This is a sample contact form ( via free, highly popular Contact Form 7 Plugin). You can place it wherever you want, even multiple times with different attributes.
[contact-form-7 id=”358″ title=”Contact form 1″]
Mix text with images and embeds
JPG, PNG or GIF
MP3 or SoundCloud embed, MixCloud, etc.
MP4 or YouTube embed, Vimeo, Dailymotion, etc.
A collection of images
Facebook post, Twitter status, etc.
External site's link
Everyone can submit new list items and vote up for the best submission
Everyone can vote up for the best list item
A list-based article
Create a funny pic
What do you know about ...?
What type of person are you?
One or multiple questions about a subject or person
A poll where each question has two competing answers
Hot or Not
A poll where each question has two opposite answers