114 lines
5.0 KiB
HTML
114 lines
5.0 KiB
HTML
<!DOCTYPE html>
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<html lang="en">
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<head>
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<!-- Google tag (gtag.js) -->
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<script async src="https://www.googletagmanager.com/gtag/js?id=G-ZJ4YKQNNG1"></script>
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<script>
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window.dataLayer = window.dataLayer || [];
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function gtag(){dataLayer.push(arguments);}
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gtag('js', new Date());
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gtag('config', 'G-ZJ4YKQNNG1');
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</script>
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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<title>Work Order Form</title>
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<link rel="stylesheet" href="styles.css" type="text/css" />
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<!-- Cyborg Bootstrap Theme -->
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<link href="https://cdn.jsdelivr.net/npm/bootswatch@5.3.0/dist/cyborg/bootstrap.min.css" rel="stylesheet">
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<script src="https://cdn.jsdelivr.net/npm/bootstrap@5.3.3/dist/js/bootstrap.bundle.min.js" integrity="sha384-YvpcrYf0tY3lHB60NNkmXc5s9fDVZLESaAA55NDzOxhy9GkcIdslK1eN7N6jIeHz" crossorigin="anonymous"></script>
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<script src="https://cdn.jsdelivr.net/npm/@popperjs/core@2.11.8/dist/umd/popper.min.js" integrity="sha384-I7E8VVD/ismYTF4hNIPjVp/Zjvgyol6VFvRkX/vR+Vc4jQkC+hVqc2pM8ODewa9r" crossorigin="anonymous"></script>
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<link rel="icon" href="{{ url_for('static', filename='Logo.png') }}">
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<link rel="preconnect" href="https://fonts.gstatic.com" crossorigin>
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<link rel="preconnect" href="https://fonts.googleapis.com">
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<link href="https://fonts.googleapis.com/css2?family=Oswald:wght@200..700&display=swap" rel="stylesheet">
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</head>
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<body>
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<nav class="navbar navbar-expand-lg navbar-dark bg-dark">
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<img src="{{ url_for('static', filename='Logo.png') }}" width="60" height="60">
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<a class="navbar-brand" href="https://thorshammerelectrical.com/index.html">Thor's Hammer Electrical</a>
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<button class="navbar-toggler" type="button" data-bs-toggle="collapse" data-bs-target="#navbarNav" aria-controls="navbarNav" aria-expanded="false" aria-label="Toggle navigation">
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<span class="navbar-toggler-icon"></span>
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</button>
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<div class="collapse navbar-collapse" id="navbarNav">
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<ul class="navbar-nav ms-auto">
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<li class="nav-item active">
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<a class="nav-link" href="https://thorshammerelectrical.com/About.html">About</a>
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</li>
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<li class="nav-item">
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<a class="nav-link" href="https://thorshammerelectrical.com/Services.html">Services</a>
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</li>
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<li class="nav-item">
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<a class="nav-link" href="https://www.help.thorshammerelectrical.com">Submit Work-Order</a>
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</li>
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<li class="nav-item">
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<a class="nav-link" href="https://thorshammerelectrical.com/Review.html">Reviews</a>
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</li>
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</ul>
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</div>
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</nav>
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<!-- Form Container -->
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<div class="col-lg-8 mx-auto">
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<h1 class="text-white">Thor's Hammer Electrical Work-Order Form</h1>
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<p class="text-white">Got a job for us? Submit it here and Leonard will get back to you as soon as possible!</p>
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<form action="/submit" method="POST">
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<!-- Form Fields -->
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<div class="mb-4">
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<label for="name" class="form-label">Name:</label>
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<input type="text" id="name" name="name" class="form-control" required>
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</div>
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<div class="mb-4">
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<label for="job" class="form-label">Job Details:</label>
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<textarea id="job" name="job" class="form-control" required></textarea>
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</div>
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<div class="mb-4">
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<label for="address" class="form-label">Address:</label>
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<textarea id="address" name="address" class="form-control" required></textarea>
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</div>
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<div class="mb-4">
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<label for="city" class="form-label">City:</label>
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<input type="text" id="city" name="city" class="form-control" required>
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</div>
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<div class="mb-4">
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<label for="state" class="form-label">State:</label>
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<input type="text" id="state" name="state" class="form-control" required>
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</div>
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<div class="mb-4">
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<label for="zipcode" class="form-label">Zip Code:</label>
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<input type="text" id="zipcode" name="zipcode" class="form-control" required>
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</div>
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<div class="mb-4">
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<label for="phone" class="form-label">Phone Number:</label>
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<input type="text" id="phone" name="phone" class="form-control" required>
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</div>
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<!-- Submit Button -->
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<div class="d-grid gap-2">
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<input type="submit" value="Submit" class="btn btn-danger btn-lg">
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</div>
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</form>
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</div>
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</div>
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<!-- Bootstrap JS -->
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<script src="https://cdn.jsdelivr.net/npm/bootstrap@5.3.3/dist/js/bootstrap.bundle.min.js" integrity="sha384-YvpcrYf0tY3lHB60NNkmXc5s9fDVZLESaAA55NDzOxhy9GkcIdslK1eN7N6jIeHz" crossorigin="anonymous"></script>
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</body>
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</html>
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