<div style="margin-bottom: 40px;" class="fusion-one-third fusion-layout-column fusion-spacing-yes">[text* your-name placeholder "Name"]</div>
<div style="margin-bottom: 40px;" class="fusion-one-third fusion-layout-column fusion-spacing-yes">[email* your-email placeholder "Email"]</div>
<div style="margin-bottom: 40px;" class="fusion-one-third fusion-layout-column fusion-column-last fusion-spacing-yes">[text* your-name placeholder "Subject"]</div>

<div style="margin-bottom: 40px;" class="fusion-one-half fusion-layout-column fusion-spacing-yes">[select menu-962 "Choose Your Course" "Physics Course" "Biology Course" "Sports Science Course" "Economics Course" "Graphic Design Course" "Music Production Course"]</div>
<div style="margin-bottom: 40px;" class="fusion-one-half fusion-layout-column fusion-column-last fusion-spacing-yes">[number* your-number min:18 max:100 step:1 "18"]</div>

<p style="margin-bottom: 40px;">[textarea your-message placeholder "Your Message"]</p>
<p>[submit class:fusion-button class:fusion-xlarge, class:button-default class:"Apply Now"] </p>