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Current File : /home2/ppcad7no/semipreciousslab.com/enquiry.php
<?php include("site-header.php")?>
<style>
#cap_enq{
margin:5px 45px 0 0 ;	
}
</style>        
        <section id="breadcrumb" data-background="assets/img/demo/slides/02.jpg" class="parallax-window">
			<div>
				<h1 class="section-title white-font text-center">Enquiry</h1>
				<ul>
					<li><a href="index.html">Home</a></li>
					<li>Enquiry</li>
				</ul>
			</div>
		</section>
		<!-- End About Us -->
<?php include("send-enquiry-code-product.php");?>                         
        
        <section id="contact-detail" class=" padd-100">
		<!--	<h2 class="section-title sep-type-2 text-center">Get in Touch</h2>-->
			
			<div class="container">
				<div class="row">
                <div class="col-md-12 text-center <?=$clrerr?>" ><?=display_sess_msg()?></div>                            
					<div class="col-sm-10">
						<div class="form-reservation" id="form-contact2">

                                <form id="contactForm"  method="post" action="" onSubmit="return EnqValidation();" enctype="multipart/form-data">

								<div class="col-md-12 ">
										<input type="text" name="enquiry_nam" id="enquiry_nam" placeholder="Name"  class="frm-sty">
								</div>
                                
                                <div class="col-md-6">
										<input type="text" id="enquiry_emai" name="enquiry_emai" placeholder="Email Id"  class="frm-sty">
								</div>


                                <div class="col-md-6">

										<input type="text" id="enquiry_mobil" name="enquiry_mobil"  placeholder="Mobile No"  class="frm-sty">
								</div>
                                
                                 <div class="col-md-12">
										<textarea name="enquiry_address" id="enquiry_address" placeholder="Address"   class="frm-sty sty-htg"></textarea>
								</div>
                                
                                
                                 <div class="col-md-12">
										<input type="text" id="enquiry_sub" value="<?=$_REQUEST['prd']?>" name="enquiry_sub" placeholder="Subject"  class="frm-sty">
								</div>
                                 <div class="col-md-12">
										<input type="text" id="enquiry_sub" value="<?=$_REQUEST['prd']?>" name="enquiry_country" placeholder="Country"  class="frm-sty">
								</div>
                                
                                 <div class="col-md-12">
										<textarea id="enquiry_detai" name="enquiry_detai" placeholder="Enquiry Details"   class="frm-sty sty-htg"></textarea>
								</div>
								
                                <div class="col-md-10">
										<input type="text" id="security_cod" name="captcha" autocomplete="off"  placeholder="Enter Security Code" class="frm-sty">
								</div>
                                
                                <div class="col-md-2">
                                <img src="amitabhcaptcha.php" class="pull-right"   width="60" height="31" alt="Captcha" id="cap_enq" />
                                </div>
                                
                                
								<div class="col-md-12">
                                <p class="text-center padd-top-30">
									<button type="submit" name="EnqSubmit"  class="btn-food">Send</button>
								</p>	</div>							
							</form>
						</div>
					</div>
                    <div class="col-sm-2 abt">
                      <img src="assets/img/enq.png">
                    </div>
				</div>
			</div>
		</section>
		
<?php include("site-footer.php")?>

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