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- <div class="span8">
- <div class="salesforce_w2l_lead">
- <form id="sf_form_salesforce_w2l_lead_2" class="w2llead placeholders" method="post" action="#sf_form_salesforce_w2l_lead_2">
- <table border="0" style="width:94%; background-color:#434343; border-color:#FFF;" cellspacing="0" cellpadding="0">
- <tr>
- <td valign="top" style="background-color:#434343; border:0;">
- <div class="sf_field sf_field_first_name sf_type_text">
- <input type="text" placeholder="First name *" value="" id="sf_first_name" class="w2linput text" name="first_name" />
- <div class="clearfix"></div>
- </div>
- </td>
- <td valign="top" style="background-color:#434343; border:0;">
- <div class="sf_field sf_field_last_name sf_type_text">
- <input type="text" placeholder="Last name *" value="" id="sf_last_name" class="w2linput text" name="last_name" />
- <div class="clearfix"></div>
- </div>
- </td>
- <td valign="top" style="background-color:#434343; border:0;">
- <div class="sf_field sf_field_email sf_type_text">
- <input type="text" placeholder="Email *" value="" id="sf_email" class="w2linput text" name="email" />
- <div class="clearfix"></div>
- </div>
- </td>
- </tr>
- <tr>
- <td valign="top" style="background-color:#434343; border:0;">
- <div class="sf_field sf_field_company sf_type_text">
- <input type="text" placeholder="Company *" value="" id="sf_company" class="w2linput text" name="company" />
- <div class="clearfix"></div>
- </div>
- </td>
- <td valign="top" style="background-color:#434343; border:0;">
- <div class="sf_field sf_field_title sf_type_text">
- <input type="text" placeholder="Title" value="" id="sf_title" class="w2linput text" name="title" />
- <div class="clearfix"></div>
- </div>
- </td>
- <td valign="top" style="background-color:#434343; border:0;">
- <div class="sf_field sf_field_phone sf_type_text">
- <input type="text" placeholder="Phone *" value="" id="sf_phone" class="w2linput text" name="phone" />
- <div class="clearfix"></div>
- </div>
- </td>
- </tr>
- <tr>
- <td valign="top" colspan="3" style="background-color:#434343; border:0;">
- <div style="align-content:center;" class="sf_field sf_field_description sf_type_textarea">
- <textarea cols="3" width="100%" id="sf_description" class="w2linput textarea" name="description" placeholder="How Can We Help You? *"></textarea>
- <div class="clearfix"></div>
- </div>
- </td>
- </tr>
- <tr>
- <td valign="top" colspan="3" style="background-color:#434343; border:0;">
- <div class="w2lsubmit"><input type="submit" name="w2lsubmit" class="w2linput submit" value="Submit" /></div>
- </td>
- </tr>
- </form>
- <p class="sf_required_fields_msg" id="requiredfieldsmsg" style="color: #f7f7f7;"><sup><span class="required">*</span></sup> These fields are required.</p>
- </div></div>
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