<form action="[%URL nohost:'1' type:'page' id:'[@content_id@]'%][%END URL%]" method="post"><input name="inp-submit" type="hidden" value="y" />
<h3>Email Enquiry Form <small>Complete this form to email us your enquiry.</small></h3>

<div class="form-group"><label for="inp-first_name">First Name </label>

<p class="small text-danger"><label for="inp-first_name">Required</label></p>
<input class="form-control" id="inp-first_name" name="inp-first_name" required="" size="40" type="text" value="[%nohtml%][@inp-first_name@][%end nohtml%]" /> <input class="hidden" name="inp-title" type="text" value="" /></div>

<div class="form-group"><label>Surname</label> <input class="form-control" name="inp-last_name" size="40" type="text" value="[%nohtml%][@inp-last_name@][%end nohtml%]" /></div>

<div class="form-group"><label>Contact Phone Number</label> <input class="form-control" name="inp-phone" size="40" type="text" value="[%nohtml%][@inp-phone@][%end nohtml%]" /></div>

<div class="form-group"><label>Email Address </label>

<p class="small text-danger"><label>Required</label></p>
<input class="form-control" name="inp-email" required="" size="40" type="email" value="[%nohtml%][@inp-email@][%end nohtml%]" /></div>

<div class="form-group"><label>Preferred Method of Contact</label> <select class="form-control" name="inp-contact_method"><option data="" end="" value="Email">Email</option><option data="" end="" value="Phone">Phone</option> </select></div>

<div class="form-group"><label>Message</label><textarea class="form-control col-xs-12 col-md-6" name="inp-msg" rows="5">[%nohtml%][@inp-msg@][%end nohtml%]</textarea></div>

<div class="form-group">
<div class="clear">&nbsp;</div>

<p><input name="state" type="hidden" value="email_sent" /></p>

<p><input class="btn btn-lg btn-default" type="submit" value="Send Email" /></p>
</div>
</form>