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Here you can Sed posuere consectetur est at lobortis. Donec ullamcorper nulla non metus auctor fringilla. Maecenas sed diam eget risus varius blandit sit amet non magna. Donec id elit non mi porta gravida at eget metus. Praesent commodo cursus magna, vel scelerisque nisl consectetur et.

HTML

              
                
<div class="container">
  <div class="row header">
    <h1>CONTACT US &nbsp;</h1>
    <h3>Fill out the form below to learn more!</h3>
  </div>
  <div class="row body">
    <form action="#">
      <ul>
        
        <li>
          <p class="left">
            <label for="first_name">first name</label>
            <input type="text" name="first_name" placeholder="John" />
          </p>
          <p class="pull-right">
            <label for="last_name">last name</label>
            <input type="text" name="last_name" placeholder="Smith" />      
          </p>
        </li>
        
        <li>
          <p>
            <label for="email">email <span class="req">*</span></label>
            <input type="email" name="email" placeholder="john.smith@gmail.com" />
          </p>
        </li>        
        <li><div class="divider"></div></li>
        <li>
          <label for="comments">comments</label>
          <textarea cols="46" rows="3" name="comments"></textarea>
        </li>
        
        <li>
          <input class="btn btn-submit" type="submit" value="Submit" />
          <small>or press <strong>enter</strong></small>
        </li>
        
      </ul>
    </form>  
  </div>
</div>
              
            
!

CSS

              
                @import "compass/css3";

// Font imports

@import url(https://fonts.googleapis.com/css?family=Lato:300,400,700);

// Color vars

$white: #fff;
$grey: #ccc;
$dark_grey: #555;
$blue: #4f6fad;
$pink: #ee9cb4;

// Mixins

@mixin lato-book { font-family: 'Lato', sans-serif; font-weight: 300; }
@mixin lato-reg { font-family: 'Lato', sans-serif; font-weight: 400; }
@mixin lato-bold { font-family: 'Lato', sans-serif; font-weight: 700; }
@mixin btn($color) {
  background-color: $color;
  border-bottom-color: darken($color, 15%);
  &:hover {
      background-color: lighten($color, 5%);
    }
}

// Functions

@function pxtoem($target, $context){
  @return ($target/$context)+0em;
}

//

body {
  background-color: lighten($grey, 10%);
  font-size: 100%;
  @include lato-reg;
}
div, textarea, input {
  @include box-sizing(border-box); 
}  
.container {  
  max-width: 510px;
  min-width: 324px;
  margin: 50px auto 0px;
  background-color: $white;
  border: 1px solid lighten($grey, 1%); 
  border-bottom: 3px solid $grey;
}
.row {
  width: 100%;
  margin: 0 0 1em 0;
  padding: 0 2.5em;
  &.header {
    padding: 1.5em 2.5em;
    border-bottom: 1px solid $grey; 
    background: url(https://images2.imgbox.com/a5/2e/m3lRbCCA_o.jpg) left -80px;
    color: $white;
  }
  &.body {
    padding: .5em 2.5em 1em;
  }
}
.pull-right {
  float: right; 
}
h1 {
  @include lato-book;
  display: inline-block;
  font-weight: 100;
  font-size: pxtoem(45, 16);
  border-bottom: 1px solid hsla(100%, 100%, 100%, 0.3);
  margin: 0 0 0.1em 0;
  padding: 0 0 0.4em 0;
}
h3 {
  @include lato-reg;
  font-size: pxtoem(20, 16);
  margin: 1em 0 0.4em 0;
}
.btn {
  font-size: pxtoem(17, 16);
  display: inline-block;
  padding: 0.74em 1.5em;
  margin: 1.5em 0 0;
  color: $white;
  border-width: 0 0 0 0;
  border-bottom: 5px solid;
  text-transform: uppercase;
  @include btn(darken($grey, 10%));
  @include lato-book;
  &.btn-submit {
    @include btn($blue);
  }
}

form {
  max-width: 100%;
  display: block;
  ul {
    margin: 0;
    padding: 0;
    list-style: none;
    li {
      margin: 0 0 0.25em 0; 
      clear: both;
      display: inline-block;
      width: 100%;
      &:last-child {
          margin: 0;    
        }
        p {
          margin: 0;
          padding: 0;
          float: left;
          &.right {
            float: right;
          }
        }     
        .divider {
          margin: 0.5em 0 0.5em 0;
          border: 0;
          height: 1px;
          width: 100%;
          display: block;
          background-color: $blue;
          background-image: linear-gradient(to right, $pink, $blue);
        }
        .req {
          color: $pink; 
        }
    }
  }
  label {
    display: block;
    margin: 0 0 0.5em 0;
    color: $blue;
    font-size: pxtoem(16, 16);
  }
  input {
    margin: 0 0 0.5em 0;
    border: 1px solid $grey;
    padding: 6px 10px;
    color: $dark_grey;
    font-size: pxtoem(16, 16);
  }
  textarea {
    border: 1px solid $grey;
    padding: 6px 10px;
    width: 100%;
    color: $dark_grey;
  }
  small {
    color: $blue;
    margin: 0 0 0 0.5em;
  }
}

// Media Queries

@media only screen and (max-width:480px) {
  .pull-right {
    float: none; 
  }
  input {
    width: 100%; 
  }
  label {
    width: 100%;
    display: inline-block;
    float: left;
    clear: both;
  }
  li, p {
   width: 100%; 
  }
  input.btn {
   margin: 1.5em 0 0.5em; 
  }
  h1 {
   font-size: pxtoem(36, 16); 
  }
  h3 {
    font-size: pxtoem(18, 16)
  }
  li small {
   display: none; 
  }
}
              
            
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JS

              
                
              
            
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