<div class="row">
<div class="col-sm-12"><label for="name">Enter Your Name</label>[text* your-name placeholder "Enter Your Name"]</div> 
<div class="col-sm-12"><label for="name">Enter Your Email</label>[email* your-email placeholder "Enter Your Email"]</div>
<div class="col-sm-12"><label for="name">Type of Insurance</label> [select* insurancetype include_blank "Health Insurance" "Car Insurance" "Home Insurance" "Business Insurance" "Life Insurance" "Travel Insurance"]</div>
<div class="col-sm-12"><label for="name">Your Employment</label>[text* your-employment placeholder "Your Employment"]</div>
<div class="col-sm-12"><label for="name">Annual Income</label>[text* annual-income placeholder "Annual Income"]</div>

<div class="form-button col-sm-12">
  <p class="submit-btn">[submit "Get Quote Now"]</p>
</div>
</div>