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Lead Capture6 fields

Lead Capture

Capture qualified leads with company details, role, and intent.

Spam protectionEmail notificationsAI sales agentSubmission dashboardNo backend needed

Live Preview

Exactly what visitors will see on your site

Get in Touch

What you'll collect

Every field in this template, ready to use out of the box.

Full Name

text · required

Email

email · required

Company

text · required

Job Title

text · required

Phone (optional)

tel · optional

What are you looking for?

select · required

Copy the Code

Choose HTML for static sites or React for component-based apps. Replace YOUR_FORM_ID with your Flowqen endpoint ID.

<form
action="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>

What is a Lead Capture?

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.

Frequently Asked Questions

Common questions about lead capture form templates.

More Lead Capture templates

Other free templates in the same category.

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