~franz/germanwindows.com.my

ref: 31565224c27d2c81c80e6293c50119ff117cf3a0 germanwindows.com.my/_includes/contactform.html -rw-r--r-- 16.5 KiB
31565224Franz Geffke added contact form to cny promo page 1 year, 10 months ago
                                                                                
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<div class="contactform">
  <div class="form-group">
    <p><strong>Request a free quote today!</strong>
    <br><small>Fields marked with * are required</small></p>
  </div>

  <div class="form">
    <form id="contact-form" data-parsley-validate>
      <div class="form-group">
        <label for="comments">Your Message</label>
        <textarea id="comments" name="comments" class="form-control" rows="4"{% if page.contactform %} placeholder="{{ page.contactform }}"{% endif %}></textarea>
      </div>
      {% if page.permalink == "/cny/"%}
      <input id="property_type" name="property_type" type="text" value="CNY2020" hidden>
      {% else %}
      <div class="form-group">
        <label for="property_type">Property Type</label>
        <select class="form-control" id="property_type" name="property_type" type="text" data-parsley-error-message="Please select your property type." required>
          <option></option>
          <option value="Condominium">Condominium</option>
          <option value="Landed">Landed Property</option>
          <option value="Commercial">Commercial</option>
        </select>
      </div>
      {% endif %}
      <div class="form-group">
        <label for="first_name">Your Details</label>
        <input id="first_name" name="first_name" type="text" class="form-control" placeholder="First Name *" data-parsley-error-message="Enter your first name." required>
      </div>
      <div class="form-group">
        <input id="last_name" name="last_name" type="text" class="form-control" placeholder="Last Name *" data-parsley-error-message="Enter your last name." required>
      </div>
      <div class="form-group">
        <input id="email_address" name="email_address" type="email" class="form-control" placeholder="Email address *" required>
      </div>
      <div class="form-group">
        <input id="mobile_phone_number" name="mobile_phone_number" type="number" class="form-control" placeholder="Mobile phone *" required>
      </div>
      <div class="form-group">
        <label for="address_street">Your Address</label>
        <input id="address_street" name="address_street" type="text" class="form-control" placeholder="Building, Street, City *" data-parsley-error-message="Please provide us with your street address." required>
      </div>
      <!--
        <div class="form-group">
          <input id="address_city" name="address_city" type="text" class="form-control" placeholder="City">
        </div>
      -->
      <div class="form-group">
        <select class="form-control" id="address_country" name="address_country" type="text">
          <option value="Australia">Australia</option>
          <option value="Indonesia">Indonesia</option>
          <option value="Malaysia"{% unless page.url == "/singapore/" %} selected{% endunless %}>Malaysia</option>
          <option value="Singapore"{% if page.url == "/singapore/" %} selected{% endif %}>Singapore</option>
          <option value="Thailand">Thailand</option>
          <option value="Vietnam">Vietnam</option>
          <option></option>
          <option value="Afghanistan">Afghanistan</option>
          <option value="Albania">Albania</option>
          <option value="Algeria">Algeria</option>
          <option value="American Samoa">American Samoa</option>
          <option value="Andorra">Andorra</option>
          <option value="Angola">Angola</option>
          <option value="Anguilla">Anguilla</option>
          <option value="Antartica">Antarctica</option>
          <option value="Antigua and Barbuda">Antigua and Barbuda</option>
          <option value="Argentina">Argentina</option>
          <option value="Armenia">Armenia</option>
          <option value="Aruba">Aruba</option>
          <option value="Austria">Austria</option>
          <option value="Azerbaijan">Azerbaijan</option>
          <option value="Bahamas">Bahamas</option>
          <option value="Bahrain">Bahrain</option>
          <option value="Bangladesh">Bangladesh</option>
          <option value="Barbados">Barbados</option>
          <option value="Belarus">Belarus</option>
          <option value="Belgium">Belgium</option>
          <option value="Belize">Belize</option>
          <option value="Benin">Benin</option>
          <option value="Bermuda">Bermuda</option>
          <option value="Bhutan">Bhutan</option>
          <option value="Bolivia">Bolivia</option>
          <option value="Bosnia and Herzegowina">Bosnia and Herzegowina</option>
          <option value="Botswana">Botswana</option>
          <option value="Bouvet Island">Bouvet Island</option>
          <option value="Brazil">Brazil</option>
          <option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
          <option value="Brunei Darussalam">Brunei Darussalam</option>
          <option value="Bulgaria">Bulgaria</option>
          <option value="Burkina Faso">Burkina Faso</option>
          <option value="Burundi">Burundi</option>
          <option value="Cambodia">Cambodia</option>
          <option value="Cameroon">Cameroon</option>
          <option value="Canada">Canada</option>
          <option value="Cape Verde">Cape Verde</option>
          <option value="Cayman Islands">Cayman Islands</option>
          <option value="Central African Republic">Central African Republic</option>
          <option value="Chad">Chad</option>
