<form class="gap-no read_m">
  <div class="form-box pa_m">
    <label for="form-box-name" class="mini-label required">Your name</label>
    <input type="text" class="input" id="form-box-name" name="form-box-name" value="Jeff Besoz" required placeholder="Jeff Besoz">
    <div class="mini-info">Please provide your first and last name</div>
  </div>
  <div class="form-box pa_m">
    <label for="form-box-message" class="mini-label">Your message to Santa Claus</label>
    <textarea class="textarea" name="form-box-message" id="form-box-message" rows="10">Dear Mister Claus,</textarea>
  </div>
  <input type="submit" class="button block prime pa_m" value="Send to Santa">
</form>