<div class="row">
    <div class="col-lg-12">
        <div class="form-group">
            <label for="contact-name" class="custom-font-family font-weight-medium">Your Name <span class="text-secondary">*</span></label>
            [text* your-name id:contact-name class:form-control class:line-height-lg]
        </div>
    </div>
    <div class="col-lg-12">
        <div class="form-group">
            <label for="contact-email" class="custom-font-family font-weight-medium">Your E-mail <span class="text-secondary">*</span></label>
            [email* your-email id:contact-email class:form-control class:line-height-lg]
[select coutrylist class:allCountryList include_blank "Afghanistan" "Albania" "Algeria" "AmericanSamoa" "Andorra" "Angola" "Anguilla" "Antigua and Barbuda" "Argentina" "Armenia" "Aruba" "Australia" "Austria" "Azerbaijan" "Bahamas" "Bahrain" "Bangladesh" "Barbados" "Belarus" "Belgium" "Belize" "Benin" "Bermuda" "Bhutan" "Bosnia and Herzegovina" "Botswana" "Brazil" "British Indian Ocean Territory" "Bulgaria" "Burkina Faso" "Burundi" "Cambodia" "Cameroon" "Canada" "Cape Verde" "Cayman Islands" "Central African Republic" "Chad" "Chile" "China" "Christmas Island" "Colombia" "Comoros" "Congo" "Cook Islands" "Costa Rica" "Croatia" "Cuba" "Cyprus" "Czech Republic" "Denmark" "Djibouti" "Dominica" "Dominican Republic" "Ecuador" "Egypt" "El Salvador" "Equatorial Guinea" "Eritrea" "Estonia" "Ethiopia" "Faroe Islands" "Fiji" "Finland" "France" "French Guiana" "French Polynesia" "Gabon" "Gambia" "Georgia" "Germany" "Ghana" "Gibraltar" "Greece" "Greenland" "Grenada" "Guadeloupe" "Guam" "Guatemala" "Guinea" "Guinea-Bissau" "Guyana" "Haiti" "Honduras" "Hungary" "Iceland" "India" "Indonesia" "Iraq" "Ireland" "Israel" "Italy" "Jamaica" "Japan" "Jordan" "Kazakhstan" "Kenya" "Kiribati" "Kuwait" "Kyrgyzstan" "Latvia" "Lebanon" "Lesotho" "Liberia" "Liechtenstein" "Lithuania" "Luxembourg" "Madagascar" "Malawi" "Malaysia" "Maldives" "Mali" "Malta" "Marshall Islands" "Martinique" "Mauritania" "Mauritius" "Mayotte" "Mexico" "Monaco" "Mongolia" "Montenegro" "Montserrat" "Morocco" "Myanmar" "Namibia" "Nauru" "Nepal" "Netherlands" "Netherlands Antilles" "New Caledonia" "New Zealand" "Nicaragua" "Niger" "Nigeria" "Niue" "Norfolk Island" "Northern Mariana Islands" "Norway" "Oman" "Pakistan" "Palau" "Panama" "Papua New Guinea" "Paraguay" "Peru" "Philippines" "Poland" "Portugal" "Puerto Rico" "Qatar" "Romania" "Rwanda" "Samoa" "San Marino" "Saudi Arabia" "Senegal" "Serbia" "Seychelles" "Sierra Leone" "Singapore" "Slovakia" "Slovenia" "Solomon Islands" "South Africa" "South Georgia and the South Sandwich Islands" "Spain" "Sri Lanka" "Sudan" "Suriname" "Swaziland" "Sweden" "Switzerland" "Tajikistan" "Thailand" "Togo" "Tokelau" "Tonga" "Trinidad and Tobago" "Tunisia" "Turkey" "Turkmenistan" "Turks and Caicos Islands" "Tuvalu" "Uganda" "Ukraine" "United Arab Emirates" "United Kingdom" "United States" "Uruguay" "Uzbekistan" "Vanuatu" "Wallis and Futuna" "Yemen" "Zambia" "Zimbabwe" "land Islands" "Antarctica" "Bolivia, Plurinational State of" "Brunei Darussalam" "Cocos (Keeling) Islands" "Congo, The Democratic Republic of the" "Cote d'Ivoire" "Falkland Islands (Malvinas)" "Guernsey" "Holy See (Vatican City State)" "Hong Kong" "Iran, Islamic Republic of" "Isle of Man" "Jersey" "Korea, Democratic People's Republic of" "Korea, Republic of" "Lao People's Democratic Republic" "Libyan Arab Jamahiriya" "Macao" "Macedonia, The Former Yugoslav Republic of" "Micronesia, Federated States of" "Moldova, Republic of" "Mozambique" "Palestinian Territory, Occupied" "Pitcairn" "Réunion" "Russia" "Saint Barthélemy" "Saint Helena, Ascension and Tristan Da Cunha" "Saint Kitts and Nevis" "Saint Lucia" "Saint Martin" "Saint Pierre and Miquelon" "Saint Vincent and the Grenadines" "Sao Tome and Principe" "Somalia" "Svalbard and Jan Mayen" "Syrian Arab Republic" "Taiwan, Province of China" "Tanzania, United Republic of" "Timor-Leste" "Venezuela, Bolivarian Republic of" "Viet Nam" "Virgin Islands, British" "Virgin Islands, U.S."]
        </div>
    </div>
    <div class="col-lg-12">
        <div class="form-group">
            <label for="contact-message" class="custom-font-family font-weight-medium">Your Message</label>
            [textarea your-message id:contact-message class:form-control rows:7]
        </div>
    </div>
    <div class="col-lg-12">
        <div class="form-group">
            [submit class:btn class:btn-dark class:btn-lg class:px-5 class:p-t-md class:p-b-md "SEND MESSAGE"]
        </div>
    </div>
</div>