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Current File : /home1/savoy/www/savoyglobal.net/old_site/views/site/training-registration.php |
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd"> <html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"> <head> <?php $this->load->view('site/header'); ?> </head> <body> <?php $this->load->view('site/menu'); ?> <div id="container"> <div class="banner"> <div class="banner_top"></div><!--banner_top end--> <div class="banner_mid_inner"><img src="<?=base_url()?>assets/images/banners/training-registration.jpg" alt="Savoy Global Training"/></div><!--banner_mid end--> <div class="banner_bot"></div><!--banner_bot end--> </div><!--banner end--> <div class="content"> <div class="content_left"> <h1>Training Registration</h1> <h5> Please fill the form below. You shall hear from us soon for Training on <br/> <strong> <?php echo $training->training_title;?> </strong> </h5> <script src="<?=base_url()?>/assets/js/formscript.js" type="text/javascript"></script> <script type="text/javascript"> JotForm.init(function(){ $('input_4').hint('ex: myname@example.com'); }); </script> <link href="<?=base_url()?>/assets/css/formstyle.css" rel="stylesheet" type="text/css" /> <style type="text/css"> .form-label{ width:150px !important; } .form-label-left{ width:150px !important; } .form-line{ padding:10px; } .form-label-right{ width:150px !important; } .form-all{ width:650px; color:Black !important; font-family:Verdana; font-size:12px; } </style> <form class="jotform-form" action="<?=site_url();?>/site/insert_training_registration" method="post" name="form_12312249228" id="12312249228" accept-charset="utf-8"> <input type="hidden" name="formID" value="12312249228" /> <div class="form-all"> <ul class="form-section"> <li class="form-line" id="id_3"> <label class="form-label-left" id="label_3" for="input_3"> Name<span class="form-required">*</span> </label> <div id="cid_3" class="form-input"><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q3_name[first]" id="first_3" /> <label class="form-sub-label" for="first_3" id="sublabel_first"> First Name </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q3_name[last]" id="last_3" /> <label class="form-sub-label" for="last_3" id="sublabel_last"> Last Name </label></span> </div> </li> <li class="form-line" id="id_6"> <label class="form-label-left" id="label_6" for="input_6"> Organization </label> <div id="cid_6" class="form-input"> <input type="text" class="form-textbox" id="input_6" name="q6_organization" size="20" /> </div> </li> <li class="form-line" id="id_5"> <label class="form-label-left" id="label_5" for="input_5"> Contact Number<span class="form-required">*</span> </label> <div id="cid_5" class="form-input"><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="tel" name="q5_contactNumber[area]" id="input_5_area" size="3"> - <label class="form-sub-label" for="input_5_area" id="sublabel_area"> Area Code </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="tel" name="q5_contactNumber[phone]" id="input_5_phone" size="8"> <label class="form-sub-label" for="input_5_phone" id="sublabel_phone"> Phone Number </label></span> </div> </li> <li class="form-line" id="id_4"> <label class="form-label-left" id="label_4" for="input_4"> E-mail<span class="form-required">*</span> </label> <div id="cid_4" class="form-input"> <input type="email" class="form-textbox validate[required, Email]" id="input_4" name="q4_email4" size="30" /> </div> </li> <li class="form-line" id="id_17"> <label class="form-label-left" id="label_17" for="input_17"> Your location / city </label> <div id="cid_17" class="form-input"> <input type="text" class="form-textbox" id="input_17" name="q17_location" size="20" /> </div> </li> <li class="form-line" id="id_7"> <label class="form-label-left" id="label_7" for="input_7"> Website </label> <div id="cid_7" class="form-input"> <input type="text" class="form-textbox" id="input_7" name="q7_website" size="20" /> </div> </li> <li class="form-line" id="id_8"> <label class="form-label-left" id="label_8" for="input_8"> In What capacity are you filling this up </label> <div id="cid_8" class="form-input"> <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio" id="input_8_0" name="q8_inWhat" value="Organization" checked /> <label for="input_8_0"> Organization </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio" id="input_8_1" name="q8_inWhat" value="Individual" /> <label for="input_8_1"> Individual </label></span><span class="clearfix"></span> </div> </div> </li> <li class="form-line" id="id_9"> <label class="form-label-left" id="label_9" for="input_9"> How did you hear about us? </label> <div id="cid_9" class="form-input"> <input type="text" class="form-textbox" id="input_9" name="q9_howDid" size="20" /> </div> </li> <li class="form-line" id="id_2"> <div id="cid_2" class="form-input-wide"> <div style="margin-left:156px" class="form-buttons-wrapper"> <button id="input_2" type="submit" class="form-submit-button"> Submit Form </button> </div> </div> </li> <li style="display:none"> Should be Empty: <input type="text" name="website" value="" /> </li> </ul> </div> <input type="hidden" id="simple_spc" name="simple_spc" value="12312249228" /> <script type="text/javascript"> document.getElementById("si" + "mple" + "_spc").value = "12312249228-12312249228"; </script> <input type="hidden" class="form-hidden" value="<?php echo $training->training_title;?>" id="input_11" name="q11_trainingService" /> <input type="hidden" class="form-hidden" value="<?php echo $training->training_id;?>" id="input_12" name="q12_trainingService_id" /> </form> </div><!--content_left end--> <?php $this->load->view('site/right.php'); ?> </div><!--content end--> </div><!--container end--> <?php $this->load->view('site/footer'); ?> </body> </html>