<form name="contact-form">
<span><i class="fa fa-pencil-square-o"></i> الاسم </span>
<br />
<input id="ContactForm1_contact-form-name" name="name" size="30" type="text" value="" />  
<br />
<span><i class="fa fa-envelope-o"></i> البريد الالكترونى <span style="color: #f56954; font-size: x-small; font-weight: bold;">مهم</span></span> 
<br />
<input id="ContactForm1_contact-form-email" name="email" size="30" type="text" value="" />  
<br />
<span><i class="fa fa-keyboard-o"></i> الرسالة <span style="color: #f56954; font-size: x-small; font-weight: bold;">مهم</span></span>
<textarea cols="25" id="ContactForm1_contact-form-email-message" name="email-message" rows="5"></textarea> 
<input id="ContactForm1_contact-form-submit" type="button" value="Send" />  
<div style="max-width: 222px; text-align: center; width: 100%;">
<div id="ContactForm1_contact-form-error-message">
</div>
<div id="ContactForm1_contact-form-success-message">
</div>
</div>
</form>
<style scoped="" type="text/css">
#comments,.post_meta,#blog-pager {display:none;}
#ContactForm1_contact-form-name, #ContactForm1_contact-form-email{
height:auto;margin:5px auto;padding:10px;background:#fafafa;color:#444;border:1px solid #ccc;border-radius:3px;box-sizing:border-box;-webkit-box-sizing:border-box;-moz-box-sizing:border-box;transition:all 0.5s ease-out;}
#ContactForm1_contact-form-email-message{width:100%;height:175px;margin:5px 0;padding:10px;background:#fafafa;color:#444;font-family:'Open Sans',sans-serif;border:1px solid #ccc;border-radius:3px;transition:all 0.5s ease-out;}
#ContactForm1_contact-form-name:focus, #ContactForm1_contact-form-email:focus, #ContactForm1_contact-form-email-message:focus{outline:none;background:#fff;color:#444;border-color:rgba(81,203,238,1);box-shadow:0 0 5px rgba(81,203,238,0.7);}
#ContactForm1_contact-form-submit{font-family:'Open Sans';float:left;background:#cf4d35;color:#fff;margin:10px auto;vertical-align:middle;cursor:pointer;padding:10px 18px!important;font-weight:700;font-size:14px;text-align:center;text-transform:uppercase;letter-spacing:.5px;border-radius:4px;border:0;transition:all .8s ease}
#ContactForm1_contact-form-submit:hover {background:#e45a40;color:#fff;}
#ContactForm1_contact-form-error-message, #ContactForm1_contact-form-success-message{width:100%;margin-top:35px;}
.contact-form-error-message-with-border {background:#f6f6f6;border:none;box-shadow:none;color:#444;padding:5px 0;}
.contact-form-success-message {background:#4fc3f7;border:none;box-shadow:none;color:#fff;}
img.contact-form-cross {line-height:40px;margin-left:5px;}
@media only screen and (max-width:640px){
#ContactForm1_contact-form-name, #ContactForm1_contact-form-email,#ContactForm1_contact-form-submit{width:100%;}}
</style>