Admin Control Panel v2.0

✎ Editing: 3c4f09481b734f34e26978f549a368fe ← Back

<div class="Inbanner" style="background:url(<?php echo asset('assets/uploads/page/recommended_banner/'.$pageContent->page_banner ) ?>)" >
									<div class="caption"> <?php echo (($lang=='ar')?$pageContent->page_name_arabic:$pageContent->page_name ); ?></div>
								</div>
								<div class="solution-inner right-in">
									<?php if(!empty($errorMessage)){ ?>
									<?php echo $errorMessage; ?>
									<?php } ?>
									<?php echo Form::open(array('url' => 'online-support','class'=>'online-form','id'=>'contact_online_form')); ?>

<div class="form-group">
											<div class="row">
												<div class="col-md-5"><label for="exampleInputEmail1"><?php echo Lang::get('messages.name');; ?></label> 
													<input type="text" class="form-control" value="<?php echo Input::old('name'); ?>" id="name" name="name" placeholder="Your Name"   >                                
												</div>
												<div class="col-md-5"><label for="exampleInputName1"><?php echo Lang::get('messages.company_name');; ?></label> 
													<input type="text"  class="form-control" id="companyName" value="<?php echo Input::old('companyName'); ?>" name="companyName"   placeholder="Your Company Name" >                                
												</div>
											</div>
										</div>

<div class="form-group">
											<div class="row">
												<div class="col-md-5"><label for="exampleInputEmail1"><?php echo Lang::get('messages.email');; ?></label> 
													<input type="text" class="form-control" id="email" value="<?php echo Input::old('email'); ?>" name="email"   placeholder="Your Email" >                                
												</div>
												<div class="col-md-5"><label for="exampleInputEmail1"><?php echo Lang::get('messages.phone_no');; ?></label> 
													<input type="text" class="form-control" id="phone" name="phone" value="<?php echo Input::old('phone'); ?>"   placeholder="Your phone" >
												</div>
											</div>
										</div>
										<div class="form-group">
										<div class="row">
										<div class="col-md-5"><label for="exampleInputEmail1"><?php echo Lang::get('messages.customer_type');; ?></label> 
											<select id="select" class=" form-control" name="customer_type" >
												<option value="0">Select</option>
												<option value="distributor"><?php echo Lang::get('messages.distributor');; ?></option>
												<option value="dealer"><?php echo Lang::get('messages.dealer');; ?></option>
												<option value="reseller"><?php echo Lang::get('messages.reseller');; ?></option>
												<option value="end-user"><?php echo Lang::get('messages.user');; ?></option>
											</select>

</div>
											<div class="col-md-5"><label for="exampleInputEmail1"><?php echo Lang::get('messages.product_model_number');; ?></label> 
												<input type="text" name="prdct_model_no" class="form-control"  placeholder="Product Model Number"> 
											</div>
										</div>

</div>
										<div class="form-group">
											<div class="row">
												<div class="col-sm-10"><label for="exampleInputEmail1"><?php echo Lang::get('messages.comment');; ?></label> 
													<textarea placeholder="Message" class="form-control" id="fmsg" name="fmsg" ></textarea>								
												</div>
											</div>
										</div>

<div class="form-group">
											<div class="captcha">
												<div class="code"> <img src="<?php echo asset('/captcha')?>" id="captchaImage"></div>
												<div class="refresh">  <i class="fa fa-refresh refreshIcon"></i> </div>
												<div class="input1"><input type="text" placeholder="Code" class="form-control" id="captcha" name="captcha"> </div>
											</div>
											<input class="btn btn-primary submit" type="submit" name="submitO" value="submit"/>
										</div>																				
									</form>
								</div>

$(document).ready(function() {
	$("#contact_ajax").validate({
			rules: {
			name: "required",								
											
			prdct_model_no: "required",								
			companyName: "required",								
			fmsg: "required",								
			captcha: "required",			
			phone: {
				required: true,
				number: true
			},
			email: {
				required: true,
				email: true
			},					
		    
								
				
			},
			messages: {
				htl_name: "Please enter your firstname",
				lastname: "Please enter your lastname",
				username: {
					required: "Please enter a username",
					minlength: "Your username must consist of at least 2 characters"
				},
				password: {
					required: "Please provide a password",
					minlength: "Your password must be at least 5 characters long"
				},
				confirm_password: {
					required: "Please provide a password",
					minlength: "Your password must be at least 5 characters long",
					equalTo: "Please enter the same password as above"
				},
				email: "Please enter a valid email address",
				agree: "Please accept our policy"
			}
		});
// var $img = $('#captchaImage');
var $loader = $('#captchaImage');

$('.refresh').on('click',function() {
d = new Date();
$("#captchaImage").attr("src", "<?php echo asset('/captcha')?>?"+d.getTime());		
});
});

</script>

Cancel