<div class="main">

<div class="my_form">
		<label for="field1"><span>Name <span class="required">*</span></span><input type="text" class="input-field" name="field1" value="" placeholder="Full Name" /></label>
		<label for="field2"><span>Email <span class="required">*</span></span><input type="email" class="input-field" name="field2" value="" placeholder="example@mail.com" /></label>
		<label for="field3"><span>Phone <span class="required">*</span></span><input type="text" class="input-field" name="field3" value="" placeholder="9963 XX XX X8" /></label>
		<label for="field4"><span>Subject</span><select name="field4" class="select-field">
		<option value="">Select One</option>
		<option value="Sample Menu 1">Sample Menu 1</option>
		<option value="Sample Menu 2">Sample Menu 2</option>
		<option value="Sample Menu 3">Sample Menu 3</option>
		<option value="Sample Menu 4">Sample Menu 4</option>
		<option value="Sample Menu 5">Sample Menu 5</option>
		<label for="field6"><span>Message <span class="required">*</span></span><textarea name="field6" class="textarea-field" placeholder="Sample Message"></textarea></label>
		<label><span>&nbsp;</span><input type="submit" value="Submit" /></label>

.main{ margin:40px auto 20px !important; width:450px;}
    max-width: 450px;
    font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif;
.my_form label{
    margin-bottom: 10px;
.my_form label > span{
    float: left;
    width: 100px;
    color: #000;
    font-weight: bold;
    font-size: 13px;
    text-shadow: 1px 1px 1px #fff;
.my_form fieldset{
    border-radius: 3px;
    -webkit-border-radius: 3px;
    -moz-border-radius: 3px;
    margin: 0px 0px 10px 0px;
    border: 1px solid #FFD2D2;
    padding: 20px;
    background: #B4ECFF;
    box-shadow: inset 0px 0px 15px #0099da;
    -moz-box-shadow: inset 0px 0px 15px #0099da;
    -webkit-box-shadow: inset 0px 0px 15px #0099da;
.my_form fieldset legend{
    color: #000;
    border-top: 1px solid #5ECBFF;
    border-left: 1px solid #5ECBFF;
    border-right: 1px solid #5ECBFF;
    border-radius: 5px 5px 0px 0px;
    -webkit-border-radius: 5px 5px 0px 0px;
    -moz-border-radius: 5px 5px 0px 0px;
    padding: 0px 8px 3px 8px;
    box-shadow: -0px -1px 2px #F1F1F1;
    -moz-box-shadow:-0px -1px 2px #F1F1F1;
    -webkit-box-shadow:-0px -1px 2px #F1F1F1;
    font-weight: normal;
    font-size: 12px;
	margin:0px 0 10px;
.my_form textarea{
.my_form input[type=text],
.my_form input[type=date],
.my_form input[type=datetime],
.my_form input[type=number],
.my_form input[type=search],
.my_form input[type=time],
.my_form input[type=url],
.my_form input[type=email],
.my_form select, 
.my_form textarea{
    border-radius: 3px;
    -webkit-border-radius: 3px;
    -moz-border-radius: 3px;
    border: 1px solid #55C8FF;
    outline: none;
    color: #000;
    padding: 5px 8px 5px 8px;
    box-shadow: inset 1px 1px 4px #FFD5E7;
    -moz-box-shadow: inset 1px 1px 4px #FFD5E7;
    -webkit-box-shadow: inset 1px 1px 4px #FFD5E7;
    background: #FFEFF6;
.my_form  input[type=submit],
.my_form  input[type=button]{
    background: #09C;
    border: 1px solid #09C;
    padding: 6px 35px;
    color: #FFF;
    box-shadow: inset -1px -1px 3px #0099da;
    -moz-box-shadow: inset -1px -1px 3px #0099da;
    -webkit-box-shadow: inset -1px -1px 3px #0099da;
    border-radius: 3px;
    border-radius: 3px;
    -webkit-border-radius: 3px;
    -moz-border-radius: 3px;    
    font-weight: bold;

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