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@extends('template.default') @section('content') <div class="header-breadcrumbs"> <div class="container"> <div class="row"> <div class="col-lg-12 col-md-12 col-sm-12 sol-xs-12"> <div class="breadcrumbs-title text-center"> <h2>Enquiry Form</h2> <div class="subheader-pages"> <ul> <li><a href="{{route('home')}}" style="color:#fff;">Home</a></li> <!-- <li><a href="{{route('inHouseTraining')}}" style="color:#fff;"></a></li> --> <li>Enquiry Form</li> </ul> </div> </div> </div> </div> </div> </div> <!-- Contact Us-area start hear --> <div class="contactus-area"> <div class="container"> <div class="row"> <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"> <div class="form-title text-center"> <h3> Enquiryform</h3> </div> </div> <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"> <div class="row"> <div class="contractus-form"> <form action="{{route('enquiryForm')}}" method="post" id="trainingrequestform"> {{csrf_field()}} <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"> <div class="row"> <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12"> <label>Name</label> <input type="text" name="name" id="name"> </div> <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12"> <label>Title</label> <input type="text" name="title"> </div> <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12"> <label>Organization</label> <input type="text" name="organizations"> </div> <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12"> <label>EmailID</label> <input type="email" name="emailid"> </div> <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12"> <label>Address</label> <input type="text" name="address"> </div> <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12 row"> <div class="col-lg-4 col-md-4 col-sm-4 col-xs-12"> <label>City</label> <input type="text" name="city"> </div> <div class="col-lg-4 col-md-4 col-sm-4 col-xs-12"> <label>State</label> <input type="text" name="state"> </div> <div class="col-lg-4 col-md-4 col-sm-4 col-xs-12"> <label>Zip</label> <input type="text" name="zip"> </div> </div> <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12"> <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12 row" style="width: 286px;"> <label>Phone</label> <input type="text" name="phone"> </div> <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12"> <label>Fax</label> <input type="text" name="fax" style="width: 286px;"> </div> <div class=" col-md-6 " style="margin-left: -12px;"> <div class="form-group"> <label class="required">Interested In</label> <div class="input-box" style="width: 558px;"> <select title="interested" name="interested" class="nice-select validate-select required-entry"> <option>Laser-Focused-Training</option> <option>Public Sessions</option> <option>In House Training</option> <option>Consulting Services</option> <option>Expert Witness</option> </select> </div> </div> </div> </div> <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12"> <div class="form-group"> <label class="required">Preferred contact method</label> <div class="input-box"> <select title="Preferred contact method" name="contactMethod" class="nice-select validate-select required-entry" style=""> <option>Email</option> <option>Phone</option> <option>Fax</option> <option>Mail</option> </select> </div> </div> </div> <!-- <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"> <h3>Questions About the Project <h3></div> <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"> <label> Please provide a quick description of the training requested:</label> <textarea name="summerize" id="summerize" ></textarea> </div> <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"> <label> Location of training</label> <textarea name="trainingLocation" id="trainingLocation" ></textarea> </div> <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"> <label>What is your timing?</label> <textarea name="timing" id="timing" ></textarea> </div> <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12"> <label>How many people to be trained?</label> <textarea name="peopleTrained" id="peopleTrained" ></textarea> </div> --> <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12" style="padding-top: 23px; "> <label> Please provide additional information,If any:</label> <textarea name="comments" id="comments"></textarea> </div> <div class="row" id="captchadiv"> <div class="col-lg-10 col-md-10 col-sm-10 col-xs-10 m-b-30" style="margin-left: -3px;"> <input type="hidden" class="hiddenRecaptcha required" name="hiddenRecaptcha" id="hiddenRecaptcha" value=""> <div id="recaptcha" class="g-recaptcha" data-callback="validateRecaptcha" data-expired-callback="expiredRecaptcha" data-sitekey="6LewakIUAAAAACSoKMaBasi3pn53TBjxqBVLKJDJ"></div> </div> </div> </div> </div> <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12" style=" margin-top: 12px;"> <!-- <button class="btn-hr" id="submitBtn">Submit Request</button> --> <input type="submit" class="btn-hr" id="submitBtn" value="Submit request" style="width: 189px;"> </div> </form> </div> </div> </div> </div> </div> </div> <!-- 40.contactus-area end hear --> @endsection @push('styles') <link href="{{{URL::asset('public/css/home.css')}}}" rel="stylesheet"> <!-- <link href="{{{URL::asset('public/css/resource.css')}}}" rel="stylesheet"> --> <link href="{{{URL::asset('public/css/contact.css')}}}" rel="stylesheet"> <link href="{{{URL::asset('public/css/category-management.css')}}}" rel="stylesheet" type="text/css" /> <style> .form-error{color:red !important; font-weight: lighter;} .color{color:red;} .msg-error { color: #c65848; } .g-recaptcha.error { border: solid 2px #c64848; padding: .3em; width: 23em; } #aaa { visibility:hidden; } .rc-anchor-normal { margin: 2px 13px 0 0; padding-right: 198px !important; } .rc-anchor-pt { padding-right: 198px !important; } .rc-anchor-pt{ padding-right: 198px !important; } .rc-anchor-normal{ margin-left: 16px !important; } #hiddenRecaptcha-error{ margin-left: 17px !important; } #recaptcha{ margin-left: 18px; } </style> <link href="{{{URL::asset('public/css/home.css')}}}" rel="stylesheet"> @endpush @push('scripts') <script type="text/javascript" src="{{{URL::asset('public/js/jquery-1.7.1.min.js')}}}"></script> <script src="https://www.google.com/recaptcha/api.js?render=explicit" async defer></script> <script> function validateRecaptcha() { response = grecaptcha.getResponse(); if (response.length === 0) { $('#hiddenRecaptcha').val(''); } else { $('#hiddenRecaptcha').val('1'); } $("#trainingrequestform").validate().element(':input[name="hiddenRecaptcha"]'); } function expiredRecaptcha() { $('#hiddenRecaptcha').val(''); $( "<label id='recaptcha-expired-error' class='form-error'>*ReCaptcha Expired! Please verify ReCaptcha again..</label>" ).appendTo('.g-recaptcha'); } $(function () { $('#trainingrequestform').validate({ errorClass: "form-error", ignore: '', rules: { name: { required: true, }, title: { required: true, }, city: { required: true, }, state: { required: true, }, zip: { required: true, number: true }, organizations: { required: true, }, emailid: { required: true, email: true }, fax: { required: true, // email: true }, address: { required: true, }, phone: { required: true, number: true }, "hiddenRecaptcha": { required: true }, }, messages: { name: "*Please enter Name", organizations: { required: "*Please enter organization" }, title: "*Please enter title", city: "*Please enter city", state: "*Please enter state", emailid: { required: "*Please enter the Email ID", email: "*Please enter a valid Email ID" }, address: { required: "*Please enter your address" }, fax: { required: "*Please enter your fax" }, zip: { required: "*Please enter the zip", number: "*Please enter a valid zip" }, phone: { required: "*Please enter the Phone Number", number: "*Please enter a valid Phone Number" }, hiddenRecaptcha: { required: "*Please verify ReCaptcha" } }, errorPlacement: function (error, element) { if(element.attr("name")==("hiddenRecaptcha")) { error.insertAfter(".g-recaptcha"); } else { error.insertAfter(element); } }, submitHandler: function (form) { form.submit(); } }); }); </script> @endpush