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<form name="" id="" method="post">
            
			<div class="form-group" id="form-group-title">
			    <div class="form-title">Name</div>
			    <div class="form-block">
			        <input class="form-control" type="text" id="title" name="title" value="" placeholder="请输入Name">
			    </div>
		        			</div>
                    
			<div class="form-group" id="form-group-ip">
			    <div class="form-title">IP</div>
			    <div class="form-block">
			        <input class="form-control" type="text" id="ip" name="ip" value="0" placeholder="请输入IP">
			    </div>
		        			</div>
                    
			<div class="form-group" id="form-group-tel">
			    <div class="form-title">Phone</div>
			    <div class="form-block">
			        <input class="form-control" type="text" id="tel" name="tel" value="" placeholder="请输入Phone">
			    </div>
		        			</div>
                    
			<div class="form-group" id="form-group-email">
			    <div class="form-title">Email</div>
			    <div class="form-block">
			        <input class="form-control" type="text" id="email" name="email" value="" placeholder="请输入Email">
			    </div>
		        			</div>
                    
			<div class="form-group" id="form-group-content">
			    <div class="form-title">Message</div>
			    <div class="form-block">
			        <textarea class="form-control" id="content" name="content" placeholder="请输入Message"></textarea>
			    </div>
		        			</div>
                    
			<div class="form-group" id="form-group-whatsapp">
			    <div class="form-title">Whastapp/Wechat</div>
			    <div class="form-block">
			        <input class="form-control" type="text" id="whatsapp" name="whatsapp" value="" placeholder="请输入Whastapp/Wechat">
			    </div>
		        			</div>
                    
			<div class="form-group" id="form-group-iparea">
			    <div class="form-title">IP地区</div>
			    <div class="form-block">
			        <input class="form-control" type="text" id="iparea" name="iparea" value="" placeholder="请输入IP地区">
			    </div>
		        			</div>
        	<div class="form-button">
		<input type="submit" name="submit" id="submit" value="提交">
		<input type="reset" name="reset" id="reset" value="重置">
	</div>
</form>