<div class="row clearfix">
<div class="col-lg-4 col-md-6 col-sm-12 form-group">[text* your-name placeholder "Your Name*"]</div>
<div class="col-lg-4 col-md-6 col-sm-12 form-group">[email* your-email placeholder "Email Address*"]</div>
<div class="col-lg-4 col-md-12 col-sm-12 form-group">[select menu-450 include_blank "Policing & Crime" "Housing & Land" "Health & Medical" "Tourism & Travel"]</div>
<div class="col-lg-12 col-md-12 col-sm-12 form-group">
[textarea your-message placeholder "Write your complaints or Suggestions ..."]
[submit class:message-btn "Send"]
</div>
</div>