<div class="contact-us">
	<div class="row">
		<div class="col-xs-12 col-sm-6">
		  <div class="col-xs-12 col-sm-12">[text* your-name class:form-control placeholder "Name"]</div>
	   	  <div class="col-xs-12 col-sm-12">[email* your-email class:form-control placeholder "Email"]</div>
                  <div class="col-xs-12 col-sm-12">[tel your-phone class:form-control placeholder "Phone"]</div>
               </div>
	       <div class="col-xs-12 col-sm-6">
                    <div>[textarea your-message class:form-control placeholder "Message"]</div>
               </div>
<div class="col-xs-12 col-sm-12">
<div class="col-xs-12 col-sm-12">
                    <div class="clearfix">[submit class:btn class:pull-left class:btn-theme class:btn-inverse class:border-2 "Send Message"] 
                    </div></div>
        <div>        <div>
</div>