mirror of
https://github.com/bigchaindb/site.git
synced 2024-11-01 15:55:36 +01:00
116 lines
5.2 KiB
HTML
116 lines
5.2 KiB
HTML
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<form id="form-enterprise" class="form form--enterprise js-parsley" action="" method="POST" accept-charset="UTF-8">
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<div class="grid grid--full grid-small--half">
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<div class="grid__col">
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<p class="form-group">
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<input class="form-control" type="text" id="name_first" name="name_first" required>
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<label class="form-label" for="name_first">First Name</label>
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</p>
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</div>
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<div class="grid__col">
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<p class="form-group">
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<input class="form-control" type="text" id="name_last" name="name_last" required>
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<label class="form-label" for="name_last">Last Name</label>
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</p>
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</div>
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<div class="grid__col">
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<p class="form-group">
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<input class="form-control" type="text" id="company" name="company" required>
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<label class="form-label" for="company">Company</label>
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</p>
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</div>
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<div class="grid__col">
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<p class="form-group">
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<input class="form-control" type="email" id="email" name="_replyto" required>
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<label class="form-label" for="email">Email</label>
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</p>
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</div>
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<div class="grid__col">
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<p class="form-group">
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<input class="form-control" type="tel" id="phone" name="phone" required>
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<label class="form-label" for="phone">Phone</label>
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</p>
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</div>
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<div class="grid__col">
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<p class="form-group">
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<select class="form-control" id="country" name="country" required data-required="true">
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<option value=""> </option>
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{% for country in site.data.countries %}
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<option value="{{ country.cca2 }}">{{ country.name.common }}</option>
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{% endfor %}
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</select>
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<label class="form-label" for="country">Country</label>
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</p>
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</div>
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<div class="grid__col">
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<p class="form-group">
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<select class="form-control" id="industry" name="industry" required data-required="true">
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<option value=""> </option>
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<option value="Automotive">Automotive</option>
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<option value="Banking">Banking</option>
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<option value="Consulting">Consulting</option>
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<option value="Data">Data</option>
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<option value="Energy">Energy</option>
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<option value="Government">Government</option>
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<option value="Healthcare">Healthcare</option>
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<option value="Identity">Identity & Security</option>
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<option value="Insurance">Insurance</option>
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<option value="Information Technology">Information Technology</option>
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<option value="Logistics">Logistics & Shipping</option>
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<option value="Manufacturing">Manufacturing</option>
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<option value="Media">Media & Content</option>
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<option value="other">Other</option>
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</select>
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<label class="form-label" for="industry">Industry</label>
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</p>
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</div>
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<div class="grid__col">
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<p class="form-group">
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<select class="form-control" id="interest" name="interest" required data-required="true">
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<option value=""> </option>
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<option value="Education">Education</option>
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<option value="Partnership">Partnership</option>
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<option value="Prototype">Proof-of-Concept / Prototype / Pilot</option>
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<option value="Implementation">Implementation</option>
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<option value="BigchainDB Enterprise Edition">BigchainDB Enterprise Subscription</option>
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</select>
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<label class="form-label" for="interest">Interested in</label>
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</p>
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</div>
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</div>
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<p class="form-group">
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<textarea class="form-control" id="comment" name="comment" rows="1"></textarea>
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<label class="form-label" for="comment">Comments</label>
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</p>
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<p class="form-group text-dimmed mini">
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Fields marked with an <span class="required">*</span> are required.
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</p>
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<p class="form-group">
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<input class="btn btn-primary" type="submit" value="Send">
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</p>
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<div class="alert alert-success animation-slide-in-from-bottom hide">
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<svg class="alert__icon icon icon-success">
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<use xlink:href="/assets/img/sprite.svg#icon-success"></use>
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</svg>
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<p>
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<strong class="alert__title">Great to hear you’re interested!</strong>
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We’ll get in touch soon.
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</p>
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</div>
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<div class="alert alert-danger hide">
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<svg class="alert__icon icon icon-fail">
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<use xlink:href="/assets/img/sprite.svg#icon-fail"></use>
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</svg>
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<p>
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<strong class="alert__title">Ops, there was an error</strong>
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Would you mind trying again?
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</p>
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</div>
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<input type="hidden" name="_subject" value="New contact form submission" />
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</form>
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