client-insomnia/index.html at master · NephilimTech/client-insomnia · GitHub

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
<!DOCTYPE html>
<html lang="en">

<head>
    <meta charset="UTF-8">
    <title>Contact Form with Budget Slider</title>

    <link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/normalize/5.0.0/normalize.min.css">

    <link rel='stylesheet' href='https://maxcdn.bootstrapcdn.com/bootstrap/3.3.5/css/bootstrap.min.css'>
    <link rel='stylesheet' href='http://code.jquery.com/ui/1.11.4/themes/smoothness/jquery-ui.css'>
    <link href="https://fonts.googleapis.com/css?family=Roboto:100" rel="stylesheet">
    <link rel="stylesheet" href="css/style.css">


</head>

<body>

    <div class="container">
        <h2>Register for </h2>
        <h1>Blockchain Technology Workshop
        </h1>
        <div class="row">

            <div class="col-md-12">
                <form method="post" action="x.php">
                    <ul class="contact-form">
                        <li>
                            <div class="col-md-6">
                                <input name="name" placeholder="Your Name" required="required" size="8" type="text">
                            </div>

                            <div class="col-md-6">
                                <input name="email" placeholder="Email" required="required" size="8" type="email">
                            </div>
                        </li>

                        <li>
                            <div class="col-md-6">
                                <input name="phno" placeholder="Phone Number" required="required" size="8" type="texr" pattern="^\d{10}">
                            </div>

                            <div class="col-md-6">
                                <input name="affiliation" placeholder="Affiliation" required="required" size="8" type="text">
                            </div>
                        </li>

                        <li>
                            <div class="col-md-6">
                                <select name="occupation" placeholder="Occupation" required="required">
                                  <option value="" disabled selected>Occupation</option>
                                  <option value="student">Student</option><option value="professional">Professional</option>
                                </select>
                            </div>
                        </li>

                        <li>
                            <div class="col-md-12">
                                <button type="submit">Submit <span class="glyphicon glyphicon-arrow-right" aria-hidden="true"></span></button>
                            </div>
                        </li>


                    </ul>
                </form>
            </div>

        </div>
    </div>
    <div style="display:block; position:fixed; clear:both; top: 1em; left: 1em;">
        <a href="https://insomnia.org.in"><img src="https://raw.githubusercontent.com/NephilimTech/insomnia2019/master/inslogow.png" height="50px"></a>
    </div>
    <div class="form-group">
        <div class="col-sm-10 col-sm-offset-2">
            <?php echo $result; ?>
        </div>
    </div>
    <script src='http://cdnjs.cloudflare.com/ajax/libs/jquery/2.1.3/jquery.min.js'></script>
    <script src='http://cdnjs.cloudflare.com/ajax/libs/jqueryui/1.11.2/jquery-ui.min.js'></script>
    <script src='http://maxcdn.bootstrapcdn.com/bootstrap/3.3.5/js/bootstrap.min.js'></script>
    <script src='https://adamkramer.nl/js/autosize.min.js'></script>


    <script src="js/index.js"></script>


</body>

</html>