/home/kkco/public_html/home__2939f42/include/brosur_umb.php
<form id="emf-form" target="_self" enctype="multipart/form-data" method="post" action="http://www.emailmeform.com/builder/form/32tGRpqdy9uNamjrc0Z5">
<b>Nama Lengkap</b>
<input id="element_0" name="element_0" value="" size="40" class="form-control validate[required]" type="text" />
<b>Email</b>
<input id="element_1" name="element_1" class="form-control validate[required,custom[email]]" value="" size="40" type="text" />
<b>No HP</b>
<input id="element_2" name="element_2" class="form-control validate[required,custom[onlyNumber]]" value="" size="40" type="text" />
<b>Alamat Lengkap</b>
<textarea id="element_3" name="element_3" cols="45" rows="10" class="form-control validate[optional] "></textarea>
<br>
<input name="element_counts" value="4" type="hidden" />
<input name="embed" value="forms" type="hidden" /><input value="KIRIM" class="btn btn-success btn-block" type="submit" />
</form>