46 lines
1.9 KiB
Plaintext
46 lines
1.9 KiB
Plaintext
<div class="contactform grid grid-cols-1 md:grid-cols-2 gap-4">
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<div class="form-control">
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<input type="text" id="name" placeholder="Votre nom"
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class="input input-bordered bg-white" />
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<label for="name" class="label floating-label">Votre nom</label>
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</div>
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<div class="form-control">
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<input type="email" id="mail" placeholder="Votre Email"
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class="input input-bordered bg-white" />
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<label for="mail" class="label floating-label">Votre Email</label>
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</div>
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<div class="form-control">
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<input type="text" id="mobile" placeholder="Votre téléphone"
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class="input input-bordered bg-white" />
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<label for="mobile" class="label floating-label">Votre téléphone</label>
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</div>
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<div class="form-control">
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<select class="select select-bordered bg-white" id="service">
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<option selected value="syndic">Un syndic</option>
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<option value="particulier">Un particulier</option>
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<option value="entreprise">Une entreprise</option>
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<option value="collectivité">Une collectivité</option>
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</select>
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<label for="service" class="label floating-label">Vous êtes:</label>
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</div>
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<div class="form-control md:col-span-2">
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<textarea id="message" class="textarea textarea-bordered bg-white h-32"></textarea>
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<label for="message" class="label floating-label">Message</label>
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</div>
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<div class="md:col-span-2 text-center">
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<button class="btn btn-primary w-full py-3"
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onclick="apx.sendform(...)">Envoyer votre demande</button>
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</div>
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<!-- Messages de feedback -->
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<div class="answerok alert alert-success hidden"></div>
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<div class="answerko alert alert-error hidden">
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<p class="text-error-content">En maintenance, ré-essayez plus tard</p>
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</div>
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</div> |