<div class="container">
    <div class="row">
        <div class="col-sm-12 col-md-3 col-lg-3 "></div>
        <div class="col-sm-12 col-md-6 col-lg-6 ">
            <div class="whitebox marg40col pad25px_left pad25px_right forgotform">
                <div class="form-top">
                    <div class="form-top-left">
                        <h3>Feedback</h3>
                    </div>
                    <div class="form-top-right">

                    </div>
                </div>
                <div class="form-bottom signup_form">
                    <div class="{PageContext::$response->message['msgClass']}">{PageContext::$response->message['msg']}</div>
                    <form name="frmfeedback" id="frmfeedback" action="" method="post" role="form">

                        <div class="form-group relative">
                            <input type="text"  name="sender_name" class="margtop10 form-control" placeholder="Name" required="true" >
                            <label class="error" style="display:none;" generated="true" for="sender_name"></label>
                            {literal}
                            <input type="email"  name="sender_email" class="form-email margtop10 form-control" placeholder="Your Email" required="true"  pattern="[a-z0-9._%+-]+@[a-z0-9.-]+\.[a-z]{2,63}$" >
                            {/literal}
                            <label class="error" style="display:none;" generated="true" for="user_email"></label>
                            <input type="text"  name="email_subject" class="margtop10 form-control" placeholder="Subject" required="true" >
                            <textarea name="email_description" class="margtop10 form-control" placeholder="Your Feedback Here" required="true"></textarea>
                        </div>
                        <input type="submit" name="btnSubmit" data-loading-text="Loading..." class="btn btn-primary yellow_btn2" value="Send">
                    </form>
                </div>
            </div>
        </div>
        <div class="col-sm-12 col-md-2 col-lg-2 "></div>
    </div>
</div>