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Contact us Form

Written by @m_k_amin 10 December 2012

You can create a contact us form for your website.

Code Snippet:

                                                
                                                <!-- this script is provided by https://www.htmlfreecode.com coded by: Kerixa Inc. -->
<!-- This Script is from www.htmlfreecode.com, Coded by:  Krishna Eydat-->
<html>
<head>
<style type="text/css">
.style1 {
	text-align: center;
}
.style2 {
	font-size: 40pt;
	color: #0000FF;
	font-family: "Times New Roman", Times, serif;
}
.style3 {
	font-size: medium;
	color: #0000FF;
	font-family: "Times New Roman", Times, serif;
}
.style5 {
	font-family: "Times New Roman", Times, serif;
	border-right-style: solid;
	border-right-width: 0px;
	border-top-style: solid;
	border-top-width: 0px;
	background-color: #CCFFFF;
}
.style6 {
	text-align: center;
	border-left-style: solid;
	border-left-width: 0px;
	border-right-style: solid;
	border-right-width: 0px;
	border-top-style: solid;
	border-top-width: 0px;
	background-color: #CCCCFF;
}
.style8 {
	border: 3px dashed #0000CC;
}
.style9 {
	font-family: "Times New Roman", Times, serif;
	border-right-style: solid;
	border-right-width: 0px;
	background-color: #CCFFFF;
}
.style11 {
	font-family: "Times New Roman", Times, serif;
	border-right-style: solid;
	border-right-width: 0px;
	border-bottom-style: solid;
	border-bottom-width: 0px;
}
.style12 {
	font-family: "Times New Roman", Times, serif;
	padding-left: 10px;
	background-color: #CCFFFF;
}
.style13 {
	font-family: "Times New Roman", Times, serif;
	border-right-style: solid;
	border-right-width: 0px;
	background-color: #D5F1FF;
}
.style15 {
	font-family: "Times New Roman", Times, serif;
	border-right-style: solid;
	border-right-width: 0px;
	border-bottom-style: solid;
	border-bottom-width: 0px;
	background-color: #D5F1FF;
}
.style17 {
	font-family: "Times New Roman", Times, serif;
	padding-left: 10px;
	background-color: #D5F1FF;
}
.style18 {
	font-family: "Times New Roman", Times, serif;
	border-left-style: solid;
	border-left-width: 0px;
	padding-left: 10px;
	background-color: #CCFFFF;
	text-align: center;
}
.style19 {
	font-size: xx-small;
}
</style>
</head>
<body>
<form method="post" action="">
<table align="center" class="style8" style="width: 551">
	<tr>
		<td class="style6" colspan="2" style="height: 136px"><span class="style2">
		<strong class="style11">Contact us</strong></span><br class="style3">
		<span class="style3">Tell us what is in your mind</span></td>
	</tr>
	<tr>
		<td class="style12" style="width: 268px; height: 40;"><strong>Your Name:</strong></td>
		<td class="style5" style="width: 421px; height: 40;"><span dir="ltr">
		<input name="name_msg" size="33" id="fa" dir="ltr" tabindex="1" maxlength="30"   lang="fa" style="float: left; width: 204px; height: 25px;" value="" onclick="this.value=''"><div class="style1">
		</div>
		</span> </td>
	</tr>
	<tr>
		<td class="style17" style="width: 268px; height: 40;"><strong>Your Email:</strong></td>
		<td class="style13" style="width: 421px; height: 40;"><span dir="ltr">
		<input name="email_msg" size="33" dir="ltr" tabindex="3" maxlength="30" id="fa1" style="float: left; width:204px; height: 25px;" value="" onclick="this.value=''"></span></td>
	</tr>
	<tr>
		<td class="style12" style="width: 268px; height: 40;"><strong>Your website:</strong></td>
		<td class="style9" style="width: 421px; height: 40;"><span dir="ltr">
		<input name="url_msg" size="21" dir="ltr" tabindex="2" maxlength="30" id="fa0" style="float: left; width: 204px; height: 25px;" value="" onclick="this.value=''"></span></td>
	</tr>
	<tr>
		<td class="style17" style="width: 268px; height: 123px;"><strong>Comment:</strong></td>
		<td class="style15" style="width: 421px; height: 123;"><span dir="ltr">
		<textarea rows="6" name="msg_body" dir="ltr" id="fa2" tabindex="4" lang="fa" onclick="this.value=''" style="width: 400px"></textarea></span></td>
	</tr>
	<tr>
		<td class="style18" style="height: 78px;" colspan="2">
<span dir="ltr">
<input type="submit" value="Submit" name="submit_msg" tabindex="5" id="fa3" style="float:center; width: 114px; height: 35px;" ><br></span>
		<br class="style19"><font face="Tahoma"><a target="_blank" href="http://www.phpfreecode.com/"><span style="font-size: 8pt; text-decoration: none">PHP Free Code</span></a></font>
</td>
	</tr>
</table>
</form>
<font face="Tahoma"><a target="_blank" href="http://www.htmlfreecode.com/"><span style="font-size: 8pt; text-decoration: none">HTML Free Code</span></a></font>
</body>
</html><a target='_blank' href='https://www.htmlfreecode.com' style='font-size: 8pt; text-decoration: none'>Html Free Codes</a>

Example:

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