
<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Name</label>
    <input class="cf_inputbox" maxlength="150" size="30" title="" id="text_0" name="text_0" type="text" />
  
  </div>
  <div class="cfclear">&nbsp;</div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Phone</label>
    <input class="cf_inputbox" maxlength="150" size="30" title="" id="text_1" name="text_1" type="text" />
  
  </div>
  <div class="cfclear">&nbsp;</div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Email</label>
    <input class="cf_inputbox" maxlength="150" size="30" title="" id="text_4" name="text_4" type="text" />
  
  </div>
  <div class="cfclear">&nbsp;</div>
</div>

<div class="form_item">
  <div class="form_element cf_textbox">
    <label class="cf_label" style="width: 150px;">Where would you like to open a 30 Minute Hit, and when?</label>
    <input class="cf_inputbox" maxlength="150" size="30" title="" id="text_6" name="text_6" type="text" />
  
  </div>
  <div class="cfclear">&nbsp;</div>
</div>

<div class="form_item">
  <div class="form_element cf_textarea">
    <label class="cf_label" style="width: 150px;">How did you hear about us?</label>
    <textarea class="cf_inputbox" rows="3" id="text_2" title="" cols="30" name="text_2"></textarea>
    
  </div>
  <div class="cfclear">&nbsp;</div>
</div>
