<div class="form-custom">
<label> Your name *</label>
    [text* your-name] 

<label> Email address *</label>
[text* your-email]

<div class="row-inline row">
<div><label> Phone number *</label>
[text* your-phone]
</div>
<div> <label>Date of birth *</label>
[email* your-date]
</div>
</div>
<label> Address *</label>
[text* your-address]

<label> Occupation:</label>
[text* your-occupation]

<div>
[submit "Submit"]
</div>
</div>