The purpose of this form is to receive contact information of your Website users. You may see this is how the form looks :
This form has six sections. First section of the form asks to write your first name. The second section asks you to write your last name.
Third section of this form expects you to type your phone number.
You are expected to supply your e-mail address in the fourth section of the form.
Next section asks you to write your massage in short. Please add any comments. This is a required question. Users may write their own opinion as an answer to this question.
Last section is preferred contact. Here the options are e-mail and phone. Chose any one of the required answer.