<div class="grid pixcode--grid">
<div class="grid__item  six-twelfths palm-one-whole">
[text* your-name placeholder "First Name"]
</div>
<div class="grid__item  six-twelfths palm-one-whole">
[text* last-name placeholder "Last Name"]
</div>
</div>
<div class="grid pixcode--grid">
<div class="grid__item  six-twelfths palm-one-whole">
[date* date id:date placeholder "Party Date"]
</div>
<div class="grid__item  six-twelfths palm-one-whole">
[select* time id:time "11:00" "11:30" "12:00" "12:30" "13:00" "13:30" "14:00" "14:30" "15:00" "15:30" "16:00" "16:30" "17:00" "17:30" "18:00" "18:30" "19:00" "19:30" "20:00" "20:30" "21:00" "21:30"]
</div>
</div>
<div class="grid pixcode--grid">
<div class="grid__item  six-twelfths palm-one-whole">
[select* type id:type "SEATED DINNER" "SEATED LUNCH" "COCKTAIL RECEPTION"]
</div>
<div class="grid__item  six-twelfths palm-one-whole">
[number* guests min:10 id:guests placeholder "Number of Guests"]
</div>
</div>
<div class="grid pixcode--grid">
<div class="grid__item  six-twelfths palm-one-whole">
[tel* tel id:tel placeholder "Phone"]
</div>
<div class="grid__item  six-twelfths palm-one-whole">
[email* email id:email placeholder "Email"]
</div>
</div>
[submit "Send Request"]
1
Reservation from [your-name] [last-name]
[your-name] <info@restaurantvago.com>
info@restaurantvago.com
From: [your-name] <[email]>
Subject: Reservation from [your-name] [last-name]

Reservation for [your-name] [last-name]
Date:[date][time]
Type:[type]
Guests:[guests]

Contact info:
Tel:[tel]
Email:[email]
Reply-To: [email]




[your-subject]
[your-name] <[your-email]>
[your-email]
Message Body:
[your-message]

--
This e-mail was sent from a contact form on Rosa (http://pixelgrade.com/demos/rosa2)




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