<p><strong>Name:</strong> (required) [text* your-name] </p> <p><strong>Email:</strong> (required) [email* your-email] </p> <p><strong>Number:</strong> [tel your-number] </p> <p><strong>City:</strong> (required) [text* your-city] </p> <p><strong>State:</strong> (required) [text* your-state] </p> <p><strong>Comment:</strong> [textarea your-message 40x3] </p> [cf7sr-simple-recaptcha] <p>[submit "Submit"]</p>