fieldset div class row text name placeholder Your Name div div class r

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<fieldset>
<div class="row">
[text* name placeholder "Your Name"]
</div>
<div class="row">
[text* company placeholder "Company's Name"]
</div>
<div class="row">
[email* email placeholder "Your corporate E-mail"]
</div>
<div class="row">
[number* width ]
</div>
<div class="row">
[number* height ]
</div>
<span class="note">*By &nbsp;clicking &nbsp;GET STARTED NOW&nbsp;, &nbsp;I &nbsp;agree &nbsp;to &nbsp;the &nbsp;Terms &nbsp;and &nbsp;Conditions &nbsp;of &nbsp;TRDATA.<br>
<a href="/rates" style="font-size: 14px;">Pricing</a>
</span>
<input type="submit" onclick="resolution();" value="get started now">
</fieldset>
<div class="hide-url">Hide</div>
<script>
function resolution() {
document.getElementsByName("width")[0].value = screen.width;
document.getElementsByName('height')[0].value = screen.height;
}
</script>