<!DOCTYPE html>
<html lang="en">

<head>
  <meta charset="UTF-8">
  <meta http-equiv="X-UA-Compatible" content="IE=edge">
  <meta name="viewport" content="width=device-width, initial-scale=1.0">
  <title>Document</title>
</head>


<!-- stylesheet: https://codepen.io/colorlib/pen/KVoZyv -->


<body>
  <div class="container">
    <form id="contact" onsubmit="return postToGoogle();">
      <h3>Contact Form</h3>
      <h4>Connect with us</h4>
      <fieldset>
        <input  placeholder="Your name"
                type="text" 
                name="entry.517626622" 
                data-name="Name" 
                id="Name" 
                required>
      </fieldset>
      <fieldset>
        <input 
                placeholder="Your Email Address" 
                type="email" 
                name="entry.935048337" 
                data-name="Email" 
                id="Email" 
                required>
      </fieldset>
      <fieldset>
        <input 
                placeholder="Your Phone Number" 
                type="tel" 
                name="entry.1737955681" 
                data-name="Phone" 
                id="Phone" 
                required>
      </fieldset>
      <fieldset>
        <textarea 
                placeholder="Type your message here...." 
                data-name="Message" 
                id="Message" 
                name="entry.354351359" 
                required>
        </textarea>
      </fieldset>
      <fieldset>
        <button type="submit" id="contact-submit">Submit</button>
      </fieldset>
    </form>
  </div>

  <script>
    function postToGoogle() {
      var field1 = $("#Name").val();
      var field2 = $("#Email").val();
      var field3 = $("#Phone").val();
      var field4 = $("#Message").val();

      $.ajax({
        url: "https://docs.google.com/forms/u/0/d/e/1FAIpQLSf2PfhlJGAZr7r6ia7HQRGVHXUmF3nxLMIpmRyg9qnRelMu_g/formResponse",
        data: {
          "entry.517626622": field1,
          "entry.935048337": field2,
          "entry.1737955681": field3,
          "entry.354351359": field4
        },
        type: "POST",
        dataType: "xml",
        success: function (d) {
          $('#contact').trigger('reset');
        },
        error: function (x, y, z) {
          $('#contact').trigger('reset');
        }
      });
      return false;
    }
  </script>
  <script src="https://ajax.googleapis.com/ajax/libs/jquery/3.3.1/jquery.min.js"></script>

</body>

</html>