<div id="requestQuote" class="hiddenfromview clearfix">
                        <div id="requestQuoteText"><p>Pureti <strong>Transforms</strong> Surfaces into <br/>Self-cleaning, Air Purifying Materials.</p></div>
                        <form name="requestQuoteForm" enctype="multipart/form-data" class="collectionform" id="Form322" method="post" action="/request-info.html">
                                <input type="hidden" value="417" name="collection">
                                <div class="collectionformfields">
                                        <div id="fieldsleft">

                                            <div id="Field_Collection_322_1" class="collectionfield">
                                                    <label id="Label_Collection_322_1" for="Collection_322_1">Name <span class="required">*</span></label> 
                                                    <input type="text" value="" size="25" maxlength="255" id="Collection_322_1" placeholder="Name" name="Collection_417_1" autocomplete="off" title="Please enter your First and Last Name in this field" class="input">
                                            </div> 

                                            <div id="Field_Collection_322_2" class="collectionfield">
                                                    <label id="Label_Collection_322_2" for="Collection_322_2">Email <span class="required">*</span></label> 
                                                    <input type="text" value="" size="25" maxlength="255" id="Collection_322_2" placeholder="Email" name="Collection_417_2" autocomplete="off" title="Please enter your First and Last Name in this field" class="input">
                                            </div>  
                                        </div>        

                                             <div id="Field_Collection_322_3" class="collectionfield">
                                                    <label id="Label_Collection_322_3" for="Collection_322_3">Message <span class="required">*</span></label> 
                                                    <textarea title="" class="input" id="Collection_322_3" placeholder="Message" name="Collection_417_3" cols="40" rows="5"></text{{**}}area>
                                            </div>  


                                            <div class="collectionsubmit"><input type="submit" value="Submit" name="Save" class="button"></div>     
                                </div>
                        </form>
                </div>