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feedback.php
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feedback.php
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<?php
include 'core/init.php';
include 'includes/overall/header.php';
?>
<html>
<body>
<div class = "row">
<div class="col-md-2"></div>
<div class="col-md-6">
<div class="panel panel-default">
<div class="panel-body">
<div class="page-header " style = "margin-top:5px; ">
<h3> Suggestion Form </h3> </div>
<form action = "feedbackBackend.php" method = "post" name= "feedback">
<!-- <form class="form-horizontal"> -->
<div class="form-group">
<div class = "col-sm-10">
<label for="inputfn3" class="col-sm-4 control-label">First Name</label>
<div class="input-group">
<span class="input-group-addon" id="basic-addon3">
<span class="glyphicon glyphicon-user" id="basic-addon3">
</span>
</span>
<input type="text" class="form-control" id="inputfn3" placeholder="First Name" name="first_name"/>
</div>
</div>
</div>
<br>
<br>
<br>
<div class="form-group">
<div class = "col-sm-10">
<label for="inputln4" class="col-sm-4 control-label">Last Name</label>
<div class="input-group">
<span class="input-group-addon" id="basic-addon4">
<span class="glyphicon glyphicon-user" id="basic-addon1">
</span>
</span>
<input type="text" class="form-control" id="inputln4" placeholder="Last Name" name="last_name"/>
</div>
</div>
</div>
<br>
<br>
<div class="form-group">
<div class = "col-sm-10">
<label for="inputemail4" class="col-sm-4 control-label">Email</label>
<div class="input-group">
<span class="input-group-addon" id="basic-addon1">@</span>
<input type="text" class="form-control" id="inputemail4" placeholder="email" name="email"/>
</div>
</div>
</div>
<br>
<br>
<div class="form-group">
<div class = "col-sm-10">
<label for = "area">Message</label>
<textarea class = "form-control" id = "area" rows = "3" name="message"></textarea>
</div>
<!-- <p>First Name:
<input name ="first_name" type = "text" />
</p> -->
<!--
<p>
Last Name:
<input name ="last_name" type = "text" />
</p>
<p>
Email:
<input name ="email" type = "text" />
</p>
-->
<!-- <p>
Message:
<textarea name = "message"></textarea> </p> -->
<br>
<br>
<div class ="form-group">
<div class = "col-sm-offeset-2 col-sm-10">
<p>
<br>
<input type = "submit" name = "submit" id = "submit" value = "Submit"/>
<input type = "reset" name ="Reset" id = "reset" value = "Reset" />
</p>
</div>
</form>
</div>
</div>
</div>
</div>
<!-- eo-row -->
</body>
</html>
<?php include 'includes/overall/footer.php';?>