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<style>
#ss-form input:focus ~ label,
#ss-form textarea:focus ~ label,
#ss-form input:valid ~ label,
#ss-form textarea:valid ~ label {
font-size: 0.75em;
color: #8e44ad;
top: -2.25rem;
-webkit-transition: all 0.125s ease;
transition: all 0.125s ease;
}
#ss-form .styled-input {
width: 33.3333%;
margin: 2rem 0 1rem;
padding: 0;
position: relative;
}
#ss-form .styled-input-in {
position: relative;
}
#ss-form .styled-input label {
color: #999;
padding: 1rem;
position: absolute;
top: 0;
left: 0;
-webkit-transition: all 0.25s ease;
transition: all 0.25s ease;
pointer-events: none;
line-height: 1;
font-family: "Helvetica", "Arial", sans-serif;
}
#ss-form .styled-input.wide {
width: 100%;
}
#ss-form input,
#ss-form textarea {
padding: 1rem 1rem;
border: 1px solid #ddd;
width: 100%;
font-size: 1rem;
background: #fafafa;
-moz-box-sizing: border-box;
-webkit-box-sizing: border-box;
box-sizing: border-box;
font-family: "Helvetica", "Arial", sans-serif;
}
#ss-form input ~ .span1,
#ss-form textarea ~ .span1 {
display: block;
width: 0;
height: 3px;
background: #8e44ad;
position: absolute;
left: 50%;
-webkit-transition: width 0.4s ease-in-out;
transition: width 0.4s ease-in-out;
}
#ss-form input ~ .span2,
#ss-form textarea ~ .span2 {
display: block;
width: 0;
height: 3px;
background: #8e44ad;
position: absolute;
right: 50%;
-webkit-transition: width 0.4s ease-in-out;
transition: width 0.4s ease-in-out;
}
#ss-form input ~ span {
bottom: 0;
}
#ss-form input:focus,
#ss-form textarea:focus {
outline: 0;
}
#ss-form input:focus ~ .span1,
#ss-form textarea:focus ~ .span1,
#ss-form input:focus ~ .span2,
#ss-form textarea:focus ~ .span2 {
width: 50%;
}
#ss-form textarea {
width: 100%;
min-height: 15em;
}
#ss-form .btn {
font-family: "Helvetica", "Arial", sans-serif;
text-transform: uppercase;
font-size: 14px;
font-weight: 800;
letter-spacing: 1px;
border-radius: 0;
padding: 0 25px;
height: 51px;
line-height: 51px;
color: #333;
background-color: #fafafa;
border: 1px solid #ddd;
cursor: pointer;
margin: 10px 0 0;
background-image: none;
}
#ss-form .btn-default:hover,
#ss-form .btn-default:focus {
background-color: #8e44ad;
border: 1px solid #0400bf;
color: white;
outline: 0;
}
#iframe_uexxnchh {
display:none;
}
</style>
<iframe name="iframe_uexxnchh" id="iframe_uexxnchh" onload="if(typeof sent_uexxnchh!='undefined'){window.location='http://www.kompiajaib.com/p/thank-you.html';}"></iframe>
<form action="https://docs.google.com/forms/d/1sl9QeTcAFyYQBO4QXZY7KqnWfEFBjPRE13dmCpJvjVg/formResponse" method="POST" id="ss-form" target="iframe_uexxnchh" onsubmit="sent_uexxnchh=true">
<div class="styled-input">
<div class="styled-input-in">
<input type="text" aria-label="Name" name="entry.2005620554" value="" id="entry.2005620554" dir="auto" title="" required="required">
<label>Name</label>
<span class="span1"></span><span class="span2"></span>
</div>
</div>
<div class="styled-input">
<div class="styled-input-in">
<input type="email" aria-label="Email" name="entry.1045781291" value="" id="entry.1045781291" dir="auto" title="Must be a valid email address" required="required">
<label>Email</label>
<span class="span1"></span><span class="span2"></span>
</div>
</div>
<div class="styled-input wide">
<div class="styled-input-in">
<textarea aria-label="Comments" name="entry.839337160" rows="8" cols="0" id="entry.839337160" dir="auto" aria-required="true" required="required"></textarea>
<label>Message</label>
<span class="span1"></span><span class="span2"></span>
</div>
</div>
<input name="draftResponse" type="hidden" value="[,,"7188574060914369684"]">
<input name="pageHistory" type="hidden" value="0">
<input name="fbzx" type="hidden" value="7188574060914369684">
<button type="submit" name="submit" class="btn btn-default">Send</button>
</div>
</form>