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HTML

              
                <div class="bg_img"></div>
<div class="form_wrapper">
  <div class="form_container">
    <div class="title_container">
      <h2>Clean and Responsive Contact Form</h2>
      <h3>Created with pure CSS Only!</h3>
    </div>
    <form>
      <div class="row clearfix">
        <div class="col_half">
          <label>First name</label>
          <div class="input_field"> <span><i aria-hidden="true" class="fa fa-user"></i></span>
            <input type="text" name="first_name" placeholder="John" required />
          </div>
        </div>
        <div class="col_half">
          <label>Last name</label>
          <div class="input_field"> <span><i aria-hidden="true" class="fa fa-user"></i></span>
            <input type="text" name="last_name" placeholder="Doe" />
          </div>
        </div>
      </div>
      <div class="row clearfix">
        <div class="col_half">
          <label>Email</label>
          <div class="input_field"> <span><i aria-hidden="true" class="fa fa-envelope"></i></span>
            <input type="email" name="email" placeholder="johndoe@gmail.com" required />
          </div>
        </div>
        <div class="col_half">
          <label>Phone</label>
          <div class="input_field"> <span><i aria-hidden="true" class="fa fa-phone"></i></span>
            <input type="tel" name="phone" placeholder="Phone no" pattern="[0-9]{10}" />
          </div>
        </div>
      </div>
      <div class="row clearfix">
        <div>
          <label>Comments</label>
          <div class="textarea_field"> <span><i aria-hidden="true" class="fa fa-comment"></i></span>
            <textarea cols="46" rows="3" name="comments"></textarea>
          </div>
        </div>
      </div>
      <input class="button" type="submit" value="Sumbit" />
    </form>
  </div>
</div>
              
            
!

CSS

              
                * {
	padding:0;
	margin:0;
}
body {
	font-family:Verdana, Geneva, sans-serif;
	font-size:14px;
	background:#f2f2f2;
}
.bg_img {
	background:url(https://static.pexels.com/photos/168066/pexels-photo-168066.jpeg) no-repeat center;
	background-size:cover;
	background-attachment:fixed;
	-webkit-filter: blur(8px);
	-moz-filter: blur(8px);
	-o-filter: blur(8px);
	-ms-filter: blur(8px);
	filter: blur(8px);
	position:absolute;
	top:0;
	left:0;
	height:100%;
	width:100%;
	z-index:0;
}
.clearfix:after {
	content: "";
	display: block;
	clear: both;
	visibility: hidden;
	height: 0;
}
.form_wrapper {
	background:#fff;
	width:500px;
	max-width:100%;
	box-sizing:border-box;
	padding:15px;
	margin:10% auto 0;
	position:relative;
	z-index:1;
	-webkit-box-shadow:0 23px 4px -21px rgba(0, 0, 0, 0.9);
	-moz-box-shadow:0 23px 4px -21px rgba(0, 0, 0, 0.9);
	box-shadow:0 23px 4px -21px rgba(0, 0, 0, 0.9);
}
.form_container {
	padding:15px;
	border:1px dashed #ccc;
}
.form_wrapper h2 {
	font-size:1.5em;
	line-height:1.5em;
	margin:0;
}
.form_wrapper .title_container {
	text-align:center;
	margin:-15px -15px 15px;
	padding:15px 0;
	border-bottom:1px dashed #ccc;
}
.form_wrapper h3 {
	font-size:1.1em;
	font-weight:normal;
	line-height:1.5em;
	margin:0;
}
.form_wrapper .row {
	margin:10px -15px;
}
.form_wrapper .row > div {
	padding:0 15px;
	box-sizing:border-box;
}
.form_wrapper .col_half {
	width:50%;
	float:left;
}
.form_wrapper label {
	display:block;
	margin:0 0 5px;
}
.form_wrapper .input_field, .form_wrapper .textarea_field {
	position:relative;
}
.form_wrapper .input_field > span, .form_wrapper .textarea_field > span {
	position:absolute;
	left:0;
	top:0;
	color:#333;
	height:100%;
	border-right:1px solid #ccc;
	text-align:center;
	width:30px;
}
.form_wrapper .textarea_field > span {
	border-bottom:1px solid #ccc;
	max-height:35px;
}
.form_wrapper .input_field > span > i, .form_wrapper .textarea_field > span > i {
	padding-top:12px;
}
.form_wrapper input[type="text"], .form_wrapper input[type="email"], .form_wrapper input[type="tel"], textarea {
	width:100%;
	padding:10px 10px 10px 35px;
	border:1px solid #ccc;
	box-sizing:border-box;
	outline:none;
	-webkit-transition: all 0.30s ease-in-out;
	-moz-transition: all 0.30s ease-in-out;
	-ms-transition: all 0.30s ease-in-out;
	transition: all 0.30s ease-in-out;
}
.form_wrapper textarea {
	height:8em;
}
.form_wrapper input[type="text"]:focus, .form_wrapper input[type="email"]:focus, .form_wrapper input[type="tel"]:focus, textarea:focus {
	-webkit-box-shadow:0 0 2px 1px rgba(255, 169, 0, 0.5);
	-moz-box-shadow:0 0 2px 1px rgba(255, 169, 0, 0.5);
	box-shadow:0 0 2px 1px rgba(255, 169, 0, 0.5);
	border:1px solid #f5ba1a;
}
.form_wrapper input[type="submit"] {
	background:#f5ba1a;
	height:50px;
	line-height:50px;
	width:100%;
	border:none;
	outline:none;
	cursor:pointer;
	color:#fff;
	font-size:1.2em;
	-webkit-transition: all 0.30s ease-in-out;
	-moz-transition: all 0.30s ease-in-out;
	-ms-transition: all 0.30s ease-in-out;
	transition: all 0.30s ease-in-out;
}
.form_wrapper input[type="submit"]:hover, .form_wrapper input[type="submit"]:focus {
	background:#daa106;
}
.credit{
	position:relative;
	z-index:1;
	text-align:center;
	padding:15px;
	color:#f5ba1a;	
}
.credit a{
	color:#daa106;	
}
@media (max-width: 600px) {
.form_wrapper .col_half {
	width:100%;
	float:none;
}
.form_wrapper label {
	margin:10px 0;
}
}
              
            
!

JS

              
                
              
            
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