<p>Nume (required)<br />
    [text* your-name] </p>

<p>Email (required)<br />
    [email* your-email] </p>

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

<p>Mesaj<br />
    [textarea your-message] </p>

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