<form action="https://designproboards.com/brand/ebookpublishingagency/lead" method="GET">
    <input type="hidden" name="brand_name" value="ebookpublishingagency.com">
    <input type="hidden" id="lead_area" name="lead_area" value="https://ebookpublishingagency.com/">
    <div class="row">
        <div class="col-md-6">
            <label class="field-txt">Name <span>*</span></label>
            <input name="name" minlength="2" type="text" placeholder="Enter your name" required>
        </div>
        <div class="col-md-6">
            <label class="field-txt">Email <span>*</span></label>
            <input type="email" name="email" placeholder="Enter email here" required>
        </div>
        <div class="col-md-12">
            <label class="field-txt">Phone Number<span>*</span></label>
            <input name="phone" minlength="11" maxlength="11" type="tel" placeholder="Phone Number" required>
        </div>
        <div class="col-md-12">
            <label class="field-txt">Additional Comments
                <span>*</span></label>
            <textarea name="message" placeholder="Enter message here" required></textarea>
        </div>
        <div class="col-md-12">
            <input class="submit" type="submit" value="Submit">

        </div>

    </div>
</form>