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Mini Shell

Mini Shell

Direktori : /home/eirtvhdf/designbeasts.com/
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Current File : //home/eirtvhdf/designbeasts.com/service_form.php

          <form method="POST" action="get.php" autocomplete="off">
  <div class="row">
          <div class="col-md-12 col-xs-12 margin-bottom-10">
      <input type="text" autocomplete="off" class="form-control" placeholder="Full Name" name="name" onfocus="this.placeholder = ''" onblur="this.placeholder = 'Full Name'"  required="required"/>
    </div>
    <input type="hidden" name="_token" value="tuLQpLVyIffWjHIVf9St12ep2ujfD8u6CGNZ9cGH">
    <div class="col-md-12 col-xs-12 margin-bottom-10">
      <input type="email" autocomplete="off" class="form-control" placeholder="Email" name="email" onfocus="this.placeholder = ''" onblur="this.placeholder = 'Email'"  required="required"/>
    </div>
    <div class="col-md-12 col-xs-12 margin-bottom-10 ">
      <input type="number" min="1" autocomplete="off" class="form-control" placeholder="Phone Number" name="number" onfocus="this.placeholder = ''" onblur="this.placeholder = 'Phone Number'" required />
    </div>
    <div class="col-md-12 col-xs-12 margin-bottom-10">
      <input type="text" autocomplete="off" class="form-control" placeholder="Country" name="country" onfocus="this.placeholder = ''" onblur="this.placeholder = 'Country'"   required="required"/>
    </div>
        
                      <input type="hidden" name="interest" value=" Exceptional Brand Development Services Your Brand Deserve ">
            
    
                         <input type="hidden" name="budget" value="not required">
              <div class="col-md-12 col-xs-12 margin-bottom-20">
      <textarea class="form-control" name="description" placeholder="Talk about your project" onfocus="this.placeholder = ''" onblur="this.placeholder = 'Project Description'" required></textarea>
    </div>
    <div class="col-md-12 col-xs-12 text-center">
      <div class="text-center mid-body">
        <input class="btn-fill btn-quote" type="submit" name="service_quote" value="Send Query" />
      </div>
    </div>
  </div>
  <input type="hidden" name="page" value="<?php echo $page_title ?>" />
</form>

Zerion Mini Shell 1.0