170 lines
No EOL
8.3 KiB
PHP
170 lines
No EOL
8.3 KiB
PHP
<?php include('./templates/_header.php'); ?>
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<section class="page-header page-header-xlg parallax parallax-3"
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style="background-image:url('assets/images/vision-min.jpg')">
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<div class="overlay dark-1"><!-- dark overlay [1 to 9 opacity] --></div>
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<div class="container">
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</div>
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</section>
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<style>
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.plugin-contact-form-error {
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background-color: #e68080;
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padding: 14px;
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border-radius: 8px;
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border: 1px solid #da7171;
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color: #fff;
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}
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#plugin-contact-form-success {
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background-color: #abbd8b;
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padding: 14px;
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border-radius: 8px;
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border: 1px solid #9eb17e;
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color: #fff;
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}
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</style>
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<!-- /PAGE HEADER -->
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<!-- -->
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<section>
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<div class="container">
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<div class="row">
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<!-- FORM -->
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<div class="col-md-9 col-sm-8">
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<h1>Schreibe uns!</strong></h1>
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<p>Du interessierst Dich für unser Geschäft oder hast Fragen zu den Produkten? Dann freuen wir uns auf eine Nachricht von Dir. Wir werden uns im Anschluss sobald wie möglich bei Dir zurückmelden.</p>
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<form role="form" action="contact_form_ajax.php" data-load="submit" method="post"
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id="plugin-contact-form">
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<div class="row contact-row">
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<div class="col-md-6">
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<input type="text" class="form-control" id="sender_firstname" name="sender_firstname"
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placeholder="Vorname" required>
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<div id="error-sender_firstname-required"
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class="alert alert-danger plugin-contact-form-error" style="display: none;">
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<button type="button" class="close" data-dismiss="alert">×</button>
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Bitte geben Sie Ihren Vornamen an.
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</div>
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</div>
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<div class="col-md-6">
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<input type="text" class="form-control" id="sender_name" name="sender_name"
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placeholder="Nachname" required>
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<div id="error-sender_name-required"
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class="alert alert-danger plugin-contact-form-error" style="display: none;">
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<button type="button" class="close" data-dismiss="alert">×</button>
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Bitte geben Sie Ihren Nachnamen an.
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</div>
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</div>
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</div>
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<div class="row contact-row">
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<div class="col-md-6">
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<input type="email" class="form-control" id="sender_email" name="sender_email"
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placeholder="E-Mail" required>
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<div id="error-sender_email-required"
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class="alert alert-danger plugin-contact-form-error" style="display: none;">
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<button type="button" class="close" data-dismiss="alert">×</button>
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Bitte geben Sie Ihre E-Mail an.
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</div>
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</div>
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<div class="col-md-6">
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<input type="email" class="form-control" id="sender_email_repeat"
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name="sender_email_repeat" placeholder="E-Mail wiederholen" required>
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<div id="error-sender_email_repeat-required"
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class="alert alert-danger plugin-contact-form-error" style="display: none;">
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<button type="button" class="close" data-dismiss="alert">×</button>
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Bitte geben Sie Ihre E-Mail erneut an.
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</div>
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</div>
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</div>
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<div class="row contact-row">
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<div class="col-md-12">
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<input type="text" class="form-control" id="sender_subject" name="sender_subject"
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placeholder="Betreff" required>
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<div id="error-sender_subject-required"
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class="alert alert-danger plugin-contact-form-error" style="display: none;">
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<button type="button" class="close" data-dismiss="alert">×</button>
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Bitte geben Sie einen Betreff an.
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</div>
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</div>
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<div class="col-md-12">
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<br>
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<textarea class="form-control" name="message" id="message" placeholder="Ihre Nachticht"
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rows="6"></textarea>
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<div id="error-message-required" class="alert alert-danger plugin-contact-form-error"
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style="display: none;">
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<button type="button" class="close" data-dismiss="alert">×</button>
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Bitte geben Sie eine Nachricht an.
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</div>
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</div>
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<div class="col-md-12" style="margin-bottom: 10px; margin-top: 10px;">
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<label class="checkbox" for="accepted_data_protection">
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<input type="checkbox" name="accepted_data_protection"
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id="accepted_data_protection">
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<i></i> Hiermit willige ich in die im Rahmen der <a target="_blank" href="/datenschutz">Datenschutzerklärung</a>
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genannte Datenverarbeitung ein.
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</label>
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<div id="error-accepted_data_protection-required"
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class="alert alert-danger plugin-contact-form-error" style="display: none;">
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<button type="button" class="close" data-dismiss="alert">×</button>
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Bitte akzeptieren Sie unsere Datenschutzerklärung.
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</div>
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</div>
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</div>
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<input type="hidden" id="required" name="required"
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value="message,sender_firstname,sender_name,sender_email,sender_email_repeat,sender_subject,accepted_data_protection">
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<input type="hidden" id="sender_token" name="sender_token" value="">
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<button type="submit" class="btn btn-primary"><i class="fa fa-check"></i> Nachricht senden
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</button>
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</form>
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</div> <!-- end col -->
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<!-- /FORM -->
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<!-- INFO -->
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<div class="col-md-3 col-sm-4">
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<h2>Kontakt</h2>
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<hr/>
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<p>
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<span class="block"><strong><i class="fa fa-map-marker"></i> Adresse:<br></strong> mivita e.K.<br>
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Leinfeld 2<br>
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87755 Kirchhaslach</span>
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<span class="block"><strong><i class="fa fa-phone"></i> Telefon:</strong> <a
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href="tel:0 8333-946 98 90">0 8333-946 98 90</a></span>
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<span class="block"><strong><i class="fa fa-envelope"></i> Email:</strong> <a
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href="mailto:info@riwa-tec.de">info@mivita.care</a></span>
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</p>
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<hr/>
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<h4 class="font300">Geschäftszeiten</h4>
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<p>
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<span class="block"><strong>Mo. - Fr.:</strong> 9-12 Uhr u. 13-16 Uhr</span>
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</p>
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</div>
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<!-- /INFO -->
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</div>
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</div>
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</section>
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<!-- / -->
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<?php include('./templates/_footer.php'); ?>
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