JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
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Your post is incomplete. I can only see the screenshot. There is no title or text. Please provide more details about the problem.
On the screenshot I can see that the form is not showing properly in mobile. Please refer to this guide on how to make your form mobile responsive.
Let us know if you have any questions. Thank you.