46 lines
1.7 KiB
Smarty
46 lines
1.7 KiB
Smarty
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<h1>{l s='Contact provider form' mod='contactform'}</h1>
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<div class="sheets">
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<div id="idTab1">
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<form action="/modules/contactform/provider.php" method="post">
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<label for="brand">{l s='brand' mod='contactform'}</label>
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<input type="text" name="brand" id="brand">
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<label for="compagny">{l s='compagny' mod='contactform'}</label>
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<input type="text" name="compagny" id="compagny">
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<label for="lastname">{l s='lastname' mod='contactform'}</label>
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<input type="text" name="lastname" id="lastname">
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<label for="firstname">{l s='firstname' mod='contactform'}</label>
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<input type="text" name="firstname" id="firstname">
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<label for="function">{l s='function' mod='contactform'}</label>
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<input type="text" name="function" id="function">
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<label for="email1">{l s='email' mod='contactform'}</label>
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<input type="text" name="email1" id="email1">
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<label for="email2">{l s='email_other' mod='contactform'}</label>
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<input type="text" name="email2" id="email2">
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<label for="phone1">{l s='phone' mod='contactform'}</label>
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<input type="text" name="phone1" id="phone1">
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<label for="phone2">{l s='phone_other' mod='contactform'}</label>
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<input type="text" name="phone2" id="phone2">
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<label for="purpose">{l s='purpose' mod='contactform'}</label>
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<input type="text" name="purpose" id="purpose">
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<label for="content">{l s='content' mod='contactform'}</label>
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<input type="text" name="content" id="content">
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<input type="hidden" name="type" value="{Contactform::TYPE_PROVIDER}">
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<button type="submit">{l s='send' mod='contactform'}</button>
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</form>
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</div>
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