system: Linux mars.sprixweb.com 3.10.0-1160.119.1.el7.x86_64 #1 SMP Tue Jun 4 14:43:51 UTC 2024 x86_64
cmd: 

Direktori : /.trash/home/uniflox/public_html/templates/
Upload File :
Current File : //.trash/home/uniflox/public_html/templates/request_form.html

 <!-- Intro Area
        ===================================== -->
        <header class="pt100 pb100 parallax-window-2" data-parallax="scroll" data-speed="0.5" data-image-src="assets/img/bg/new-img-bg-2.jpg" data-positionY="1000">
            <div class="intro-body text-center">
                <div class="container">
                    <div class="row">
                        <div class="col-md-12 pt50">
                            <h1 class="brand-heading font-montserrat text-uppercase color-light" data-in-effect="fadeInDown">
                                Let's Talk
                                <small class="color-light alpha7">CONTACT US AND WE WILL RESPOND WITHIN 24 HOURS</small>
                            </h1>
                        </div>
                    </div>
                </div>

            </div>
        </header>


        <!-- Contact Us Area
        =====================================-->
        <div id="contact" class="pt50 pb100">
            <div class="container">
                <div class="row">

                    <div class="col-md-6">
                        <div class="row">

                            <!-- title start -->
                            <div class="col-md-12 mb50">
                                <h1 class="font-size-normal color-black">
                                    <small class="color-blue">Request Pricing</small>
                                    Drop Us a Message
                                </h1>
                                <h5 class="color-dark">If you are interested in finding out more about how we can help your organization, please fill out the form below.</h5>
                            </div>
                            <!-- title end -->

                            <!-- contact info start -->
                            <div class="col-md-12 col-sm-3 col-xs-12">
                                <span class="icon-map color-blue el-icon2x"></span>
                                <h5 class="color-black"><strong>Address</strong></h5>
                                <p class="color-black">42, Street No 7, Near Govt. School, Khemkaran, Tarn Taran, Punjab, 143419</p>
                            </div>

                            <div class="col-md-3 col-sm-3 col-xs-6">
                                <span class="icon-megaphone color-blue el-icon2x"></span>
                                <h5 class="color-black"><strong>Phone</strong></h5>
                                <p class="color-black">+91-80700-79700</p>
                            </div>

                            <div class="col-md-3 col-sm-3 col-xs-6">
                                <span class="icon-envelope color-blue el-icon2x"></span>
                                <h5 class="color-black"><strong>Email</strong></h5>
                                <p class="color-black">sale@uniflox.com</p>
                            </div>
                            <!-- contact info end -->

                        </div><!-- row left end -->
                    </div><!-- col left end -->

                    <div class="col-md-6">
                        <div class="contact contact-us-two border-primary">
                            <div class="col-sm-12 col-xs-12 text-center mb20">
                                <h4 class="pb25 bb-solid-1 text-uppercase">
                                    Pricing Request Form
                                    <small class="text-lowercase">Please complete the form and we will get back to you.</small>
                                </h4>
                            </div>
                            <form name="contactform" id="contactForm" method="post" action="assets/php/send.php">

                                <!-- fullname start -->
                                <div class="form-group col-md-6 col-sm-6 col-xs-12">
                                    <input type="text" name="senderName" id="senderName" class="input-md input-rounded form-control" placeholder="Fullname" maxlength="100" required>
                                </div>
                                <!-- fullname end -->

                                <!-- email start -->
                                <div class="form-group col-md-6 col-sm-6 col-xs-12">
                                    <input type="email" name="senderEmail" id="senderEmail" class="input-md input-rounded form-control" placeholder="Enter Email Address" maxlength="100" required>
                                </div>
                                 <!-- email end -->

                                <!-- website start -->
                                <div class="form-group col-md-6 col-sm-6 col-xs-12">
                                    <input type="text" name="senderWebsite" id="senderWebsite" class="input-md input-rounded form-control" placeholder="Enter Contact Number" maxlength="100">
                                </div>
								 <div class="form-group col-md-6 col-sm-6 col-xs-12">
                                    <select name="txtservices" id="services" class="input-md input-rounded form-control">
									  <option value="Website Design">Website Design</option>
									  <option value="Web Development">Web Development</option>
									  <option value="Mobile App">Mobile App</option>
									  <option value="Ecommerce Website">Ecommerce Website</option>
									  <option value="SEO">SEO</option>
									  <option value="SMO">SMO</option>
									  <option value="PPC">PPC</option>
									</select>
								</div>
                                <!-- website end -->
								<div class="form-group col-md-6 col-sm-6 col-xs-12">
                                    <input type="text" name="senderWebsite" id="senderWebsite" class="input-md input-rounded form-control" placeholder="Enter Your Budget" maxlength="100">
                                </div>
                                <!-- security start -->
                                <div class="form-group col-md-6 col-sm-6 col-xs-12">
                                    <input type="text" name="senderHuman" id="senderHuman" class="input-md input-rounded form-control" placeholder="" required>
                                    <input type="hidden" name="checkHuman_a" id="checkHuman_a">
                                    <input type="hidden" name="checkHuman_b" id="checkHuman_b">
                                </div>
                                  <!-- security end -->

                                <!-- textarea start -->
                                <div class="form-group col-md-12 col-sm-12 col-xs-12">
                                    <textarea class="form-control" name="message" id="message" rows="7" required></textarea>
                                </div>
                                <!-- textarea end -->

                                <!-- button start -->
                                <div class="form-group col-md-12 col-sm-12 col-xs-12">
                                    <button type="submit" name="sendMessage" id="sendMessage" class="button button-md button-block button-grad-stellar">Request Now</button>
                                </div>
                                <!-- button end -->

                                <div id="sendingMessage" class="statusMessage sending-message"><p>Sending your message. Please wait...</p></div>
                                <div id="successMessage" class="statusMessage success-message"><p>Thanks for sending your message! We'll get back to you shortly.</p></div>
                                <div id="failureMessage" class="statusMessage failure-message"><p>There was a problem sending your message. Please try again.</p></div>
                                <div id="incompleteMessage" class="statusMessage"><p>Please complete all the fields in the form before sending.</p></div>

                            </form>
                        </div><!-- div contact end -->
                    </div><!-- col end -->

                </div><!-- row end -->
            </div><!-- container end -->
        </div>
		 <!-- Info Area
        ===================================== -->
        <section class="pt75 pb75" style="background:url(assets/img/bg/img-bg-19.jpg) 50% 0 no-repeat;">
            <h1 class="font-pacifico text-center color-light">
                Need More Help?
            </h1>
            <h5 class="text-center color-light">
                Lorem ipsum dolor sit amet, consectetur adipisicing elit. Porro, libero, temporibus quam eaque<br>numquam debitis excepturi assumenda necessitatibus dolore dolorum vero enim distinctio ipsa. 
            </h5>
            <p class="text-center">
                <a class="button-3d button-md button-pasific">Submit Ticket Now</a>
            </p>
        </section>