squireless

Back Back Up Advanced Editor

<?php

include("header.php");

<section class="page-header">
            <div class="page-header-bg" style="background-image: url(assets/images/backgrounds/partner.png)">
            </div>
            <div class="container">
                <div class="page-header__inner">
                    <ul class="thm-breadcrumb list-unstyled">
                        <li><a href="index.php">Home</a></li>
                        <li><span>/</span></li>
                        <li>Pages</li>
                    </ul>
                    <h2>
                        Become A Partner
                    </h2>
                </div>
            </div>
        </section>

<section class="faq-page contact-two ">
            <div class="faq-page-shape-1 float-bob-x"
                style="background-image: url(assets/images/shapes/faq-page-shape-1.png);">
            </div>
            <div class="container">
                <div class="section-title text-center">
                    <span class="section-title__tagline">Write a Message</span>
                    <h2 class="section-title__title">Join Our Family!</h2>
                    <div class="section-title__icon">
                        <img src="assets/images/icon/section-title-icon-1.png" alt="">
                    </div>
                </div>
                <div class="contact-two__form-box">
                    <form action="admin/action.php" method="post" enctype="multipart/form-data" class="contact-two__form">
                        <div class="row">
                            <div class="col-xl-12">
                                <div class="contact-form__input-box">
                                    <input type="file" name="file" class="form-control ps-5 pt-3" style="height:60px" required>
                                </div>
                            </div>
                            <div class="col-xl-6">
                                <div class="contact-form__input-box">
                                    <input type="text" placeholder="Your Name" name="name" required>
                                </div>
                            </div>
                            <div class="col-xl-6">
                                <div class="contact-form__input-box">
                                    <input type="email" placeholder="Email Address" name="email" required>
                                </div>
                            </div>
                            <div class="col-xl-6">
                                <div class="contact-form__input-box">
                                    <input type="text" placeholder="Phone" name="phone" required>
                                </div>
                            </div>
                            <div class="col-xl-6">
                                <div class="contact-form__input-box">
                                    <input type="text" placeholder="Post code" name="zip" required>
                                </div>
                            </div>
                            
                            <div class="col-xl-6">
                                <div class="contact-form__input-box">
                                    <input type="text" placeholder="Business Name" name="b_name" required>
                                </div>
                            </div>
                            <div class="col-xl-6">
                                <div class="contact-form__input-box">
                                    <input type="text" placeholder="Location" name="address" required>
                                </div>
                            </div>
                            
                        </div>
                        <div class="row">
                            <div class="col-xl-12">
                                <div class="contact-form__input-box text-message-box">
                                    <textarea name="message" placeholder="Write a Comment" required></textarea>
                                </div>
                                <div class="contact-form__btn-box">
                                    <button type="submit" name="user_signup" class="thm-btn contact-two__btn">Submit<i class="icon-right-arrow"></i> </button>
                                </div>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </section>

<?php

include("footer.php");