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mattsharpe/index.html

Created March 19, 2020 17:31
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Form styling
Raw
index.html
<!doctype html>
<html lang="en">
<head>
<!-- Required meta tags -->
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
<!-- Bootstrap CSS -->
<link rel="stylesheet" href="https://stackpath.bootstrapcdn.com/bootstrap/4.4.1/css/bootstrap.min.css" integrity="sha384-Vkoo8x4CGsO3+Hhxv8T/Q5PaXtkKtu6ug5TOeNV6gBiFeWPGFN9MuhOf23Q9Ifjh" crossorigin="anonymous">
<title>Order for Doorstep Collective</title>
</head>
<body class="bg-light">
<nav class="navbar navbar-light bg-light">
<span class="navbar-brand" >Order for Doorstep Collective</span>
</nav>
<div class="container">
<form name="contactform" method="post" action="feedback_form.php">
<h4 class="mb-3">Your Details</h4>
<div class="row mb-3">
<div class="col-md-6">
<label for="firstName">First Name <em>(required)</em></label>
<input class="form-control" required type="text" name="firstName" maxlength="50" size="25">
</div>
<div class="col">
<label for="firstName">Last Name <em>(required)</em></label>
<input class="form-control" required type="text" name="lastName" maxlength="50" size="25">
</div>
</div>
<div class="row mb-3">
<div class="col">
<label for="firstName">Email Address <em>(required)</em></label>
<input class="form-control" required type="text" name="email" maxlength="80" size="25">
</div>
</div>
<div class="row mb-3">
<div class="col">
<label for="phoneNumber">Telephone Number</label>
<input class="form-control" type="text" name="phoneNumber" maxlength="30" size="25">
</div>
</div>
<h4 class="mb-3">Delivery Options</h4>
<div class="row mb-3">
<div class="col-md-6 col-xs-12">
<h6>Delivery Days Wanted: <em>(required)</em></h6>
<input type="checkbox" name="deliveryDays[]" value="Monday" id="Monday">
<label for="Monday">Monday</label><br>
<input type="checkbox" name="deliveryDays[]" value="Tuesday" id="Tuesday">
<label for="Tuesday">Tuesday</label><br>
<input type="checkbox" name="deliveryDays[]" value="Wednesday" id="Wednesday">
<label for="Wednesday">Wednesday</label><br>
<input type="checkbox" name="deliveryDays[]" value="Thursday" id="Thursday">
<label for="Thursday">Thursday</label><br>
<input type="checkbox" name="deliveryDays[]" value="Friday" id="Friday">
<label for="Friday">Friday</label><br>
<input type="checkbox" name="deliveryDays[]" value="Saturday" id="Saturday">
<label for="Saturday">Saturday</label><br>
<input type="checkbox" name="deliveryDays[]" value="Sunday" id="Sunday">
<label for="Sunday">Sunday</label><br>
</div>
<div class="col-md-6">
<h6>Delivery Options Wanted: <em>(required)</em></h6>
<input type="checkbox" name="orderOption[]" value="orderOption1" id="orderOption1">
<label for="orderOption1">Hot Food</label><br>
<input type="checkbox" name="orderOption[]" value="orderOption2" id="orderOption2">
<label for="orderOption2">Cold Food</label><br>
<input type="checkbox" name="orderOption[]" value="orderOption3" id="orderOption3">
<label for="orderOption3">Prescriptions</label><br>
</div>
</div>
<div class="row mb-3">
<div class="col">
<h6>Dietary Requirements: <em>(required)</em></h6>
<textarea class="form-control" name="dietaryRequirements" maxlength="1000" cols="25" rows="3"></textarea>
</div>
</div>
<div class="row mb-3">
<div class="col-1">
<input type="checkbox" name="privacy" value="privacy" id="privacy" checked>
</div>
<div class="col">
<label class="pull-right" for="privacy">I'm happy that my data will be used to bring me necessary items and then be annihilated once this is all over.</label>
</div>
</div>
<div class="row mb-3">
<div class="col">
<input type="submit" value="Submit" class="btn btn-primary">
</div>
</div>
</form>
</div>
<!-- Optional JavaScript -->
<!-- jQuery first, then Popper.js, then Bootstrap JS -->
<script src="https://code.jquery.com/jquery-3.4.1.slim.min.js" integrity="sha384-J6qa4849blE2+poT4WnyKhv5vZF5SrPo0iEjwBvKU7imGFAV0wwj1yYfoRSJoZ+n" crossorigin="anonymous"></script>
<script src="https://cdn.jsdelivr.net/npm/popper.js@1.16.0/dist/umd/popper.min.js" integrity="sha384-Q6E9RHvbIyZFJoft+2mJbHaEWldlvI9IOYy5n3zV9zzTtmI3UksdQRVvoxMfooAo" crossorigin="anonymous"></script>
<script src="https://stackpath.bootstrapcdn.com/bootstrap/4.4.1/js/bootstrap.min.js" integrity="sha384-wfSDF2E50Y2D1uUdj0O3uMBJnjuUD4Ih7YwaYd1iqfktj0Uod8GCExl3Og8ifwB6" crossorigin="anonymous"></script>
</body>
</html>
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