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HTML

            
              <body>
  <!--Begin Form-->
<header class="header">
  <h2>Roget Freelancing</h2>
  <h3>Responsive Design Contact Form</h3>
</header>
<div class="container">
      <form class="contact" action="/action_page.php" method="post">
        <h4>Contact Form</h4>
        <h5>Interested? Contact Roget Freelancing today! </h5>
        
        <fieldset> <!--Begin First Name-->
           <input placeholder="First Name" type="text" tabindex="1" required autofocus>
        </fieldset><!-- End First Name-->
         
       <fieldset><!--Begin Last Name-->
           <input placeholder="Last Name" type="text" tabindex="2" required autofocus>
       </fieldset>
        <!-- End Last Name-->
      <!--Begin Email-->
       <fieldset>
         <input placeholder="Your Email Address" type="email" tabindex="3" required>
       </fieldset>
        <!-- End Email-->
    <!--Begin Country-->
       <fieldset>
        <select id="country" name="country" tabindex="4">
          <option selected>Select Country:</option>
          <option value="1">Australia</option>
          <option value="2">United Kingdom</option>
          <option value="3">United States of America</option>
        </select>
       </fieldset>
      <!--End Country-->
      <!--Begin State-->  
      <fieldset>
          <select id="state" name="state" class="state" tabindex="5">
          <option selected>Select State or Territory:</option>
          <option value="1">Alabama</option>
          <option value="2">Alaska</option> 
          <option value="3">Arizona</option>
          <option value="4">Arkansas</option>
          <option value="5">California</option>  
          <option value="6">Colorado</option>
          <option value="7">Connecticut</option>
          <option value="8">Delaware</option>  
          <option value="9">Florida</option> 
          <option value="10">Georgia</option>  
          <option value="11">Hawaii</option> 
          <option value="12">Idaho</option> 
          <option value="13">Illinois</option>
          <option value="14">Indiana</option> 
          <option value="15">Iowa</option> 
          <option value="16">Kansas</option>
          <option value="17">Kentucky</option> 
          <option value="18">Louisiana</option>
          <option value="19">Maine</option> 
          <option value="20">Maryland</option>
          <option value="21">Massachusetts</option>  
          <option value="22">Michigan</option>
          <option value="23">Minnesota</option>
          <option value="24">Mississippi</option>
          <option value="25">Missouri</option> 
          <option value="26">Montana</option>
          <option value="27">Nebraska</option> 
          <option value="28">Nevada</option>
          <option value="29">New Hampshire</option>  
          <option value="30">New Jersey</option>
          <option value="31">New Mexico</option>         
          <option value="32">New York</option>
          <option value="33">North Carolina</option>     
          <option value="34">North Dakota</option>
          <option value="35">Ohio</option> 
          <option value="36">Oklahoma</option>
          <option value="37">Oregon</option>   
          <option value="38">Pennsylvania</option>
          <option value="39">Rhode Island</option>       
          <option value="40">South Carolina</option>
          <option value="41">South Dakota</option>
          <option value="42">Tennessee</option>
          <option value="43">Texas</option>
          <option value="44">Utah</option>
          <option value="45">Vermont</option>
          <option value="46">Virginia</option>
          <option value="47">Washington</option>
          <option value="48">West Virginia</option>
          <option value="49">Wisconsin</option>
          <option value="50">Wyoming</option>
          <option value="51">District of Columbia</option>
          <option value="52">American Samoa</option>
          <option value="53">Guam</option>
          <option value="54">North Mariana Islands</option>
          <option value="55">Puerto Rico</option>
          <option value="56">U.S. Virgin Islands</option>
        </select>
       </fieldset><!--End States-->
 
       <fieldset>
         <input placeholder="Message Subject" type="text" tabindex="6">
       </fieldset>
    
       <fieldset>
         <textarea placeholder="Type your message here..." name="subject" tabindex="7" required></textarea>
       </fieldset>
     <!--End State-->
     <!--Begin Submit Button-->
       <fieldset>
         <button name="submit" type="submit" id="submit" data-submit="...Sending">Submit</button> 
       </fieldset>
      <!--End Submit Button-->
  </form>
  
</div>
</body>
!

