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250 lines (239 loc) · 7.75 KB
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8" />
<meta name="viewport" content="width=device-width, initial-scale=1.0" />
<title>Document</title>
<link
href="https://cdn.jsdelivr.net/npm/bootstrap@5.3.3/dist/css/bootstrap.min.css"
rel="stylesheet"
integrity="sha384-QWTKZyjpPEjISv5WaRU9OFeRpok6YctnYmDr5pNlyT2bRjXh0JMhjY6hW+ALEwIH"
crossorigin="anonymous"
/>
<style>
.input-group {
margin: 5px;
}
.tst2 {
display: flex;
justify-content: center;
margin-left: 35%;
margin-right: 35%;
margin-top: 10%;
}
</style>
<link
rel="stylesheet"
href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.2/css/all.min.css"
/>
<script
src="https://cdn.jsdelivr.net/npm/bootstrap@5.3.3/dist/js/bootstrap.bundle.min.js"
integrity="sha384-YvpcrYf0tY3lHB60NNkmXc5s9fDVZLESaAA55NDzOxhy9GkcIdslK1eN7N6jIeHz"
crossorigin="anonymous"
></script>
</head>
<body>
<div
class="tst2 text-left py-3 opacity-20"
style="background-color: rgb(218, 214, 214)"
>
<form method="post" novalidate>
<table class="tble">
<!-- First Name -->
<tr>
<td>First name</td>
<td>
<div class="input-group has-validation">
<span class="input-group-text">
<i class="fa-solid fa-user"></i>
</span>
<input
type="text"
class="form-control"
id="validationCustom01"
placeholder="First Name"
aria-describedby="fee01"
required
/>
<div id="fee01" class="invalid-feedback">
Please enter your first name.
</div>
</div>
</td>
</tr>
<!-- Last Name -->
<tr>
<td>Last name</td>
<td>
<div class="input-group has-validation">
<span class="input-group-text">
<i class="fa-solid fa-user"></i>
</span>
<input
type="text"
class="form-control"
placeholder="Last Name"
required
/>
<div class="invalid-feedback">Please enter your last name.</div>
</div>
</td>
</tr>
<!-- Email -->
<tr>
<td>Email</td>
<td>
<div class="input-group has-validation">
<span class="input-group-text">
<i class="fa-solid fa-envelope"></i>
</span>
<input
type="email"
class="form-control"
placeholder="E-Mail Address"
required
/>
<div class="invalid-feedback">
Please enter a valid email address.
</div>
</div>
</td>
</tr>
<!-- Phone -->
<tr>
<td>Phone#</td>
<td>
<div class="input-group has-validation">
<span class="input-group-text">
<i class="fa fa-phone"></i>
</span>
<input
type="tel"
class="form-control"
placeholder="(845)555-1212"
pattern="[0-9]{3}-[0-9]{3}-[0-9]{4}"
required
/>
<div class="invalid-feedback">
Please enter a valid phone number (e.g., 123-456-7890).
</div>
</div>
</td>
</tr>
<!-- Address -->
<tr>
<td>Address</td>
<td>
<div class="input-group has-validation">
<span class="input-group-text">
<i class="fa-solid fa-house"></i>
</span>
<input
type="text"
class="form-control"
placeholder="Address"
required
/>
<div class="invalid-feedback">Please enter your address.</div>
</div>
</td>
</tr>
<!-- City -->
<tr>
<td>City</td>
<td>
<div class="input-group has-validation">
<span class="input-group-text">
<i class="fa-solid fa-house"></i>
</span>
<input
type="text"
class="form-control"
placeholder="City"
required
/>
<div class="invalid-feedback">Please enter your city.</div>
</div>
</td>
</tr>
<!-- State -->
<tr>
<td>State</td>
<td>
<div class="input-group has-validation">
<span class="input-group-text">
<i class="fa-solid fa-bars"></i>
</span>
<select class="form-select" required>
<option value="" disabled selected>
Please Select Your State
</option>
<option>India</option>
<option>US</option>
<option>UK</option>
<option>Dubai</option>
</select>
<div class="invalid-feedback">Please select your state.</div>
</div>
</td>
</tr>
<!-- Hosting Radio Buttons -->
<tr>
<td rowspan="2">Do you have hosting?</td>
<td>
<div class="form-check">
<input
type="radio"
name="hosting"
class="form-check-input"
required
/>
<label class="form-check-label">Yes</label>
</div>
</td>
</tr>
<tr>
<td>
<div class="form-check">
<input
type="radio"
name="hosting"
class="form-check-input"
required
/>
<label class="form-check-label">No</label>
<div class="invalid-feedback">Please select an option.</div>
</div>
</td>
</tr>
<!-- Project Description -->
<tr>
<td>Project Description</td>
<td>
<div class="input-group has-validation">
<span class="input-group-text">
<i class="fa-solid fa-pencil"></i>
</span>
<textarea class="form-control" required></textarea>
<div class="invalid-feedback">
Please provide a project description.
</div>
</div>
</td>
</tr>
</table>
<!-- Submit Button -->
<div style="padding-left: 150px; padding-top: 20px">
<div class="input-group">
<button type="submit" class="btn btn-warning px-4 py-2 text-white">
Send
</button>
<span class="input-group-text bg-warning text-white p-2">
<i class="fa-solid fa-paper-plane"></i>
</span>
</div>
</div>
</form>
</div>
</body>
</html>