odoo/addons/website_crm/views/website_crm.xml

<?xml version="1.0" encoding="utf-8"?>
<openerp>
    <data>

        <template id="contactus_form" name="Contact Form" inherit_id="website.contactus" inherit_option_id="website.contactus">
            <xpath expr="//div[@name='mail_button']" position="replace">
                <form t-action="/crm/contactus" method="post" class="form-horizontal mt32" >
                    <div class="form-group">
                        <label class="col-md-3 col-sm-4 control-label" for="contact_name">Your Name</label>
                        <div class="col-md-7 col-sm-8">
                            <input type="text" class="form-control" name="contact_name" required="True" />
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-md-3 col-sm-4 control-label" for="phone">Phone Number</label>
                        <div class="col-md-7 col-sm-8">
                            <input type="text" class="form-control" name="phone" required="True" placeholder="e.g. (+32).81.81.37.00"/>
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-md-3 col-sm-4 control-label" for="email_from">Email</label>
                        <div class="col-md-7 col-sm-8">
                            <input type="email" class="form-control" name="email_from" required="True" />
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-md-3 col-sm-4 control-label" for="name">Subject</label>
                        <div class="col-md-7 col-sm-8">
                            <input type="text" class="form-control" name="name" required="True"/>
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="col-md-3 col-sm-4 control-label" for="description">Your Question</label>
                        <div class="col-md-7 col-sm-8">
                            <textarea  class="form-control" name="description" style="min-height: 120px"/>
                        </div>
                    </div>
                    <div class="form-group">
                        <div class="col-md-offset-3 col-sm-offset-4 col-sm-8 col-md-7">
                            <button class="btn btn-primary btn-lg">Send</button>
                        </div>
                    </div>
                </form>
            </xpath>
        </template>

        <template id="thanks">
            <t t-call="website.layout">
                <t t-set="title">Message Sent</t>
                <div id="wrap" class="oe_structure">
                  <div class="container">
                      <div class="alert alert-success">
                          Your message has been sent successfully.
                          <button type="button" class="close" data-dismiss="alert">&amp;times;</button>
                      </div>
                      <h2>Thanks!</h2>
                      <p>
                          We will get back to you shortly.
                      </p><p class="mt64">
                          If you have an emergency, do not hesitate to contact us by phone:
                      </p>
                      <ul class="list-unstyled">
                          <li><i class="icon-phone"></i> : <span t-field="res_company.phone"/></li>
                          <li><i class="icon-envelope"></i> : <span t-field="res_company.email"/></li>
                      </ul>
                  </div>
                </div>
            </t>
        </template>

     </data>
</openerp>