<form id="dc-form" class="dc-form" action=" https://crm.zoho.com/crm/WebToLeadForm" method="POST" name="WebToLeadsxxxxx" onsubmit="return check_form(this)" _lpchecked="1">

<div class="dc-form-fields">

<input name="xnQsjsdp" type="hidden" value="xxxxx">

<input id="zc_gad" name="zc_gad" type="hidden" value="">

<input name="xmIwtLD" type="hidden" value="xxxxxx">

<input name="actionType" type="hidden" value="xxxxxx=">

<input style="display: none;" name=" returnURL" type="text" value="http://www.inspirationgroup.biz/ty/?testparam=testval&testparm2=val2">

<input id="Lead-Source" name="Lead Source" type="hidden" value="xxxxx">

<input id="name" name="Last Name" type="text" placeholder="שם">

<input id="mail" name="Email" type="text" placeholder="דואר אלקטרוני">

<input id="phone" name="Phone" type="tel" placeholder="מספר טלפון">

<input class="dc-form-submit" id="dc-form-submit" value="שלח >>" type="submit">

</div>

</form>