| Server IP : 127.0.0.2 / Your IP : 3.129.209.49 Web Server : Apache/2.4.18 (Ubuntu) System : User : www-data ( ) PHP Version : 7.0.33-0ubuntu0.16.04.16 Disable Function : disk_free_space,disk_total_space,diskfreespace,dl,exec,fpaththru,getmyuid,getmypid,highlight_file,ignore_user_abord,leak,listen,link,opcache_get_configuration,opcache_get_status,passthru,pcntl_alarm,pcntl_fork,pcntl_waitpid,pcntl_wait,pcntl_wifexited,pcntl_wifstopped,pcntl_wifsignaled,pcntl_wexitstatus,pcntl_wtermsig,pcntl_wstopsig,pcntl_signal,pcntl_signal_dispatch,pcntl_get_last_error,pcntl_strerror,pcntl_sigprocmask,pcntl_sigwaitinfo,pcntl_sigtimedwait,pcntl_exec,pcntl_getpriority,pcntl_setpriority,php_uname,phpinfo,posix_ctermid,posix_getcwd,posix_getegid,posix_geteuid,posix_getgid,posix_getgrgid,posix_getgrnam,posix_getgroups,posix_getlogin,posix_getpgid,posix_getpgrp,posix_getpid,posix,_getppid,posix_getpwnam,posix_getpwuid,posix_getrlimit,posix_getsid,posix_getuid,posix_isatty,posix_kill,posix_mkfifo,posix_setegid,posix_seteuid,posix_setgid,posix_setpgid,posix_setsid,posix_setuid,posix_times,posix_ttyname,posix_uname,pclose,popen,proc_open,proc_close,proc_get_status,proc_nice,proc_terminate,shell_exec,source,show_source,system,virtual MySQL : OFF | cURL : ON | WGET : ON | Perl : ON | Python : ON | Sudo : ON | Pkexec : ON Directory : /var/www/html/resources/views/pages/Public-Session/ |
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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>Public Session </h2> --}}
<div class="subheader-pages">
<ul>
<li><a href="{{route('home')}}" style="color:#fff;">Home</a></li>
<li><a href="{{route('publicSessions')}}" style="color:#fff;">Public Sessions</a></li>
<li>Contact Information</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>Public Session-Contact Information</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('contactThankyou')}}" method="post" id="publicSessionContactForm" name="publicSessionContactForm">
{{ 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" >
</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-3 col-md-3 col-sm-3 col-xs-12">
<label>City</label>
<input type="text" name="city" >
</div>
<div class="col-lg-3 col-md-3 col-sm-3 col-xs-12">
<label>State</label>
<input type="text" name="state" >
</div>
<div class="col-lg-3 col-md-3 col-sm-3 col-xs-12">
<label>Zip</label>
<input type="text" name="zip" >
</div>
<div class="col-lg-3 col-md-3 col-sm-3 col-xs-12">
<label>Country</label>
<input type="text" name="country" >
</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">
<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" >
</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" class="nice-select validate-select required-entry" style="" name="contact">
<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">
<label>Select request form </label>
</div>
<div class="row">
<div class="col-sm-4">
Public Session Contact Form
<div class="col-sm-4">
<input type="radio">
</div>
</div>
</div>
<div class="row">
<div class="col-sm-4">
Consulting Services Contact Form
<div class="col-sm-4">
<input type="radio">
</div>
</div>
</div>
<div class="row">
<div class="col-sm-4">
Expert Witness Contact Form
<div class="col-sm-4">
<input type="radio">
</div>
</div>
</div>
<div class="row">
<div class="col-sm-4">
In-House Training Request Form
<div class="col-sm-4">
<input type="radio">
</div>
</div>
</div> -->
<div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
<br>
<h3> Questions About Your Interest</h3>
</div>
<div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
<label>Which public sessions are you interested in?</label>
<textarea name="sessionInterested" id="summarize" ></textarea >
</div>
<div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
<label>What does your organization do?</label>
<textarea name="organization" id="workingside" ></textarea>
</div>
<div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
<label>What is your area of responsibility (# people, sq. feet, etc.)?</label>
<textarea name="responsibility" id="jurisdiction" ></textarea>
</div>
<div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
<label>Other comments or questions?</label>
<textarea name="comment" id="notes" ></textarea>
</div>
<div class="col-lg-10 col-md-10 col-sm-10 col-xs-10 m-b-30">
<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="6Le7K_shAAAAAD4eFbdBCsfLWBb3pWkrjEmbpAI1"></div>
</div>
</div>
</div>
</div>
<div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
<br>
<!-- <button class="btn-hr" id="btn-validate">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')
<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;
}
</style>
<link href="{{{URL::asset('public/css/home.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" /> -->
@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');
}
$("#publicSessionContactForm").validate().element(':input[name="hiddenRecaptcha"]');
}
$(document).ready(function(){
{{-- $('#submitBtn').click(function(){
console.log(grecaptcha.getResponse());
}); --}}
});
function expiredRecaptcha() {
$("<label id='recaptcha-expired-error' class='form-error'>*ReCaptcha Expired! Please verify ReCaptcha again..</label>").appendTo('.g-recaptcha');
}
$(function() {
$('#publicSessionContactForm').validate({
errorClass: "form-error",
ignore:'',
rules: {
name : {
required:true,
},
organizations: {
required:true,
},
emailid: {
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"
},
emailid: {
required:"*Please enter the Email ID",
email:"*Please enter a valid Email ID"
},
address: {
required:"*Please enter your address"
},
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