Вот код самой формы:
<form class="form text-top" method="post" id="order_form">
<div class="fields incon pad-invert"> <div class="incon" style="width: auto;"> <div class="field" data-type="name">
<div class="name"> <div class=""> Имя <span class="required">*</span> </div> </div> <div class="input">
<input type="text" name="name" class="form-control" style="border-radius: 30px; border-color: rgb(220, 220, 220); color: rgb(49, 49, 49); background-color: rgba(246, 246, 246, 0.439216);">
</div> </div> </div><div class="incon" style="width: auto;"> <div class="field" data-type="phone"> <div class="name"> <div class=""> Телефон <span class="required">*</span> </div> </div> <div class="input">
<input type="text" name="phone" class="form-control" style="border-radius: 30px; border-color: rgb(220, 220, 220); color: rgb(49, 49, 49); background-color: rgba(246, 246, 246, 0.439216);">
</div> </div> </div> </div> <div class="macros-button"><div class="btn-out full xs-none"> <div class="btn-inner incon"> <button class="btn submit font-text" id="uid116" data-action="" hack-data-id="" data-ym_goal="" data-ga_category="" data-ga_action="" data-id="">
<span class="text">Получить скидку 70%</span>
<input onclick="AjaxFormRequest();" value=""> </button>
</style>
</div>
</div>
</div>
</form>
До меня делалось, возможно лишнего много.