<section style="max-width:800px;margin:auto;padding:40px 20px;background:#fff;border-radius:8px;">
  
<h2>Request Towing Service</h2>
<p>Fill out the form below and we will contact you as soon as possible.</p>

<form action="#" method="POST" style="display:flex;flex-direction:column;gap:15px;">

<input type="text" name="name" placeholder="Full Name" required 
style="padding:12px;border:1px solid #ccc;border-radius:5px;">

<input type="tel" name="phone" placeholder="Phone Number" required 
style="padding:12px;border:1px solid #ccc;border-radius:5px;">

<input type="text" name="location" placeholder="Your Location" required 
style="padding:12px;border:1px solid #ccc;border-radius:5px;">

<select name="service" required style="padding:12px;border:1px solid #ccc;border-radius:5px;">
<option value="">Select Service</option>
<option>Emergency Towing</option>
<option>Flatbed Towing</option>
<option>Jump Start</option>
<option>Lockout Service</option>
<option>Tire Change</option>
</select>

<textarea name="message" placeholder="Describe your issue..." rows="4"
style="padding:12px;border:1px solid #ccc;border-radius:5px;"></textarea>

<button type="submit" style="background:#e11d48;color:#fff;padding:15px;border:none;border-radius:5px;font-size:16px;">
GET HELP NOW
</button>

</form>

</section>