Vorname *
{!! Form::text('firstname', '', ['class' => 'form-control ' . ($errors->has('firstname') ? 'error' : ''), 'id' => 'firstname', 'required' => true]) !!}
@if ($errors->has('firstname'))
{{ $errors->first('firstname') }}
@endif
Nachname *
{!! Form::text('lastname', '', ['class' => 'form-control ' . ($errors->has('lastname') ? 'error' : ''), 'id' => 'lastname', 'required' => true]) !!}
@if ($errors->has('lastname'))
{{ $errors->first('lastname') }}
@endif
PLZ *
{!! Form::text('zipcode', '', ['class' => 'form-control ' . ($errors->has('zipcode') ? 'error' : ''), 'id' => 'zipcode', 'required' => true]) !!}
@if ($errors->has('zipcode'))
{{ $errors->first('zipcode') }}
@endif
Stadt *
{!! Form::text('city', '', ['class' => 'form-control ' . ($errors->has('city') ? 'error' : ''), 'id' => 'city', 'required' => true]) !!}
@if ($errors->has('city'))
{{ $errors->first('city') }}
@endif
E-Mail *
{!! Form::email('email', '', ['class' => 'form-control ' . ($errors->has('email') ? 'error' : ''), 'id' => 'email', 'required' => true]) !!}
@if ($errors->has('email'))
{{ $errors->first('email') }}
@endif
Aus Sicherheitsgründen erhälst du eine E-Mail als Bestätigung, die Du über einen Link bestätigen musst.
{!! Form::hidden("action", "submit-reminder-service") !!}