<div class="mt30">
                        <div class="row">
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label>Name *</label>[text* name id:name class:form-control]
                                </div>
                            </div>
                            <div class="col-md-6">
                                <div class="form-group">
                                    <label>E-mail *</label>[text* email id:email class:form-control ]
                                </div>
                            </div>
                        </div>
                        <div class="form-group">
                            <label>Message *</label>[textarea* message id:message class:form-control x3]
                        </div>
<div class="form-group">
                  <label>Captcha</label>   [captchac captcha-286 size:m] [captchar captcha-286 10/ ]
</div>
                         [submit class:btn class:btn-primary "Send Message"]
                        
</div>