          <option value="Chile">Chile</option>
          <option value="China">China</option>
          <option value="Christmas Island">Christmas Island</option>
          <option value="Cocos Islands">Cocos (Keeling) Islands</option>
          <option value="Colombia">Colombia</option>
          <option value="Comoros">Comoros</option>
          <option value="Congo">Congo</option>
          <option value="Congo">Congo, the Democratic Republic of the</option>
          <option value="Cook Islands">Cook Islands</option>
          <option value="Costa Rica">Costa Rica</option>
          <option value="Cota D'Ivoire">Cote d'Ivoire</option>
          <option value="Croatia">Croatia (Hrvatska)</option>
          <option value="Cuba">Cuba</option>
          <option value="Cyprus">Cyprus</option>
          <option value="Czech Republic">Czech Republic</option>
          <option value="Denmark">Denmark</option>
          <option value="Djibouti">Djibouti</option>
          <option value="Dominica">Dominica</option>
          <option value="Dominican Republic">Dominican Republic</option>
          <option value="East Timor">East Timor</option>
          <option value="Ecuador">Ecuador</option>
          <option value="Egypt">Egypt</option>
          <option value="El Salvador">El Salvador</option>
          <option value="Equatorial Guinea">Equatorial Guinea</option>
          <option value="Eritrea">Eritrea</option>
          <option value="Estonia">Estonia</option>
          <option value="Ethiopia">Ethiopia</option>
          <option value="Falkland Islands">Falkland Islands (Malvinas)</option>
          <option value="Faroe Islands">Faroe Islands</option>
          <option value="Fiji">Fiji</option>
          <option value="Finland">Finland</option>
          <option value="France">France</option>
          <option value="France Metropolitan">France, Metropolitan</option>
          <option value="French Guiana">French Guiana</option>
          <option value="French Polynesia">French Polynesia</option>
          <option value="French Southern Territories">French Southern Territories</option>
          <option value="Gabon">Gabon</option>
          <option value="Gambia">Gambia</option>
          <option value="Georgia">Georgia</option>
          <option value="Germany">Germany</option>
          <option value="Ghana">Ghana</option>
          <option value="Gibraltar">Gibraltar</option>
          <option value="Greece">Greece</option>
          <option value="Greenland">Greenland</option>
          <option value="Grenada">Grenada</option>
          <option value="Guadeloupe">Guadeloupe</option>
          <option value="Guam">Guam</option>
          <option value="Guatemala">Guatemala</option>
          <option value="Guinea">Guinea</option>
          <option value="Guinea-Bissau">Guinea-Bissau</option>
          <option value="Guyana">Guyana</option>
          <option value="Haiti">Haiti</option>
          <option value="Heard and McDonald Islands">Heard and Mc Donald Islands</option>
          <option value="Holy See">Holy See (Vatican City State)</option>
          <option value="Honduras">Honduras</option>
          <option value="Hong Kong">Hong Kong</option>
          <option value="Hungary">Hungary</option>
          <option value="Iceland">Iceland</option>
          <option value="India">India</option>
          <option value="Iran">Iran (Islamic Republic of)</option>
          <option value="Iraq">Iraq</option>
          <option value="Ireland">Ireland</option>
          <option value="Israel">Israel</option>
          <option value="Italy">Italy</option>
          <option value="Jamaica">Jamaica</option>
          <option value="Japan">Japan</option>
          <option value="Jordan">Jordan</option>
          <option value="Kazakhstan">Kazakhstan</option>
          <option value="Kenya">Kenya</option>
          <option value="Kiribati">Kiribati</option>
          <option value="Democratic People's Republic of Korea">Korea, Democratic People's Republic of</option>
          <option value="Korea">Korea, Republic of</option>
          <option value="Kuwait">Kuwait</option>
          <option value="Kyrgyzstan">Kyrgyzstan</option>
          <option value="Lao">Lao People's Democratic Republic</option>
          <option value="Latvia">Latvia</option>
          <option value="Lebanon">Lebanon</option>
          <option value="Lesotho">Lesotho</option>
          <option value="Liberia">Liberia</option>
          <option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
          <option value="Liechtenstein">Liechtenstein</option>
          <option value="Lithuania">Lithuania</option>
          <option value="Luxembourg">Luxembourg</option>
          <option value="Macau">Macau</option>
          <option value="Macedonia">Macedonia, The Former Yugoslav Republic of</option>
          <option value="Madagascar">Madagascar</option>
          <option value="Malawi">Malawi</option>
          <option value="Maldives">Maldives</option>
          <option value="Mali">Mali</option>
          <option value="Malta">Malta</option>
          <option value="Marshall Islands">Marshall Islands</option>
          <option value="Martinique">Martinique</option>
          <option value="Mauritania">Mauritania</option>
          <option value="Mauritius">Mauritius</option>
          <option value="Mayotte">Mayotte</option>
          <option value="Mexico">Mexico</option>
          <option value="Micronesia">Micronesia, Federated States of</option>
          <option value="Moldova">Moldova, Republic of</option>
          <option value="Monaco">Monaco</option>
          <option value="Mongolia">Mongolia</option>
