<style type="text/css">
.form-style-6 {font: 95% Arial, Helvetica, sans-serif; max-width: 400px; margin: 10px auto; padding: 16px; background: #24578a;}
.form-style-6 h1 {background: #24578a; padding: 10px 0; font-size: 160%; font-weight: 600; text-align: center; color: #fff; margin: -10px -10px 10px -10px;}

.form-style-6 input[type="text"], .form-style-6 input[type="date"], .form-style-6 input[type="datetime"], .form-style-6 input[type="email"], .form-style-6 input[type="number"], .form-style-6 input[type="search"], .form-style-6 input[type="time"], .form-style-6 input[type="url"], .form-style-6 textarea, .form-style-6 select {-webkit-transition: all 0.30s ease-in-out; -moz-transition: all 0.30s ease-in-out; -ms-transition: all 0.30s ease-in-out; -o-transition: all 0.30s ease-in-out; outline: none; box-sizing: border-box; -webkit-box-sizing: border-box; -moz-box-sizing: border-box; width: 100%; background: #fff; margin-bottom: 2%; border: 1px solid #ccc; padding: 3%; color: #555; font: 95% Arial, Helvetica, sans-serif;}

.form-style-6 input[type="text"]:focus, .form-style-6 input[type="date"]:focus, .form-style-6 input[type="datetime"]:focus, .form-style-6 input[type="email"]:focus, .form-style-6 input[type="number"]:focus, .form-style-6 input[type="search"]:focus, .form-style-6 input[type="time"]:focus, .form-style-6 input[type="url"]:focus, .form-style-6 textarea:focus,
.form-style-6 select:focus {box-shadow: 0 0 5px #24578a; padding: 3%; border: 1px solid #24578a;}
.form-style-6 input[type="submit"], .form-style-6 input[type="button"] {box-sizing: border-box; -webkit-box-sizing: border-box; -moz-box-sizing: border-box; width: 100%; padding: 3%; background: #24578a; border-bottom: 2px solid #24578a; border-top-style: none; border-right-style: none; border-left-style: none; color: #fff; font-weight:600; font-family: 'Roboto', sans-serif; font-size: 20px;}
.form-style-6 input[type="submit"]:hover, .form-style-6 input[type="button"]:hover {background: #24578a; opacity:0.8; }

<style type="text/css">
.form-style-6{font: 95% Arial, Helvetica, sans-serif; max-width: 400px; margin: 10px auto; padding: 16px; background: #24578a;}
.form-style-6 h1{background: #24578a; padding: 10px 0; font-size: 160%; font-weight: 600; text-align: center; color: #fff; margin: -10px -10px 10px -10px;}

.form-style-6 input[type="text"], .form-style-6 input[type="date"], .form-style-6 input[type="datetime"], .form-style-6 input[type="email"], .form-style-6 input[type="number"], .form-style-6 input[type="search"], .form-style-6 input[type="time"], .form-style-6 input[type="url"], .form-style-6 textarea, .form-style-6 select {-webkit-transition: all 0.30s ease-in-out; -moz-transition: all 0.30s ease-in-out; -ms-transition: all 0.30s ease-in-out; -o-transition: all 0.30s ease-in-out; outline: none; box-sizing: border-box; -webkit-box-sizing: border-box; -moz-box-sizing: border-box; width: 100%; background: #fff; margin-bottom: 2%; border: 1px solid #ccc; padding: 3%; color: #555; font: 95% Arial, Helvetica, sans-serif;}

.form-style-6 input[type="text"]:focus, .form-style-6 input[type="date"]:focus, .form-style-6 input[type="datetime"]:focus, .form-style-6 input[type="email"]:focus, .form-style-6 input[type="number"]:focus, .form-style-6 input[type="search"]:focus, .form-style-6 input[type="time"]:focus, .form-style-6 input[type="url"]:focus, .form-style-6 textarea:focus, .form-style-6 select:focus {box-shadow: 0 0 5px #24578a; padding: 3%; border: 1px solid #24578a;}

.form-style-6 input[type="submit"], .form-style-6 input[type="button"] {box-sizing: border-box; -webkit-box-sizing: border-box; width: 100%; padding: 3%; background: #24578a; border-bottom: 2px solid #24578a; border-top-style: none; border-right-style: none; border-left-style: none; color: #fff; font-weight:600; font-family: 'Roboto', sans-serif; font-size: 20px;}

.form-style-6 input[type="submit"]:hover, .form-style-6 input[type="button"]:hover {background: #24578a; opacity:0.8;}

.verif-contain {width:60px; margin-left:auto; margin-right:auto; margin-bottom:15px;}

.contact-output {padding:0;	padding-bottom:20px;}

.antiSpam {display: none;}