hedera-web/forms/cms/contact/ui.xml

<vn>
<h1 id="title">
	<t>IWantCustomer</t>
</h1>
<div id="main" class="contact">
	<form
		id="contact-form">
		<input type="hidden" name="srv" value="json:misc/contact"/>
	<div class="card form">
		<p>
			<t>FillFormData</t>
		</p>
		<p>
			<t>OrCallUs</t>
		</p>
		<div>
			<label><t>Name</t></label>
			<input type="text" name="name"/>
		</div>
		<div>
			<label><t>City</t></label>
			<input type="text" name="city"/>
		</div>
		<div>
			<label><t>PC</t></label>
			<input type="text" name="pc"/>
		</div>
		<div>
			<label><t>Phone</t></label>
			<input type="text" name="phone"/>
		</div>
		<div>
			<label><t>EMail</t></label>
			<input type="text" name="email"/>
		</div>
		<div>
			<label><t>Message</t></label>
			<textarea name="message"/>
		</div>
		<div class="form-group captcha">
			<label><t>Anti-Spam</t></label>
			<input type="text" name="captcha"/>
			<img alt="Captcha" id="captcha-img"/>
		</div>
		<p class="mandatory-message">
			<t>AllFieldsMandatory</t>
		</p>
		<button class="thin">
			<t>Send</t>
		</button>
	</div>
	</form>
</div>
</vn>