__contactus.liquid 2.7 KB

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  1. <h4 >Get a quote</h4>
  2. <form id="form_contact" data-action="/contact" class="form-default" role="form">
  3. <input type="hidden" name="_token" value="{{ csrf_token }}">
  4. <input type="hidden" name="consulting_products" value="{{product.title }}">
  5. <div class="row">
  6. <div class="col-md-6">
  7. <div class="form-group has-feedback">
  8. <label for="" class="text-uppercase c-gray-light">Your name</label>
  9. <input type="text" name="customer_name" class="form-control form-control-lg" required>
  10. <span class="glyphicon form-control-feedback" aria-hidden="true"></span>
  11. <div class="help-block with-errors"></div>
  12. </div>
  13. </div>
  14. <div class="col-md-6">
  15. <div class="form-group has-feedback">
  16. <label for="" class="text-uppercase c-gray-light">Email address</label>
  17. <input type="email" name="email" class="form-control form-control-lg" required>
  18. <span class="glyphicon form-control-feedback" aria-hidden="true"></span>
  19. <div class="help-block with-errors"></div>
  20. </div>
  21. </div>
  22. </div>
  23. <div class="row">
  24. <div class="col-md-6">
  25. <div class="form-group has-feedback">
  26. <label for="" class="text-uppercase c-gray-light">Company name</label>
  27. <input type="text" name="company_name" class="form-control form-control-lg">
  28. <span class="glyphicon form-control-feedback" aria-hidden="true"></span>
  29. <div class="help-block with-errors"></div>
  30. </div>
  31. </div>
  32. <div class="col-sm-6">
  33. <div class="form-group has-feedback">
  34. <label for="" class="text-uppercase c-gray-light">Phone/whats_app</label>
  35. <input type="text" name="whats_app" class="form-control form-control-lg" required>
  36. <span class="glyphicon form-control-feedback" aria-hidden="true"></span>
  37. <div class="help-block with-errors"></div>
  38. </div>
  39. </div>
  40. </div>
  41. <div class="row">
  42. <div class="col-md-12">
  43. <div class="form-group has-feedback">
  44. <label for="" class="text-uppercase c-gray-light">Message</label>
  45. <textarea name="content" class="form-control no-resize" rows="5" required></textarea>
  46. <span class="glyphicon form-control-feedback" aria-hidden="true"></span>
  47. <div class="help-block with-errors"></div>
  48. </div>
  49. </div>
  50. </div>
  51. <div class="">
  52. <button type="reset" class="btn-reset d-none"></button>
  53. <button type="submit" class="btn btn-styled btn-base-1 mt-4">Send message</button>
  54. </div>
  55. </form>