform-addon"><i class="fa fa-comment fa-2x"></i></span>
<textarea class="ccformfield" name="comments" rows="8" placeholder="Message" required></textarea>
</div>
<div class="ccfield-prepend">
<input class="ccbtn" type="submit" value="Submit">
</div>
</form>
</div>
<style>.footer,.generic-footer{margin-bottom:98px}@media (min-width:374px){.footer,.generic-footer{margin-bottom:78px}}@media (min-width:546px){.footer,.generic-footer{margin-bottom:56px}}@media (min-width:1055px){.footer,.generic-footer{margin-bottom:0}}.disclaimer{position:fixed;z-index:9999999;bottom:0;right:0;border-top:2px solid #ff5c62;text-align:center;font-size:14px;font-weight:400;background-color:#fff;padding:5px 10px 5px 10px}.disclaimer a:hover{text-decoration:underline}@media (min-width:1052px){.disclaimer{text-align:right;border-left:2px solid red;border-top-left-radius:10px}}@media (min-width:1920px){.disclaimer{width:60%}}</style><div class="disclaimer">@Copyright <a title="https://www.javabitpro.com/" target="_blank" href="https://www.javabitpro.com/" style="color: black;"><b>www.javabitpro.com</b></a></div>
/*Mode CSS*/
//Mode JS