forked from verdnatura/hedera-web
55 lines
995 B
XML
Executable File
55 lines
995 B
XML
Executable File
<vn>
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<h1 id="title">
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_IWantCustomer
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</h1>
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<div id="main" class="contact">
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<form
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id="contact-form">
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<input type="hidden" name="srv" value="json:misc/contact"/>
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<div class="card form">
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<p>
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_FillFormData
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</p>
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<p>
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_OrCallUs
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</p>
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<div>
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<label>_Name</label>
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<input type="text" name="name"/>
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</div>
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<div>
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<label>_City</label>
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<input type="text" name="city"/>
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</div>
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<div>
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<label>_PC</label>
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<input type="text" name="pc"/>
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</div>
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<div>
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<label>_Phone</label>
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<input type="text" name="phone"/>
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</div>
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<div>
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<label>_EMail</label>
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<input type="text" name="email"/>
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</div>
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<div>
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<label>_Message</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>_Anti-Spam</label>
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<input type="text" name="captcha"/>
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<img alt="Captcha" id="captcha-img"/>
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</div>
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<p class="mandatory-message">
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_AllFieldsMandatory
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</p>
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<button class="thin">
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_Send
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</button>
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</div>
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</form>
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</div>
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</vn>
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