<div class="cons-contact-form">
<div class="section-head left wt-small-separator-outer">
<div class="wt-small-separator site-text-primary">
<div class="sep-leaf-left"></div>
<div>Formulaire de contact</div><div class="sep-leaf-right"></div></div><h2>Restons en contact</h2></div>
<div class="row">
<div class="col-lg-12 col-md-12">
<div class="form-group"><input name="username" type="text" required="" class="form-control" placeholder="Nom"></div>
</div>
<div class="col-lg-12 col-md-12">
<div class="form-group"><input name="email" type="text" class="form-control" required="" placeholder="Email"></div>
</div>
<div class="col-lg-12 col-md-12">
<div class="form-group"><input name="phone" type="text" class="form-control" required="" placeholder="Téléphone"></div>
</div>
<div class="col-lg-12 col-md-12">
<div class="form-group"><input name="subject" type="text" class="form-control" required="" placeholder="Sujet"></div>
</div>
<div class="col-md-12">
<div class="form-group"><textarea name="message" class="form-control" rows="4" placeholder="Message"></textarea></div>
</div>
<div class="col-md-12"><button type="submit" class="site-button site-btn-effect">Envoyer</button></div>
</div>
</div>