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HTML

              
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<div class="max-w-screen-lg mx-auto p-5">
  <div class="grid grid-cols-1 md:grid-cols-12 border">
    <div class="bg-gray-900 md:col-span-4 p-10 text-white">
      <p class="mt-4 text-sm leading-7 font-regular uppercase">
        Contact
      </p>
      <h3 class="text-3xl sm:text-4xl leading-normal font-extrabold tracking-tight">
        Get In <span class="text-indigo-600">Touch</span>
      </h3>
      <p class="mt-4 leading-7 text-gray-200">
        Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s.
      </p>
      
      <div class="flex items-center mt-5">
        <svg class="h-6 mr-2 text-indigo-600" fill="currentColor" version="1.1" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 489.536 489.536" xmlns:xlink="http://www.w3.org/1999/xlink" enable-background="new 0 0 489.536 489.536">
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        <span class="text-sm">House #14, Street #12, Darulaman Road, Kabul, Afghanistan.</span>
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      <div class="flex items-center mt-5">
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</svg>
        <span class="text-sm">+93 749 99 65 50</span>
      </div>
      <div class="flex items-center mt-5">
        <svg class="h-6 mr-2 text-indigo-600" fill="currentColor" version="1.1" id="Capa_1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px"
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          </svg>
        <span class="text-sm">24/7</span>
      </div>
      
    </div>
    <form class="md:col-span-8 p-10">
  <div class="flex flex-wrap -mx-3 mb-6">
    <div class="w-full md:w-1/2 px-3 mb-6 md:mb-0">
      <label class="block uppercase tracking-wide text-gray-700 text-xs font-bold mb-2" for="grid-first-name">
        First Name
      </label>
      <input class="appearance-none block w-full bg-gray-200 text-gray-700 border border-red-500 rounded py-3 px-4 mb-3 leading-tight focus:outline-none focus:bg-white" id="grid-first-name" type="text" placeholder="Jane">
      <p class="text-red-500 text-xs italic">Please fill out this field.</p>
    </div>
    <div class="w-full md:w-1/2 px-3">
      <label class="block uppercase tracking-wide text-gray-700 text-xs font-bold mb-2" for="grid-last-name">
        Last Name
      </label>
      <input class="appearance-none block w-full bg-gray-200 text-gray-700 border border-gray-200 rounded py-3 px-4 leading-tight focus:outline-none focus:bg-white focus:border-gray-500" id="grid-last-name" type="text" placeholder="Doe">
    </div>
  </div>
  <div class="flex flex-wrap -mx-3 mb-6">
    <div class="w-full px-3">
      <label class="block uppercase tracking-wide text-gray-700 text-xs font-bold mb-2" for="grid-password">
        Email Address
      </label>
      <input class="appearance-none block w-full bg-gray-200 text-gray-700 border border-gray-200 rounded py-3 px-4 mb-3 leading-tight focus:outline-none focus:bg-white focus:border-gray-500" id="grid-email" type="email" placeholder="********@*****.**">
    </div>
  </div>
    
    <div class="flex flex-wrap -mx-3 mb-6">
    <div class="w-full px-3">
      <label class="block uppercase tracking-wide text-gray-700 text-xs font-bold mb-2" for="grid-password">
        Your Message
      </label>
      <textarea rows="10" class="appearance-none block w-full bg-gray-200 text-gray-700 border border-gray-200 rounded py-3 px-4 mb-3 leading-tight focus:outline-none focus:bg-white focus:border-gray-500">
        
      </textarea>
    </div>
    <div class="flex justify-between w-full px-3">
      <div class="md:flex md:items-center">
        <label class="block text-gray-500 font-bold">
          <input class="mr-2 leading-tight" type="checkbox">
          <span class="text-sm">
            Send me your newsletter!
          </span>
        </label>
      </div>
      <button class="shadow bg-indigo-600 hover:bg-indigo-400 focus:shadow-outline focus:outline-none text-white font-bold py-2 px-6 rounded" type="submit">
        Send Message
      </button>
    </div>
      
  </div>
    
</form>
    
  </div>
</div>


<!-- Credit: Componentity.com -->
<a href="https://componentity.com" target="_blank" class="block">
  <img src="http://codenawis.com/componentity/wp-content/uploads/2020/08/logo-componentity-%E2%80%93-9.png" class="w-48 mx-auto my-5">
</a>



  

              
            
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CSS

              
                @import url("https://fonts.googleapis.com/css2?family=Poppins:wght@300,400;500,600;700&display=swap");

body {
  font-family: "Poppins", sans-serif !important;
}

              
            
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