Capture qualified leads with company details, role, and intent.
Exactly what visitors will see on your site
Every field in this template, ready to use out of the box.
Full Name
text · required
email · required
Company
text · required
Job Title
text · required
Phone (optional)
tel · optional
What are you looking for?
select · required
Choose HTML for static sites or React for component-based apps. Replace YOUR_FORM_ID with your Flowqen endpoint ID.
<formaction="https://flowqen.com/api/f/YOUR_FORM_ID"method="POST"class="max-w-xl mx-auto rounded-[32px] border border-white/10 bg-[#1f1a17] px-6 py-7 shadow-[0_28px_90px_rgba(23,16,12,0.28)] sm:px-8"><h2 class="text-2xl font-semibold tracking-tight text-white mb-6">Get in Touch</h2><div class="space-y-4"><div><label class="mb-1.5 block text-sm font-medium text-stone-200">Full Name</label><input type="text" name="full_name" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" placeholder="Jane Doe" required /></div><div><label class="mb-1.5 block text-sm font-medium text-stone-200">Email</label><input type="email" name="email" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" placeholder="jane@example.com" required /></div><div><label class="mb-1.5 block text-sm font-medium text-stone-200">Company</label><input type="text" name="company" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" placeholder="Acme Inc." required /></div><div><label class="mb-1.5 block text-sm font-medium text-stone-200">Job Title</label><input type="text" name="job_title" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" placeholder="e.g. Marketing Manager" required /></div><div><label class="mb-1.5 block text-sm font-medium text-stone-200">Phone (optional)</label><input type="tel" name="phone" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition placeholder:text-stone-400 focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" placeholder="+1 (555) 000-0000" /></div><div><label class="mb-1.5 block text-sm font-medium text-stone-200">What are you looking for?</label><select name="looking_for" class="w-full rounded-[20px] border border-white/10 bg-white/5 px-4 py-3 text-sm text-white outline-none transition focus:border-[#ff8a6c] focus:ring-4 focus:ring-[#E14E3A]/18" required><option value="">Select...</option><option value="Option A">Option A</option><option value="Option B">Option B</option><option value="Option C">Option C</option><option value="Other">Other</option></select></div></div><!-- Honeypot (spam protection) --><div style="display:none"><input type="text" name="_gotcha" style="display:none" /></div><button type="submit" class="mt-6 w-full rounded-[20px] bg-white py-3 text-sm font-semibold text-[#201814] transition hover:bg-stone-100">Submit</button></form>
A lead capture form template is designed to collect high-quality sales leads from your website. This HTML form gathers company name, job title, and what the prospect is looking for, giving your sales team the context they need to follow up effectively. A staple for B2B landing pages, gated content, and marketing campaigns.
Common questions about lead capture form templates.
Other free templates in the same category.
Create your form in 30 seconds — pre-filled with all the fields above. Free forever.