20 lines
1.0 KiB
PHP
20 lines
1.0 KiB
PHP
<script type="text/javascript" src="/public/js/basescript.js"></script>
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<?php echo $this->data['system']['validator']->get_js(); ?>
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<?php $html = $this->factory->get_helper('html'); $html->set_data($this->data); ?>
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<div id="subnavigation"> </div>
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<div id="inhalt">
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<h2>Kontaktformular</h2>
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<div style="float:none; "><?php echo $this->render_flash(); ?></div>
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<form action="/pages/contact/send" method="post"><fieldset>
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<p><?php $html->get_input('name', 'Ihr Name*:'); ?></p>
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<p><?php $html->get_input('firma', 'Firma:'); ?></p>
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<p><?php $html->get_input('mail', 'Ihre E-Mail*:'); ?></p>
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<p><?php $html->get_input('telefon', 'Rückrufnummer:'); ?></p>
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<p><?php $html->get_dropdown('thema', '=Bitte Thema auswählen,Angebot=Anfrage für ein Angebot,Design=Frage zu Design,Technik=Frage zu Code&Technik,Jobs=Jobangebote,Allgemein=Allgemeine Anfrage'); ?></p>
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<p><?php $html->get_textarea('message', 'Ihr Anliegen:'); ?></p>
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<p><input type="submit" value="Absenden"></p>
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</fieldset></form>
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</div>
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