<div class="container">

  <form class="form" method="POST" action="https://api.formjam.io/form/e2535831-b3d4-4f74-8b20-f9495684915c">

    <input type="hidden" name="_honeypot" value="" />

    <h1>Contact Us</h1>

    <div class="row">

      <div class="input-group">

        <label for="firstName">First Name</label>

        <input name="firstName" id="firstName" required pattern="^\w+[\w\s]*\w+$" maxlength="50" autofocus placeholder="e.g. John" />

      </div>

      <div class="input-group">

        <label for="lastName">Last Name</label>

        <input name="lastName" id="lastName" required pattern="^\w+[\w\s]*\w+$" maxlength="100" placeholder="e.g. Doe" />

      </div>

    </div>

    <div class="input-group">

      <label for="email">E-mail</label>

      <input name="email" type="email" id="email" maxlength="200" required placeholder="e.g. john.doe@example.com" />

    </div>

    <div class="input-group">

      <label for="subject">Subject</label>

      <input name="subject" id="subject" required pattern="^\w+[\w\s]*\w+$" maxlength="50" placeholder="e.g. John's Enquiry" />

    </div>

    <div class="input-group">

      <label for="reason">Which of the following best describes your enquiry?</label>

      <select name="reason" id="reason">

        <option>-</option>

        <option>I want to buy</option>

        <option>I want more information</option>

      </select>

    </div>

    <div class="input-group">

      <label for="message">Message</label>

      <textarea name="message" id="message" maxlength="4000" required placeholder="e.g. Hello..."></textarea>

    </div>

    <div class="row input-group">

      <input name="consentGiven" id="consentGiven" type="checkbox" required>

      <label for="consentGiven">I agree to the Privacy Policy</label>

    </div>

    <div class="row input-group">

      <input name="marketingConsentGiven" id="marketingConsentGiven" type="checkbox">

      <label for="marketingConsentGiven">I agree to being contacted for marketing purposes</label>

    </div>

    <button type="submit">Submit</button>

  </form>

</div>