CSS

            
              /* font-family: 'Lato', sans-serif;
font-family: 'Irish Grover', cursive; #ffbe00 c9d6df 00bbf0 0960bd 393e46 */

@import url('https://fonts.googleapis.com/css?family=Irish+Grover|Lato:400,700,700i');


* {
  margin: 0;
  padding: 0;
  box-sizing: border-box;
    -webkit-box-sizing: border-box;
  -moz-box-sizing: border-box;
  
}

html {
  background-image: url(https://s3-us-west-2.amazonaws.com/s.cdpn.io/1148131/fabric-1100790_1920.jpg);
}

body {
  background: transparent;
  font-family: 'Lato', sans-serif;
  padding: 10px;
  margin: 0;
  line-height: 30px;
  
}

header {
  background: rgba(255, 255, 255, 0.7);
  max-width: 550px;
  width: 100%;
  margin: 0 auto;
  margin-top: 20px;
  padding: 20px;
  border-radius: 40px;
  position: relative;
}

header h2 {
  display: block;
  color: black;
  font-family: 'Irish Grover', cursive;
  font-size: 2em;
  font-weight: 700;
  text-align: center;
 
}

header h3 {
  display: block;
  black: color;
  font-family: 'Lato', sans-serif;
  font-size: 1.5em;
  font-weight: 700;
  text-align: center;
  
}

.container {
  max-width: 600px;
  width: 100%;
  margin: 0 auto;
  position: relative;
}

form {
  background-color: #ffbe00;
  padding: 40px;
  margin: 50px 0;
  border-radius: 40px;
  
}

.contact h4 {
  display: block;
  font-family: 'Irish Grover', cursive;
  font-size: 2em;
  text-transform: uppercase;
  font-weight: 700;
  text-align: center; 
  }

.contact h5 {
  display: block;
  font-family: 'Lato', sans-serif;
  font-weight: 400;
  font-size: 1em;
  text-align: center;
  text-transform: none;
   
}


/* Style for Form */

fieldset {
  border: ;
  margin: 0 0 10px;
  min-width: 100%;
  padding: 0;
  width: 100%;
}
 
.contact input[type="text"], .contact input[type="email"],
.contact select, .contact textarea{
  width: 100%;
  border: 1px solid black;
  background: #c9d6df;
  margin: 0 0 5px;
  padding: 10px;
  font-size: .80em;
}

.contact input[type="text"]:hover, .contact input[type="email"]:hover,
.contact select:hover, .contact textarea:hover{
  -webkit-transition:border-color 0.3s ease-in-out;
  -moz-transition: border-color 0.3s ease-in-out;
  transition: border-color 0.3s ease-in-out;
  border: 1px solid #00bbf0;
}

.contact textarea {
  height: 100px;
  max-width: 100%;
  resize: none;
}

.contact button[type="submit"] {
  cursor: pointer;
  width: 100%;
  border: none;
  background: #00bbf0;
  color: black;
  margin: 0 0 5px;
  padding: 10px;
  font-size: 1em;
  font-weight: 700;
}

.contact button[type="submit"]:hover {
  background: #0960bd;
  -webkit-transition:border-color 0.3s ease-in-out;
  -moz-transition: border-color 0.3s ease-in-out;
  transition: border-color 0.3s ease-in-out;
  border: 1px solid #AAA;
}

.contact button[type="submit"]:active {
  box-shadow: inset 0 1px 3px rgba(0, 0, 0, 0.5);
}

.contact input:focus, .contact textarea:focus {
  outline: 0;
  border: 1px solid #999;
}

::-webkit-input-placeholder {
  color: #393e46;
}

:-moz-input-placeholder {
  color: #393e46;
}

::-moz-input-placeholder {
  color: #393e46;
}

:-ms-input-placeholder {
  color: #393e46;
}
!

JS

            
              $("form").submit(function(){
  alert("Thank Your for Submitting your Form!");
});
!
999px
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