          <option value="Montserrat">Montserrat</option>
          <option value="Morocco">Morocco</option>
          <option value="Mozambique">Mozambique</option>
          <option value="Myanmar">Myanmar</option>
          <option value="Namibia">Namibia</option>
          <option value="Nauru">Nauru</option>
          <option value="Nepal">Nepal</option>
          <option value="Netherlands">Netherlands</option>
          <option value="Netherlands Antilles">Netherlands Antilles</option>
          <option value="New Caledonia">New Caledonia</option>
          <option value="New Zealand">New Zealand</option>
          <option value="Nicaragua">Nicaragua</option>
          <option value="Niger">Niger</option>
          <option value="Nigeria">Nigeria</option>
          <option value="Niue">Niue</option>
          <option value="Norfolk Island">Norfolk Island</option>
          <option value="Northern Mariana Islands">Northern Mariana Islands</option>
          <option value="Norway">Norway</option>
          <option value="Oman">Oman</option>
          <option value="Pakistan">Pakistan</option>
          <option value="Palau">Palau</option>
          <option value="Panama">Panama</option>
          <option value="Papua New Guinea">Papua New Guinea</option>
          <option value="Paraguay">Paraguay</option>
          <option value="Peru">Peru</option>
          <option value="Philippines">Philippines</option>
          <option value="Pitcairn">Pitcairn</option>
          <option value="Poland">Poland</option>
          <option value="Portugal">Portugal</option>
          <option value="Puerto Rico">Puerto Rico</option>
          <option value="Qatar">Qatar</option>
          <option value="Reunion">Reunion</option>
          <option value="Romania">Romania</option>
          <option value="Russia">Russian Federation</option>
          <option value="Rwanda">Rwanda</option>
          <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
          <option value="Saint LUCIA">Saint LUCIA</option>
          <option value="Saint Vincent">Saint Vincent and the Grenadines</option>
          <option value="Samoa">Samoa</option>
          <option value="San Marino">San Marino</option>
          <option value="Sao Tome and Principe">Sao Tome and Principe</option>
          <option value="Saudi Arabia">Saudi Arabia</option>
          <option value="Senegal">Senegal</option>
          <option value="Seychelles">Seychelles</option>
          <option value="Sierra">Sierra Leone</option>
          <option value="Slovakia">Slovakia (Slovak Republic)</option>
          <option value="Slovenia">Slovenia</option>
          <option value="Solomon Islands">Solomon Islands</option>
          <option value="Somalia">Somalia</option>
          <option value="South Africa">South Africa</option>
          <option value="South Georgia">South Georgia and the South Sandwich Islands</option>
          <option value="Span">Spain</option>
          <option value="SriLanka">Sri Lanka</option>
          <option value="St. Helena">St. Helena</option>
          <option value="St. Pierre and Miguelon">St. Pierre and Miquelon</option>
          <option value="Sudan">Sudan</option>
          <option value="Suriname">Suriname</option>
          <option value="Svalbard">Svalbard and Jan Mayen Islands</option>
          <option value="Swaziland">Swaziland</option>
          <option value="Sweden">Sweden</option>
          <option value="Switzerland">Switzerland</option>
          <option value="Syria">Syrian Arab Republic</option>
          <option value="Taiwan">Taiwan, Province of China</option>
          <option value="Tajikistan">Tajikistan</option>
          <option value="Tanzania">Tanzania, United Republic of</option>
          <option value="Togo">Togo</option>
          <option value="Tokelau">Tokelau</option>
          <option value="Tonga">Tonga</option>
          <option value="Trinidad and Tobago">Trinidad and Tobago</option>
          <option value="Tunisia">Tunisia</option>
          <option value="Turkey">Turkey</option>
          <option value="Turkmenistan">Turkmenistan</option>
          <option value="Turks and Caicos">Turks and Caicos Islands</option>
          <option value="Tuvalu">Tuvalu</option>
          <option value="Uganda">Uganda</option>
          <option value="Ukraine">Ukraine</option>
          <option value="United Arab Emirates">United Arab Emirates</option>
          <option value="United Kingdom">United Kingdom</option>
          <option value="United States">United States</option>
          <option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
          <option value="Uruguay">Uruguay</option>
          <option value="Uzbekistan">Uzbekistan</option>
          <option value="Vanuatu">Vanuatu</option>
          <option value="Venezuela">Venezuela</option>
          <option value="Virgin Islands (British)">Virgin Islands (British)</option>
          <option value="Virgin Islands (U.S)">Virgin Islands (U.S.)</option>
          <option value="Wallis and Futana Islands">Wallis and Futuna Islands</option>
          <option value="Western Sahara">Western Sahara</option>
          <option value="Yemen">Yemen</option>
          <option value="Yugoslavia">Yugoslavia</option>
          <option value="Zambia">Zambia</option>
          <option value="Zimbabwe">Zimbabwe</option>
        </select>
      </div>

      <input type="hidden" name="page_url" value="{{ page.url }}" />
      <input type="hidden" name="honey" value="" />

      <button type="submit" value="Submit" class="btn btn-default" onclick="javascript:_paq.push(['trackEvent', 'Contact-Form', 'Submit']);">Request a free quote</button>
    </form>
  </div>
</div>