<div class="row">
	<div class="col-xs-12 col-sm-6">
		<div class="input-style-1 type-2 color-2">
[text text-151 placeholder "Enter your name"]
		</div>
	</div>
	<div class="col-xs-12 col-sm-6">
		<div class="input-style-1 type-2 color-2">
[text text-151 placeholder "Enter your email"]
		</div>
	</div>
	<div class="col-xs-12 col-sm-6">
		<div class="input-style-1 type-2 color-2">
[text text-151 placeholder "Enter your name"]
		</div>
	</div>	
	<div class="col-xs-12 col-sm-6">
		<div class="drop-wrap drop-wrap-s-3 color-2">
		  	<div class="drop">
			 	<b>Department</b>
				<a href="#" class="drop-list"><i class="fa fa-angle-down"></i></a><span><a href="#">01 kids</a><a href="#">02 kids</a><a href="#">03 kids</a><a href="#">04 kids</a><a href="#">05 kids</a></span>
		   	</div>
		</div>						
	</div>
	<div class="col-xs-12 text-center">
		<textarea class="area-style-1 color-1" required="" placeholder="Enter your comment"></textarea>
		<button type="submit" class="c-button bg-dr-blue-2 hv-dr-blue-2-o"><span>submit comment</span></button>
	</div>
</div>