ura.design/request.html

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section_id: contact
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      <h3>Email Us</h3>
      <p>Convinced yet? If you need some design magic for your open source project, send us your submission so we can help you. Don’t worry if you are on a tight budget!</p>
  <p>Fields marked with an * are required.</p>
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          <p id='thanks' class='hide'>
            Thanks for contacting us, we'll be in touch soon!
          </p>
              <p>First Name *<br />
          <input class='required' name='name' placeholder='NAME' type='text'></p>
              <p>Last Name *<br />
          <input class='required' name='surname' placeholder='SURNAME' type='text'</p>
              <p>E-mail *<br />
          <input class='required email' name='email' placeholder='EMAIL' type='text'></p>
              <p>What services do you need? *<br />
              <input type="checkbox" name="Logo" value="1"> Logo<br />
              <input type="checkbox" name="Brand Identity Guide" value="0"> Brand Identity Guide<br />
              <input type="checkbox" name="Style Guide" value="0"> Style Guide<br />
              <input type="checkbox" name="Documentation" value="0"> Documentation<br />
              <input type="checkbox" name="Consultancy" value="0"> Consultancy<br /></p>
              <p>Your open source project name *<br />
          <input class='required' name='project name' placeholder='Project Name' type='text'></p>
              <p>Tell us about your open source project, the more details, the better: *<br />
                    <textarea class='required' name='message' placeholder='Details'></textarea></p>
              <p>Your budget (USD $) *<br />
                    <blockquote>If your budget is 0, we suggest a pledge for Ura with at least $2 (suggested: $5) on Patreon. This allows us to keep helping projects and buy coffee when working.</blockquote>
                  <input class='required' name='budget' placeholder='0' type='number' min="0" max="9999999"></p>
            <p>Enter your bid and we will get back to you with a time & cost estimate.</p>
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          <input class='submit' type='submit'>
        </form>
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