<div class="row">
<div class="col-12">
<h3>Contact with us</h3>
<h5>Contact details</h5>
</div>
<div class="col-12">
<div class="form-group">
<label>Your Name*</label>[text* your-name placeholder "Your name here*"]
</div>
</div>
<div class="col-12">
<div class="form-group">
<label>Your Email*</label>[email* your-email placeholder "Email*"]
</div>
</div>
<div class="col-12">
<div class="form-group">
<label>Phone Number*</label>[number* your-number placeholder "Number*"]
</div>
</div>
<div class="col-12">
<h5 class="contact-title">Company details</h5>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Company*</label>[text* your-name placeholder "Company name here"]
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Company Address*</label>[text* your-name placeholder "Company address here"]
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>How many employees do you have?</label>[select* employee id:employee first_as_label "-- None --" "10" "15" "20"]
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Company where business is registered?</label>[select* empladd id:empadd first_as_label "-- None --" "USA" "UK" "Canada"]
</div>
</div>
<div class="col-12">
<h5 class="contact-title">What we need to know to get started</h5>
</div>
<div class="col-12">
<div class="form-group">
<label>Estimated amount of money sent across currencies monthly*</label>[select* empladd id:empadd first_as_label "-- None --" "USA" "UK" "Canada"]
</div>
</div>
<div class="col-12">
<div class="form-group">
<label>Estimated number of payments made monthly*</label>[select* empladcompany_asset_numd id:company_asset_num first_as_label "-- None --" "10" "20" "30"]
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<label>Send your Message</label>[textarea your-message cols:30 rows:10 placeholder "Your Message"]
</div>
</div>
<div class="col-12">
[acceptance gdpr class:gdpr-term ]Accept <a href="https://themes.hibotheme.com/palmela/terms-conditions/">Terms Of Service</a> and <a href="https://themes.hibotheme.com/palmela/privacy-policy/">Privacy Policy</a>.[/acceptance]
</div>
<div class="col-12">
<button type="submit" class="btn-one d-block w-100">Send Message</button>
</div>
</div>