<div class="farmart-contact-member">
<div class="field-input"><label><span class="email-icon fm-icon"><i aria-hidden="true" class="icon-envelope"></i></span>[email* your-email placeholder "Email"]</label></div>

<div class="field-input"><label><span class="password-icon fm-icon"><i aria-hidden="true" class="icon-lock"></i></span>[password* password placeholder "Password "]</label></div>

<div class="field-input"><label><span class="password-icon fm-icon"><i aria-hidden="true" class="icon-rotation-lock"></i></span>[password* re-password placeholder "Re-type Password"]</label></div>
</div>

<div class="field-submit">[submit "Register Now"]</div>