<p>Je naam (verplicht)<br />
    [text* your-name] </p>

<p>Je e-mail (verplicht)<br />
    [email* your-email] </p>

<p>Onderwerp<br />
    [text your-subject] </p>

<p>Je bericht<br />
    [textarea your-message] </p>

<p>[submit "Verzenden"]</p>