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Viewing File: /home/u403625155/domains/connecttogetherwith.com/public_html/charityworld/web/business.php

<?php 

require "../../mail.php";

?>



<!--Author: W3layouts
Author URL: http://w3layouts.com
License: Creative Commons Attribution 3.0 Unported
License URL: http://creativecommons.org/licenses/by/3.0/
-->
<!DOCTYPE HTML>
<html>
<head>
<title>App</title>
<!-- Custom Theme files -->
<link href="css/style.css" rel="stylesheet" type="text/css" media="all"/>
<!-- Custom Theme files -->
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> 
<meta name="keywords" content="Ensaluto Form Responsive,Login form web template, Sign up Web Templates, Flat Web Templates, Login signup Responsive web template, Smartphone Compatible web template, free webdesigns for Nokia, Samsung, LG, SonyErricsson, Motorola web design" />
<!--Google Fonts-->
<link href='http://fonts.googleapis.com/css?family=Open+Sans:300italic,400italic,600italic,700italic,800italic,400,300,600,700,800' rel='stylesheet' type='text/css'>
<!--Google Fonts-->
<script src="js/jquery.min.js"></script>
<script src="https://unpkg.com/sweetalert/dist/sweetalert.min.js"></script>
</head>

<style type="text/css">

	.app{
		padding: 20px;
	}
	.app input{
		background-color: #f2f2f2;
		border-top: 1px solid #fff;
	}
	select[name='advert_budget']{
		background-color: #f2f2f2;
		border-top: 1px solid #fff;
		width: 72%;
		outline: none;
		padding: 10px;
	}
	.date{
		background-color: #f2f2f2;
		border-top: 1px solid #fff;
		outline: none;
		padding: 7px;
	}
	.app h1{
		padding: 10px;
		font-weight: bolder;
		font-size: 24px;
	}
	label{
		text-align: right;
	}
	::placeholder{
		font-size: 13px;
	}
	input[type='checkbox']{
		transform: scale(1.5);
		margin: 10px;
	}

	input[type='radio']{
		transform: scale(1.5);
		margin: 10px;
	}
	button{
		margin-top: 15px;
		padding: 10px 25px;
		background-color: black;
		color: white;
		border: none;
		border-radius: 4px;
		cursor: pointer;
	}


	@media screen and (max-width: 1024px) {
		.app{
			width: 60%;
		}

	}


	@media screen and (max-width: 600px) {
		.app{
			width: 85%;
		}

	}


</style>

<body>
<!--sign up form start here-->
<div class="app">
	
	<h1>Business Promotion</h1>
	<p style="color: white;font-size: 12px;">Promote your business to a large social media audience.</p><br>

	<form method="POST">

		<label><b>User Details:</b> </label><br>
		<input type="text" name="fname" placeholder="First Name">
		
		<input type="text" name="lname" placeholder="Last Name">
		
		<input type="text" name="email" placeholder="Email">

		<input type="text" name="phone" placeholder="Phone"><br>

		<label><b>Address Details: </b></label><br>
		<input type="text" name="address" placeholder="Address">

		<input type="text" name="street_address" placeholder="Street Address">
		
		<input type="text" name="city" placeholder="City">
		
		<input type="text" name="state" placeholder="State/Province/Region">
		
		<input type="text" name="country" placeholder="Country"><br>

		<label><b>Type Of Business: </b></label><br>
		<input type="text" name="business" placeholder="Business Type"><br><br>

		<input type="text" name="location" placeholder="Business Location"><br>

		<label><br>Additional information about your Business: </label><br>
		<input type="text" name="info" placeholder=""><br>

		<label>Advertisement Budget: </label><br>
		<select name="advert_budget">
			<option value="$500 - $5,000 (small promotion)">$500 - $5,000 (small promotion)</option>
			<option value="$5,000 - $50,000 (mid promotion)">$5,000 - $50,000 (mid promotion)</option>
			<option value="$50,000 and above (mega promotion)">$50,000 and above (mega promotion)</option>
		</select><br>

		<label><b>Gender: </b></label><br>
		<span>Male</span><input type="radio" name="gender" value="male">
		<span>Female</span><input type="radio" name="gender" value="female">

		<p style="color: white;font-size: 12px;">NOTE: Your Payment has to be made in other for your application to be approved. Payment Validates Application.</p><br>

		<label><b>Consent*</b></label><br>
		<span>I Agree</span><input type="radio" name="choice" value="agree">
		<span>I Disagree</span><input type="radio" name="choice" value="disagree"><br>

		<button name="send">Submit</button>

	</form>





	<?php

	if($_POST){
		$fname=$_POST['fname'];
		$lname=$_POST['lname'];
		$email=$_POST['email'];
		$phone=$_POST['phone'];
		$address=$_POST['address'];
		$street_address=$_POST['street_address'];
		$city=$_POST['city'];
		$state=$_POST['state'];
		$country=$_POST['country'];
		$business=$_POST['business'];
		$location=$_POST['location'];
		$info=$_POST['info'];
		$advert_budget=$_POST['advert_budget'];
		$gender=$_POST['gender'];
		$choice=$_POST['choice'];
		
		$subject="New Permit Request";

	$message = "<p>
		Name: $fname " . " " . $lname . " <br/>
		Email of Client: $email <br/>
		Phone Number: $phone <br/>
		Address: $address <br/>
		Street Address: $street_address <br/>
		City: $city <br/>
		State: $state <br/>
		Country: $country <br/>
		business: $business <br/>
		Location: $location <br/>
		Info: $info <br/>
		Advert Budget: $advert_budget <br/>
		Gender: $gender <br/>
		Choice: $choice <br/>
	</p>";
		
		sendmail("support@connecttogetherwith.com","$subject","$message");
		
		echo"
		<script>
		swal('Great','We have received your request We Will Respond As Soon As Possible','success')
		</script>
		";
	}

?>





<script src="https://unpkg.com/sweetalert/dist/sweetalert.min.js"></script>



</div>
<!--sign up form end here-->
</body>
</html>
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