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Sh3ll

Server : Apache
System : Linux server1.cgrithy.com 3.10.0-1160.95.1.el7.x86_64 #1 SMP Mon Jul 24 13:59:37 UTC 2023 x86_64
User : nobody ( 99)
PHP Version : 8.1.23
Disable Function : NONE
Directory : /home/dnlcambodia/public_html/Quotation/

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Current File : /home/dnlcambodia/public_html/Quotation/index.php

<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Request a Quote</title>
<!-- Bootstrap CSS -->
<link href="https://stackpath.bootstrapcdn.com/bootstrap/4.5.2/css/bootstrap.min.css" rel="stylesheet">
</head>
<body>

<div class="container">
    <h2 class="mt-5 mb-4">Request a Quote</h2>
    <form action="#" method="post">
        <div class="form-group">
            <label for="name">Name:</label>
            <input type="text" class="form-control" id="name" name="name" required>
        </div>
        <div class="form-group">
            <label for="email">Email:</label>
            <input type="email" class="form-control" id="email" name="email" required>
        </div>
        <div class="form-group">
            <label for="phone">Phone:</label>
            <input type="text" class="form-control" id="phone" name="phone" required>
        </div>
        <div class="form-group">
            <label for="company">Company:</label>
            <input type="text" class="form-control" id="company" name="company" required>
        </div>
        <div class="form-group">
            <label for="address">Address:</label>
            <textarea class="form-control" id="address" name="address" required></textarea>
        </div>
        <div class="form-group">
            <label for="serviceRequested">Service Requested:</label>
            <textarea class="form-control" id="serviceRequested" name="serviceRequested" required></textarea>
        </div>
        <button type="submit" class="btn btn-primary">Submit</button>
    </form>
</div>

<!-- Bootstrap JS and dependencies (Optional) -->
<script src="https://code.jquery.com/jquery-3.5.1.slim.min.js"></script>
<script src="https://cdn.jsdelivr.net/npm/@popperjs/core@2.5.4/dist/umd/popper.min.js"></script>
<script src="https://stackpath.bootstrapcdn.com/bootstrap/4.5.2/js/bootstrap.min.js"></script>

</body>
</html>

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