<div class="pure-u-1 pure-u-md-1-3">
<label for="last-name">Last Name</label>
<input id="last-name" class="pure-u-23-24" type="text">
</div>
<div class="pure-u-1 pure-u-md-1-3">
<label for="email">E-Mail</label>
<input id="email" class="pure-u-23-24" type="email" required>
</div>
<div class="pure-u-1 pure-u-md-1-3">
<label for="city">City</label>
<input id="city" class="pure-u-23-24" type="text">
</div>
<div class="pure-u-1 pure-u-md-1-3">
<label for="state">State</label>
<select id="state" class="pure-input-1-2">
<option>AL</option>
<option>CA</option>
<option>IL</option>
</select>
</div>
</div>
<fieldset class="pure-group">
<input type="text" class="pure-input-1-2" placeholder="A title">
<textarea class="pure-input-1-2" placeholder="Your message"></textarea>
</fieldset>
<button type="submit" class="pure-button pure-button-primary">Send</button>