<div style="margin-top: -10px;">

	<div class="row">
		<div class="col-md-6" style="margin-bottom: 14px;">
			<label style="display: block; margin: 0 0 2px 0; line-height: 1.1;">Your Name</label>[text* your-name]
		</div>

		<div class="col-md-6" style="margin-bottom: 14px;">
			<label style="display: block; margin: 0 0 2px 0; line-height: 1.1;">Your Email</label>[email* your-email]
		</div>
	</div>

	<div class="row">
		<div class="col-md-6" style="margin-bottom: 14px;">
			<label style="display: block; margin: 0 0 2px 0; line-height: 1.1;">Phone Number</label>[tel tel-767]
		</div>

		<div class="col-md-6" style="margin-bottom: 14px;">
			<label style="display: block; margin: 0 0 2px 0; line-height: 1.1;">Company</label>[text text-1]
		</div>
	</div>

	<div class="row">
		<div class="col-md-12" style="margin-bottom: 14px;">
			<label style="display: block; margin: 0 0 2px 0; line-height: 1.1;">Your Message</label>[textarea your-message rows:5]
		</div>
	</div>

	<div>
		[submit class:btn-color-black "SEND MESSAGE"]
	</div>

</div>