<p>Your Name (required)<br />
    [text* your-name] </p>

<p>Your Email (required)<br />
    [email* your-email] </p>

<p>Address<br />
[text address]

<p>Phone<br />
[text phone]

<p>Subject<br />
   [select subject "Prayer" "Testimony" "Question" "Other"]</p>

<p>Your Message<br />
    [textarea your-message] </p>

<p>[submit "Send"]</p>