CINXE.COM
Submit Form
<!DOCTYPE html> <html> <head> <meta charset="utf-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1"> <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1"> <title>Submit Form</title> <link href="/css/global.css?v=2.02" type="text/css" rel="stylesheet" /> </head> <body> <div class="layui-container"> <div class="layui-row layui-hide-xs layui-col-space5"> <div class="layui-col-xs3"><a href="//www.164580.com/"><img src="/images/logo.png" border="0" /></a></div> <div class="layui-col-xs9"></div> </div> <div class="layui-row layui-col-space5" align="center"> <form class="layui-form" name="form1" method="post" action="/feedback.php"> <fieldset class="layui-elem-field" style="width:400px;text-align:center"> <legend><b>Submit Form</b></legend> <div class="layui-field-box"> <div class="layui-form-item"> <label class="layui-form-label">Title</label> <div class="layui-input-inline"> <input type="text" name="title" required lay-verify="required" placeholder="" autocomplete="off" class="layui-input" value="Membership Service"> </div> <div class="layui-form-mid layui-word-aux"><font color="#FF0000">*</font></div> </div> <div class="layui-form-item layui-form-text layui-hide-xs"> <label class="layui-form-label">Content</label> <div class="layui-input-block"> <textarea name="detail" class="layui-textarea"></textarea> <input name="webtitle" type="hidden" id="webtitle" value="membership service" /> </div> </div> <fieldset class="layui-elem-field layui-field-title" style="width:400px;text-align:center"> <legend>Contact information</legend> <div class="layui-field-box"> <div class="layui-form-item"> <label class="layui-form-label">Name</label> <div class="layui-input-inline"> <input type="text" name="linkman" required lay-verify="required" autocomplete="off" class="layui-input" value=""> </div> </div> <div class="layui-form-item"> <label class="layui-form-label">Phone</label> <div class="layui-input-inline"> <input type="text" name="tel" required lay-verify="required" autocomplete="off" class="layui-input" value=""> </div> <div class="layui-form-mid layui-word-aux"><font color="#FF0000">*</font></div> </div> <div class="layui-form-item layui-hide-xs"> <label class="layui-form-label">email</label> <div class="layui-input-inline"> <input type="text" name="email" autocomplete="off" class="layui-input" value="" required lay-verify="email"> </div> <div class="layui-form-mid layui-word-aux"><font color="#FF0000">*</font></div> </div> <div class="layui-form-item layui-hide-xs"> <label class="layui-form-label">Company</label> <div class="layui-input-block" style="width:250px;"> <input type="text" name="companyname" autocomplete="off" class="layui-input" value=""> </div> </div> </div> </fieldset> <div class="layui-form-item"> <button class="layui-btn" lay-submit lay-filter="formDemo">Submit</button> </div> </div></fieldset> <input name="company_id" type="hidden" id="company_id" value="" /> <input name="product_id" type="hidden" id="product_id" value="" /> <input name="typ" type="hidden" id="typ" value="reg" /> <input name="up" type="hidden" id="up" value="1" /> <input name="fromUrl" type="hidden" id="up" value="" /> <input name="tms" type="hidden" id="tms" value="1733304314" /> </form> </div> <div class="layui-row layui-hide-xs"> <!--foot--> <div class="footer clearfix"> <div class="ft-link"> <a href="http://www.globalfastener.com/about/" title="Customer Service">About Us</a> | <a href="/about/pricing.php">Pricing</a> | <a href="/about/term.php">Terms of Use</a> | <a href="/about/faq.php" title="Customer Service">FAQ</a> | <a href="/about/contact.php">Contact Us</a> © Copyright 2009-2024 GlobalFastener Inc </div> <div style="width:300px;margin:0 auto; padding:0;"> </div> </div> <script type="text/javascript" src="/system/layui/layui.js"></script> <script type="text/javascript" src="/js/layw.js?v=2.01"></script> <script> var _hmt = _hmt || []; (function() { var hm = document.createElement("script"); hm.src = "//hm.baidu.com/hm.js?8087b863d24acb3928062e5ca830fc22"; var s = document.getElementsByTagName("script")[0]; s.parentNode.insertBefore(hm, s); })(); </script><!--foot--> </div> </div> <script type="text/javascript" src="/system/layui/layui.js"></script> <script type="text/javascript" src="/js/layw.js"></script> </body> </html>