<div class="qodef-grid qodef-layout--columns qodef-col-num--1"> 
    <div class="qodef-grid-inner">
        <div class="qodef-grid-item">
             [text* your-name placeholder "Name"] 
        </div>
    </div> 
</div> 
<div class="qodef-grid qodef-layout--columns qodef-col-num--1"> 
    <div class="qodef-grid-inner">
        <div class="qodef-grid-item">
             [email* your-email placeholder "Email"] 
        </div>
    </div> 
</div>
<div class="qodef-grid qodef-layout--columns qodef-col-num--1"> 
    <div class="qodef-grid-inner">
        <div class="qodef-grid-item">
             [tel* Phone placeholder "Number"]
        </div>
    </div> 
</div> 

<div class="qodef-grid qodef-layout--columns qodef-col-num--1"> 
    <div class="qodef-grid-inner">
        <div class="qodef-grid-item">
     [select* SelectCountry placeholder "Select Country " "Afghanistan" "	Albania" "	Algeria" "	American Samoa" "	Andorra" "	Angola" "	Anguilla" "	Antarctica" "	Antigua And Barbuda" "Argentina" "	Armenia" "	Aruba" "	Australia" "	Austria" "	Azerbaijan" "	Bahamas" "	Bahrain" "	Bangladesh" "	Barbados" "	Belarus" "	Belgium" "	Belize" "	Benin" "	Bermuda" "	Bhutan" "	Bolivia" "	Bosnia And Herzegowina" "	Botswana" "	Bouvet Island" "	Brazil" "	British Indian Ocean Territory" "	Brunei Darussalam" "	Bulgaria" "	Burkina Faso" "	Burundi" "	Cambodia" "	Cameroon" "	Canada" "	Cape Verde" "	Cayman Islands" "	Central African Republic" "	Chad" "	Chile" "	China" "	Christmas Island" "	Cocos (Keeling) Islands" "	Colombia" "	Comoros" "	Congo" "	Congo, The Democratic Republic Of The" "	Cook Islands" "	Costa Rica" "	Cote D'Ivoire" "	Croatia (Local Name: Hrvatska)" "	Cuba" "	Cyprus" "	Czech Republic" "	Denmark" "	Djibouti" "	Dominica" "	Dominican Republic" "	Ecuador" "	Egypt" "	El Salvador" "	Equatorial Guinea" "	Eritrea" "	Estonia" "	Ethiopia" "	Falkland Islands (Malvinas)" "	Faroe Islands" "	Fiji" "	Finland" "	France" "	France, Metropolitan" "	French Guiana" "	French Polynesia" "	French Southern Territories" "	Gabon" "	Gambia" "	Georgia" "	Germany" "	Ghana" "	Gibraltar" "	Greece" "	Greenland" "	Grenada" "	Guadeloupe" "	Guam" "	Guatemala" "	Guinea" "	Guinea-Bissau" "	Guyana" "	Haiti" "	Heard And Mc Donald Islands" "	Holy See (Vatican City State)" "	Honduras" "	Hong Kong" "	Hungary" "	Iceland" "	India" "	Indonesia" "	Iran (Islamic Republic Of)" "	Iraq" "	Ireland" "	Israel" "	Italy" "	Jamaica" "	Japan" "	Jordan" "	Kazakhstan" "	Kenya" "	Kiribati" "	Korea, Democratic People's Republic Of" "	Korea, Republic Of" "	Kuwait" "	Kyrgyzstan" "	Lao People's Democratic Republic" "	Latvia" "	Lebanon" "	Lesotho" "	Liberia" "	Libyan Arab Jamahiriya" "	Liechtenstein" "	Lithuania" "	Luxembourg" "	Macau" "	Macedonia, Former Yugoslav Republic Of" "	Madagascar" "	Malawi" "	Malaysia" "	Maldives" "	Mali" "	Malta" "	Marshall Islands" "	Martinique" "	Mauritania" "	Mauritius" "	Mayotte" "	Mexico" "	Micronesia, Federated States Of" "	Moldova, Republic Of" "	Monaco" "	Mongolia" "	Montenegro" "	Montserrat" "	Morocco" "	Mozambique" "	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" "	Pitcairn" "	Poland" "	Portugal" "	Puerto Rico" "	Qatar" "	Reunion" "	Romania" "	Russian Federation" "	Rwanda" "	Saint Kitts And Nevis" "	Saint Lucia" "	Saint Vincent And The Grenadines" "	Samoa" "	San Marino" "	Sao Tome And Principe" "	Saudi Arabia" "	Senegal" "	Serbia" "	Seychelles" "	Sierra Leone" "	Singapore" "	Slovakia (Slovak Republic)" "	Slovenia" "	Solomon Islands" "	Somalia" "	South Africa" "	South Georgia, South Sandwich Islands" "	Spain" "	Sri Lanka" "	St. Helena" "	St. Pierre And Miquelon" "	Sudan" "	Suriname" "	Svalbard And Jan Mayen Islands" "	Swaziland" "	Sweden" "	Switzerland" "	Syrian Arab Republic" "	Taiwan" "	Tajikistan" "	Tanzania, United Republic Of" "	>Thailand" "	Timor-Leste (East Timor)" "	Togo" "	Tokelau" "	Tonga" "	Trinidad And Tobago" "	Tunisia" "	Turkey" "	Turkmenistan" "	Turks And Caicos Islands" "	Tuvalu" "	Uganda" "	Ukraine" "	United Arab Emirates" "	United Kingdom" "	United States" "	United States Minor Outlying Islands" "	Uruguay" "	Uzbekistan" "	Vanuatu" "	Venezuela" "	Viet Nam" "	Virgin Islands (British)" "	Virgin Islands (U.S.)" "	Wallis And Futuna Islands" "	Western Sahara" "	Yemen" "	Yugoslavia" "	Zambia" "Zimbabwe"]
        </div>
    </div> 
</div> 
 <div class="qodef-grid qodef-layout--columns qodef-col-num--1"> 
    <div class="qodef-grid-inner">
        <div class="qodef-grid-item">
            [textarea your-message placeholder "Messages"]
        </div>
    </div>
</div>
<div class="qodef-grid qodef-layout--columns qodef-col-num--1"> 
    <div class="qodef-grid-inner">
        <div class="qodef-grid-item"> 
            [submit "Send message" ]
        </div>
    </div>
</div>