<form action="http://www.example.com/cgi-bin/FormMail.pl" method="post">
<input type="hidden" name="recipient" value="connect@omegadesignla.com" />
<input type="hidden" name="subject" value="From the feedback form" />
<div class="row">
<div class="large-6 columns">
<label>Name:
<input type="text" placeholder="Full Name" />
</label>
</div>
<div class="large-6 columns">
<label>Email:
<input type="text" placeholder="Email" />
</label>
</div>
</div>
<div class="row">
<div class="large-4 columns">
<label>Phone Number:
<input type="text" placeholder="Phone Number" />
</label>
</div>
<div class="large-8 columns">
<label>What are you interested in(check all that apply)
</label>
<input id="checkbox1" type="checkbox"><label for="checkbox1">Printing
</label>
<input id="checkbox2" type="checkbox"><label for="checkbox2">Web Development
</label>
<input id="checkbox2" type="checkbox"><label for="checkbox2">Promotional
</label>
</div>
</div>
<div class="row">
<div class="large-12 columns">
<label>Message
<textarea placeholder="message"></textarea>
</label>
</div>
</div>
<br><button class="button" name="Send" type="submit">SEND</button><br>
</form>
[edited by: phranque at 9:50 pm (utc) on Oct 25, 2014]
[edit reason] exemplified domain [/edit]
