forked from verdnatura/hedera-web
55 lines
1.2 KiB
XML
Executable File
55 lines
1.2 KiB
XML
Executable File
<vn>
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<div id="form" class="contact">
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<div class="box">
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<div class="header">
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<h1><t>IWantCustomer</t></h1>
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</div>
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<div class="body">
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<p>
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<t>FillFormData</t>
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</p>
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<p>
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<t>OrCallUs</t>
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</p>
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<form action="forms/cms/contact/send-data.php" method="post" id="contact-form">
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<div class="form-group">
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<label><t>Name</t></label>
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<input type="text" name="name"/>
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</div>
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<div class="form-group">
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<label><t>City</t></label>
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<input type="text" name="city"/>
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</div>
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<div class="form-group">
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<label><t>PC</t></label>
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<input type="text" name="pc"/>
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</div>
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<div class="form-group">
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<label><t>Phone</t></label>
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<input type="text" name="phone"/>
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</div>
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<div class="form-group">
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<label><t>EMail</t></label>
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<input type="text" name="email"/>
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</div>
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<div class="form-group">
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<label><t>Message</t></label>
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<textarea name="message"/>
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</div>
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<div class="form-group captcha">
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<label><t>Anti-Spam</t></label>
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<img alt="Captcha" id="captcha-img"/>
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<input type="text" name="captcha"/>
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</div>
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<p>
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<t>AllFieldsMandatory</t>
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</p>
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<button class="flat">
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<t>Send</t>
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</button>
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</form>
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</div>
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</div>
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</div>
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</vn>
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