<div class="row">
<div class="col-sm-12"><label for="name">Enter Your Name</label>[text* your-name placeholder "Enter Your Name"]</div> 
<div class="col-sm-12"><label for="name">Enter Your Email</label>[email* your-email placeholder "Enter Your Email"]</div>
<div class="col-sm-12"><label for="name">Type of Insurance</label> [select* insurancetype include_blank "Health Insurance" "Car Insurance" "Home Insurance" "Business Insurance" "Life Insurance" "Travel Insurance"]</div>
<div class="col-sm-12"><label for="name">Your Employment</label>[text* your-employment placeholder "Your Employment"]</div>
<div class="col-sm-12"><label for="name">Annual Income</label>[text* annual-income placeholder "Annual Income"]</div>

<div class="form-button col-sm-12">
  <p class="submit-btn">[submit "Get Quote Now"]</p>
</div>
</div>
1
Reobiz - Multipurpose Business WordPress Theme "[your-subject]"
Reobiz - Multipurpose Business WordPress Theme <support@rstheme.com>
xyz@rstheme.com
From: [your-name] <[your-email]>
Phone: [your-phone]
Type of Insurance: [insurancetype]
Your Employment: [your-employment]
Annual Income: [annual-income]

-- 
This e-mail was sent from a contact form on Reobiz - Multipurpose Business WordPress Theme (http://rstheme.com/products/wordpress/reobiz)
Reply-To: [your-email]




Reobiz - Multipurpose Business WordPress Theme "[your-subject]"
Reobiz - Multipurpose Business WordPress Theme <support@rstheme.com>
[your-email]
Message Body:
[your-message]

-- 
This e-mail was sent from a contact form on Reobiz - Multipurpose Business WordPress Theme (http://rstheme.com/products/wordpress/reobiz)
Reply-To: support@rstheme.com



Thank you for your message. It has been sent.
There was an error trying to send your message. Please try again later.
One or more fields have an error. Please check and try again.
There was an error trying to send your message. Please try again later.
You must accept the terms and conditions before sending your message.
The field is required.
The field is too long.
The field is too short.
There was an unknown error uploading the file.
You are not allowed to upload files of this type.
The file is too big.
There was an error uploading the file.
The date format is incorrect.
The date is before the earliest one allowed.
The date is after the latest one allowed.
The number format is invalid.
The number is smaller than the minimum allowed.
The number is larger than the maximum allowed.
The answer to the quiz is incorrect.
The e-mail address entered is invalid.
The URL is invalid.
The telephone number is invalid.