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HTML

              
                <form id="js-share-form">
	<input id="js-share-input" type="text" placeholder="ENTER PHONE">
	<input type="submit" value="Submit">
</form>
              
            
!

CSS

              
                
              
            
!

JS

              
                $( '#js-share-form' ).on( 'submit', function( event ) {
	event.preventDefault();
	
	// Santize phone input
	var phoneNumber = $( '#js-share-input' ).val().replace(/\D/g, '').trim();
	if ( phoneNumber.length === 10 ) {
		$.post( 'http://<YOUR HEROKU APP IP ADDRESS HERE>/sms', {
			phone: phoneNumber,
			message: 'Thank you for signing up. Use coupon code VOLTAGE for ..% off your order.'
		}, function( response ) {
			// Add your code to show a confirmation message after form is submitted to node app
		} );
	}
	
	return false;
} );
              
            
!
999px

Console