<div class="contact_form_elements row">
    <div class="contact_form_name input-icons">
<i class="fa fa-user icon"></i>[text* c_name class:ctxt placeholder "Enter your name here"]
    </div>
    <div class="c_form_email input-icons">
<i class="fa fa-envelope icon"></i>[email* c_email class:ctxt placeholder "Enter email address here"]
    </div>
    <div class="c_form_message input-icons">
<i class="fa fa-pencil icon"></i>[textarea c_message class:ctxts placeholder "Enter message here"]
    </div>
    <div class="contact_checkbox">
        [checkbox* c_check class:c_check use_label_element "I agree to the Terms & Conditions"]
    </div>
    <div class="contact_form_button">
        [submit id:c_submit class:c_submit "Submit Request"]
    </div>
</div>