<div class="grid pixcode--grid">
<div class="grid__item  six-twelfths palm-one-whole">
[text* your-name placeholder "Prénom"]
</div>
<div class="grid__item  six-twelfths palm-one-whole">
[text* last-name placeholder "Nom"]
</div>
</div>
<div class="grid pixcode--grid">
<div class="grid__item  six-twelfths palm-one-whole">
[date* date id:date placeholder "Date"]
</div>
<div class="grid__item  six-twelfths palm-one-whole">
[select* time id:time "11h00" "11h30" "12h00" "12h30" "13h00" "13h30" "14h00" "14h30" "15h00" "15h30" "16h00" "16h30" "17h00" "17h30" "18h00" "18h30" "19h00" "19h30" "20h00" "20h30" "21h00" "21h30"]
</div>
</div>
<div class="grid pixcode--grid">
<div class="grid__item  six-twelfths palm-one-whole">
[select* type id:type "SOUPER ASSIS" "DÎNER ASSIS" "RÉCEPTION COCKTAIL"]
</div>
<div class="grid__item  six-twelfths palm-one-whole">
[number* guests min:10 id:guests placeholder "Nombre de personnes"]
</div>
</div>
<div class="grid pixcode--grid">
<div class="grid__item  six-twelfths palm-one-whole">
[tel* tel id:tel placeholder "Téléphone"]
</div>
<div class="grid__item  six-twelfths palm-one-whole">
[email* email id:email placeholder "Couriel"]
</div>
</div>
[submit "Envoyer"]