<form action="https://designproboards.com/brand/floridaseomarketers/lead" method="GET" class="validate-popupform">
    <input type="hidden" name="brand_name" value="floridaseomarketers.com">
    <input type="hidden" id="lead_area" name="lead_area" value="https://floridaseomarketers.com/signup/">
    <div class="input-main" bis_skin_checked="1">
        <div class="form-group" bis_skin_checked="1">
            <input type="text" name="name" class="form-control input-box" placeholder="Full Name" required="">
        </div>
        <div class="form-group" bis_skin_checked="1">
            <input type="text" name="email" class="form-control input-box" placeholder="Email Address" required="">
        </div>
        <div class="form-group" bis_skin_checked="1">
            <input type="tel" name="phone" maxlength="30" class="form-control input-box" placeholder="Phone Number"
                required="">
        </div>
        <div class="form-group" bis_skin_checked="1">
            <textarea class="form-control" id rows="3" name="message" value="" placeholder="Description"></textarea>
        </div>
        <div class="form-btn" bis_skin_checked="1">
            <button type="submit" class="btn submit hvr-bounce-to-right">
                Get Your Free Proposal
            </button>
        </div>
    </div>
</form>