<div class="jform validate"><div class="field">[text* text-564 id:id class:required class:alphanumeric class:iecn placeholder "Name"]</div><div class="field">[email* email-508 class:email placeholder "Email"]</div><div class="field phone">[tel* tel-502 class:number placeholder "Phone Number"]</div><div class="field textarea"><textarea name="msg" class="iemsg required" rows="4" placeholder="Name on the Logo and Design Preferences"></textarea></div><p class="pull-left">Fastest Turnaround Time & 24/7 Customer Support </p>[submit id:id class:class "Submit Your Request"]</div>