">
    <div class="feedback-data">
        <input type="text" name="name" placeholder="Name">
        <input type="text" name="mail" placeholder="Mail">

        <div class="captcha">
            <p><?php 
echo Translations::Translate('Enter symbols');
?>
 <br> <?php 
echo Translations::Translate('in the picture');
?>
</p>
            <?php 
$cap = new DwCaptcha();
$capObj = $cap->GetRandomCaptcha();
?>
            <input type="hidden" name="cap_id" value="<?php 
echo $capObj->GetId();
?>
">
            <img style="width: 90px; height: 40px" src="<?php 
echo $capObj->GetImgUrl();
?>
" alt="kaptcha">
            <input name="cap" type="text" >
        </div><!-- /captcha -->

    </div><!-- /feedback-data -->

    <div class="feedback-message">