<div class="roofing-form-wrapper clearfix">
<div class="roofing-form-inner clearfix">
<div class="col-md-12">[text* fname class:roofing-form-input placeholder "Name"]</div>
<div class="col-md-12">[email* mail class:roofing-form-input placeholder "Email"]</div>
<div class="col-md-12">[text* phone class:roofing-form-input placeholder "Phone"]</div>
<div class="col-md-12">[textarea* address 40x5 class:roofing-form-textarea placeholder "Address"]</div>
<div class="col-md-12">[submit class:roofing-form-button "Submit"]</div>
</div>
</div>