Request4 fields

Callback Request

Let visitors request a callback at their preferred time.

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Copy the Code

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

<form
  action="https://rowen.in/api/f/YOUR_FORM_ID"
  method="POST"
  class="max-w-lg mx-auto bg-white rounded-2xl shadow-sm border border-gray-200 p-8"
>
  <h2 class="text-xl font-bold text-gray-900 mb-6">Request a Callback</h2>

  <div class="space-y-4">
    <div>
      <label class="block text-sm font-medium text-gray-700 mb-1">Full Name</label>
      <input type="text" name="full_name" class="w-full border border-gray-300 rounded-lg px-4 py-2.5 text-sm focus:outline-none focus:ring-2 focus:ring-[#E14E3A]/20 focus:border-[#E14E3A]" placeholder="Jane Doe" required />
    </div>

    <div>
      <label class="block text-sm font-medium text-gray-700 mb-1">Phone</label>
      <input type="tel" name="phone" class="w-full border border-gray-300 rounded-lg px-4 py-2.5 text-sm focus:outline-none focus:ring-2 focus:ring-[#E14E3A]/20 focus:border-[#E14E3A]" placeholder="+1 (555) 000-0000" required />
    </div>

    <div>
      <label class="block text-sm font-medium text-gray-700 mb-1">Best Time to Call</label>
      <select name="best_time" class="w-full border border-gray-300 rounded-lg px-4 py-2.5 text-sm focus:outline-none focus:ring-2 focus:ring-[#E14E3A]/20 focus:border-[#E14E3A]" required>
        <option value="">Select...</option>
        <option value="Morning">Morning</option>
        <option value="Afternoon">Afternoon</option>
        <option value="Evening">Evening</option>
      </select>
    </div>

    <div>
      <label class="block text-sm font-medium text-gray-700 mb-1">Regarding</label>
      <textarea name="regarding" rows="4" class="w-full border border-gray-300 rounded-lg px-4 py-2.5 text-sm focus:outline-none focus:ring-2 focus:ring-[#E14E3A]/20 focus:border-[#E14E3A] resize-none" placeholder="What is this about?" required></textarea>
    </div>
  </div>

  <!-- Honeypot (spam protection) -->
  <div style="display:none">
    <input type="text" name="_gotcha" style="display:none" />
  </div>

  <button type="submit" class="w-full bg-[#E14E3A] text-white py-3 rounded-lg font-semibold hover:bg-[#c9432f] transition mt-6">
    Request Callback
  </button>
</form>

What is a Callback Request?

A callback request form template lets website visitors ask your team to call them back at a convenient time. This HTML form collects a phone number, preferred time slot, and a brief description of what the call is about. Ideal for sales teams, customer service departments, and professional services.

Frequently Asked Questions

Common questions about request form templates.

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