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<div class="container center">
        <!-- Header Section -->
        <p><span>CONTACT US</span><br>Nam porttitor blandit accumsan. Ut vel dictum sem, a pretium dui. In malesuada
        </p><br>
        <!-- Form Section -->
        <div class="form-box center">
            <form method="post">
                <div class="row1">
                    <div class="row1-1"><label for="fullname">FULL NAME</label><br><input type="text" name="fullname" id="fullname" minlength="6" pattern="[a-zA-Z]{6,}" required></div>
                    <div class="row1-2"><label for="phone">PHONE</label><br><input type="text" name="phone" id="phone" minlength="11" pattern="09[0-9]{9}" required></div>
                    <div class="row1-3"><label for="email">EMAIL</label><br><input type="email" name="email" id="email" required></div>
                </div><br>
                <div class="row2">
                    <div class="row2-1"><label for="gender">GENDER</label><br><select name="gender" id="gender" required>
                            <option value="" disabled selected>Please Select</option>
                            <option value="Male">Male</option>
                            <option value="Female">Female</option>
                            <option value="Other">Other</option>
                        </select></div>
                    <div class="row2-2"><label for="city">CITY</label><br><select name="ciry" id="city" required>
                            <option value="" disabled selected>Please Select</option>
                            <option value="Abrantes">Abrantes</option>
                            <option value="Beja">Beja</option>
                            <option value="Elvas">Elvas</option>
                            <option value="Guarda">Guarda</option>
                            <option value="Valbom">Valbom</option>
                        </select></div>
                </div><br>
                <div class="row3"><label for="message">MESSAGE</label><br><textarea placeholder="Nam porttior blandit accumsan" name="message" id="message" cols="70" rows="10"></textarea><br>
                </div>
                <br>
                <div class="submit center"><input type="submit" name="submit"></div>
            </form>
            <hr>
        </div>
    </div>