<form class="form-horizontal well well-lg" role="form" method="post" action="index.php">

    <div class="form-group">
        <label for="name" class="col-sm-3 control-label">Name</label>
        <div class="col-sm-8">
            <input type="text" class="form-control" id="name" name="name" placeholder="First & Last Name" value="">
        </div>
    </div>
    <div class="form-group">
        <label for="email" class="col-sm-3 control-label">Email</label>
        <div class="col-sm-8">
            <input type="email" class="form-control" id="email" name="email" placeholder="example@domain.com" value="">
        </div>
    </div>
    <div class="form-group">
        <label for="message" class="col-sm-3 control-label">Message</label>
        <div class="col-sm-8">
            <textarea class="form-control" rows="4" name="message"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label for="human" class="col-sm-3 control-label">2 + 3 = ?</label>
        <div class="col-sm-8">
            <input type="text" class="form-control" id="human" name="human" placeholder="Your Answer">
        </div>
    </div>
    <div class="form-group">
        <div class="col-sm-8 col-sm-offset-3">
          <input type="submit" name="submit" type="submit" class="btn btn-primary btn-success pull-right" value="Send"></input>
        </div>
    </div>
    <div class="form-group">
        <div class="col-sm-8 col-sm-offset-3">
            <! Will be used to display an alert to the user>
        </div>
    </div>

</form>