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smart_card_request_page.html
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smart_card_request_page.html
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<!DOCTYPE html>
<html>
<head>
<meta charset="UTF-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" type="text/css" href="css/bootstrap.min.css">
<link rel="stylesheet" href="css/bootstrap-theme.min.css">
<!--[if lt IE 9]>
<script src="http://html5shiv.googlecode.com/svn/trunk/html5.js"></script>
<script src="js/html5shiv-printshiv.js"></script>
<![endif]-->
<title> Metro Online Management</title>
<style type="text/css">
.demo-content{
padding: 30px;
font-size: 18px;
text-align: center;
min-height: 100px;
background: #8eccc6;
margin-bottom: 10px;
}
.demo-content.bg-alt{
background: #abb1b8;
}
body{
padding-top: 70px;
}
.navbar-header {
height: 80px;
}
.navbar-brand {
padding-top: 0;
padding-bottom: 0;
line-height: 80px;
font-size: 30px;
}
.nav.navbar-nav > li > a {
padding-top: 30px;
padding-bottom: 30px;
}
.footer-basic-centered{
background-color: #232426;
box-sizing: border-box;
text-align: center;
font-size: 20px;
position: absolute;
right: 0;
bottom: 0;
left: 0;
}
.footer-basic-centered .footer-links{
list-style: none;
font-weight: bold;
color: #ffffff;
padding: 20px;
}
.footer-basic-centered .footer-links a{
display:inline-block;
text-decoration: none;
color: inherit;
}
.bs-example{
margin: 10px;
}
.form-horizontal .control-label{
padding-top: 7px;
}
.padding {
padding-left: 10em;
padding-bottom: 5px;
}
</style>
</head>
<body>
<script src="js/jquery-3.2.1.js"></script>
<script src="js/bootstrap.js"></script>
<div id="myNavbar" class="navbar navbar-default navbar-inverse navbar-fixed-top" role="navigation">
<div class="container-fluid bg-color">
<div class="navbar-header">
<button type="button" class="navbar-toggle" data-toggle="collapse" data-target="#navbarCollapse">
<span class="sr-only">Metro Online Management</span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
<span class="icon-bar"></span>
</button>
<a class="navbar-brand" href="HomePage.html">Metro Online Management</a>
</div>
<div class="collapse navbar-collapse" id="navbarCollapse">
<ul class="nav navbar-nav">
<li><a href="HomePage.html">Home</a></li>
<li><a href="admin_login.php" target="_blank">Admin Login</a></li>
<li class="active"><a href="smart_card_request_page.html">Smart Card Request</a></li>
<li><a href="smart_card_login.php">Smart Card Login</a></li>
<li><a href="train_and_timings.php">Trains and Timings</a></li>
<li><a href="routes_and_stations.php">Routes and Stations</a></li>
</ul>
</div>
</div>
</div>
<h2 class="padding">Smart Card Request Page</h2>
<div class="container">
<div class="row">
<div class="col-lg-8 col-lg-offset-2">
<form id="contact-form" method="post" action="php/new_customer_request_card.php">
<div class="controls">
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>Firstname *</label>
<input type="text" name="fname" class="form-control" placeholder="Please enter your firstname" required="required" data-error="Firstname is required.">
<div class="help-block with-errors"></div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Lastname</label>
<input type="text" name="lname" class="form-control" placeholder="Please enter your lastname" required="required" data-error="Lastname is required.">
<div class="help-block with-errors"></div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>Email *</label>
<input type="email" name="email" class="form-control" placeholder="Please enter your email" required="required" data-error="Valid email is required.">
<div class="help-block with-errors"></div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Phone *</label>
<input type="tel" name="phone" class="form-control" placeholder="Please enter your phone">
<div class="help-block with-errors"></div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>Username *</label>
<input type="text" name="username" class="form-control" placeholder="Please enter username" required="required" data-error="Valid username is required.">
<div class="help-block with-errors"></div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Password *</label>
<input type="password" name="password" class="form-control" placeholder="Please enter password" required="required" data-error="Enter valid password">
<div class="help-block with-errors"></div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label>Address *</label>
<textarea name="address" class="form-control" placeholder="Smart Card will be delivered to this address" rows="4" required="required" data-error="Please,enter your address"></textarea>
<div class="help-block with-errors"></div>
</div>
</div>
<div class="col-md-12">
<input type="submit" name="submit" class="btn btn-success btn-send" value="Send Request">
</div>
</div>
<div class="row">
<div class="col-md-12">
<p class="text-muted"><strong>*</strong> These fields are required.</p>
</div>
</div>
</div>
</form>
</div>
</div>
</div>
<footer class="footer-basic-centered">
<p class="footer-links">
<a href="HomePage.html">Home</a>
|
<a href="contact_us.html">Contact Us</a>
</p>
</footer>
</body>
</html>