<label> [text* your-name placeholder "Your Name"] </label>

<label> [email* your-email placeholder "Email Address"] </label>

<label> [tel* tel-363 placeholder "Mobile Number"] </label>

<label> [tel* tel-237 placeholder "Alternet Mobile Number"] </label>

<label> <b>Select Course</b>
[checkbox* checkbox-119 use_label_element "Ph.D. (Education)" "M.Ed." " B.Ed. " "B.Ed. M.Ed. Integrated" "D.El.Ed." "M.A. (Education)" "Diploma in Guidance & Counseling" "B.Com.(C.A./Plain)" "B.A.(C.A./Plain)" "M.A.(Psychology)"] </label>

[text text-134 placeholder "In short, write your question !"]

[submit "Submit"]