<div class="chewy_pb_contact">
		<p class="clearfix">
			<!-- <label class="et_pb_contact_form_label">Name</label> -->
			[text* your-name id:your-name class:input class:et_pb_contact_name class:chewy_input placeholder "Name"]
		</p>
		<p class="clearfix">
			<!-- <label class="et_pb_contact_form_label">Email</label> -->
			[text* your-email id:your-email class:input class:et_pb_contact_email class:chewy_input placeholder "Email"]
		</p>
		<p class="clearfix">
			<!-- <label class="et_pb_contact_form_label">Mobile</label> -->
			[text* phone id:phone class:input class:et_pb_contact_name class:chewy_input placeholder "Mobile No."]
		</p>
	<div class="clear"></div>
	<p class="clearfix chewy-question-label">
		<strong><label class="et_pb_contact_form_label">Question One: </label></strong>
		<p class="chewy-question">Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Donec quam felis, ultricies nec?</p>
		[textarea* question-1 id:question-1 class:et_pb_contact_message class:input class:chewy_textarea placeholder "Answer Question One"]
	</p>
	<div class="clear"></div>
	<p class="clearfix chewy-question-label">
		<strong><label class="et_pb_contact_form_label">Question Two: </label></strong>
		<p class="chewy-question">Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor?</p>
		[textarea* question-2 id:question-2 class:et_pb_contact_message class:input class:chewy_textarea placeholder "Answer Question Two"]
	</p>
	[submit class:chewy_pb_contact_submit "Submit"]
</div>