"Quick Contact"
Bootstrap 3.3.0 Snippet by tarasignh

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<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<!------ Include the above in your HEAD tag ---------->
<div class="container">
<div class="col-xs-12 col-sm-6 col-md-6 col-lg-6 col-offset-6 quickform">
<h2>Quick Contact</h2>
<form action="" method="get">
<input name="" type="text" placeholder="Name">
<input name="" type="text" placeholder="Email Id">
<input name="" type="text" placeholder="Phone No.">
<textarea name="" cols="" rows="" placeholder="Message"></textarea>
<button>Submit</button>
</form>
</div>
</div>
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.quickform { background:#000; padding:30px 25px;}
.quickform h2 { text-transform:uppercase; color:#FFF; margin:15px 0px;}
.quickform input { width:100%; height:auto; float:left; border:1px solid #fff; padding:12px 5px; color:#999; background:none; margin:0px 0px 20px 0px;}
.quickform textarea { width:100%; height:auto; min-height:230px; float:left; border:1px solid #fff; padding:8px 5px; color:#999; background:none; margin:0px 0px 20px 0px; resize:none;}
.quickform button { background:#CCC; color:#333; padding:8px 15px; border:1px solid #fff; background:none; font-size:12px; text-transform:uppercase; color:#fff;}
.quickform button:hover { background:#fff; color:#333;}
.quickform input[type="text"]:focus {
border-color: #66afe9;
outline: 0;
-webkit-box-shadow: inset 0 1px 1px rgba(0,0,0,.075), 0 0 8px rgba(102, 175, 233, 0.6);
box-shadow: inset 0 1px 1px rgba(0,0,0,.075), 0 0 8px rgba(102, 175, 233, 0.6);
}
.quickform textarea[type="text"]:focus {
border-color: #66afe9;
outline: 0;
-webkit-box-shadow: inset 0 1px 1px rgba(0,0,0,.075), 0 0 8px rgba(102, 175, 233, 0.6);
box-shadow: inset 0 1px 1px rgba(0,0,0,.075), 0 0 8px rgba(102, 175, 233, 0.6);
}
.quickform textarea:focus {
border-color: #66afe9;
outline: 0;
-webkit-box-shadow: inset 0 1px 1px rgba(0,0,0,.075), 0 0 8px rgba(102, 175, 233, 0.6);
box-shadow: inset 0 1px 1px rgba(0,0,0,.075), 0 0 8px rgba(102, 175, 233, 0.6);
}
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