"Contact Us"
Bootstrap 3.3.0 Snippet by MTaqi

<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <div class="container"> <div class="row"> <div class="col-md-2"> </div> <div class="col-md-8"> <h1>Contact Us</h1> <p class="lead">Have a question or want further information?</p> <p>Fill in the short form and we will get back to you as soon as possible.</p> <br> <!-- BEGIN DOWNLOAD PANEL --> <div class="panel panel-default well"> <div class="panel-body"> <form action="" class="form-horizontal track-event-form bv-form" data-goaltype="”General”" data-formname="”ContactUs”" method="post" id="contact-us-all" novalidate="novalidate"> <input name="elqSiteId" type="hidden" value="928"> <input name="sFDCLastCampaignID" type="hidden" value="701400000012Lql"> <input name="elqFormName" type="hidden" value="EMEAAllContactUsSubmissions"> <input name="nexturl" type="hidden" value=""> <input name="Partner" type="hidden" value=""> <input name="language" type="hidden" value="en"> <div class="form-group"> <div class="col-sm-6"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-user"></i> </div> <input type="text" class="form-control" id="exampleInputFirstName" placeholder="Enter first name" name="C_FirstName" data-bv-field="C_FirstName"> </div> <small data-bv-validator="notEmpty" data-bv-validator-for="C_FirstName" class="help-block" style="display: none;">Required</small></div> <div class="col-sm-6"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-user"></i> </div> <input type="text" class="form-control" id="exampleInputLastName" placeholder="Enter last name" name="C_LastName" data-bv-field="C_LastName"></div> <small data-bv-validator="notEmpty" data-bv-validator-for="C_LastName" class="help-block" style="display: none;">Required</small></div> </div> <div class="form-group"> <div class="col-sm-6"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-envelope"></i> </div> <input type="text" class="form-control" id="exampleInputEmail1" placeholder="Enter email" name="C_EmailAddress" data-bv-field="C_EmailAddress"> </div> <small data-bv-validator="notEmpty" data-bv-validator-for="C_EmailAddress" class="help-block" style="display: none;">Required</small></div> <div class="col-sm-6"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-briefcase"></i> </div> <input type="text" class="form-control" id="exampleInputCompany" placeholder="Enter company" name="C_Company"> </div> </div> </div> <div class="form-group"> <div class="col-sm-6"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-globe"></i> </div> <select data-placeholder="Choose country" class="C_Country_Modal form-control" id="C_Country" name="C_Country" data-bv-field="C_Country"> <option value="">--Select--</option> <option value="United States">United States</option> <option value="Afghanistan">Afghanistan</option> <option value="Albania">Albania</option> <option value="Algeria">Algeria</option> <option value="American Samoa">American Samoa</option> <option value="Andorra">Andorra</option> <option value="Angola">Angola</option> <option value="Anguilla">Anguilla</option> <option value="Antarctica">Antarctica</option> <option value="Antigua and Barbuda">Antigua and Barbuda</option> <option value="Argentina">Argentina</option> <option value="Armenia">Armenia</option> <option value="Aruba">Aruba</option> <option value="Australia">Australia</option> <option value="Austria">Austria</option> <option value="Azerbaijan">Azerbaijan</option> <option value="Bahamas">Bahamas</option> <option value="Bahrain">Bahrain</option> <option value="Bangladesh">Bangladesh</option> <option value="Barbados">Barbados</option> <option value="Belarus">Belarus</option> <option value="Belgium">Belgium</option> <option value="Belize">Belize</option> <option value="Benin">Benin</option> <option value="Bermuda">Bermuda</option> <option value="Bhutan">Bhutan</option> <option value="Bolivia">Bolivia</option> <option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option> <option value="Botswana">Botswana</option> <option value="Bouvet Island">Bouvet Island</option> <option value="Brazil">Brazil</option> <option value="British Indian Ocean Territory">British Indian Ocean Territory</option> <option value="Brunei Darussalam">Brunei Darussalam</option> <option value="Bulgaria">Bulgaria</option> <option value="Burkina Faso">Burkina Faso</option> <option value="Burundi">Burundi</option> <option value="Cambodia">Cambodia</option> <option value="Cameroon">Cameroon</option> <option value="Canada">Canada</option> <option value="Cape Verde">Cape Verde</option> <option value="Cayman Islands">Cayman Islands</option> <option value="Central African Republic">Central African Republic</option> <option value="Chad">Chad</option> <option value="Chile">Chile</option> <option value="China">China</option> <option value="Christmas Island">Christmas Island</option> <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option> <option value="Colombia">Colombia</option> <option value="Comoros">Comoros</option> <option value="Congo">Congo</option> <option value="Congo, The Democratic Republic of the">Congo, The Democratic Republic of the</option> <option value="Cook Islands">Cook Islands</option> <option value="Costa Rica">Costa Rica</option> <option value="CÙte d'Ivoire">Côte d'Ivoire</option> <option value="Croatia">Croatia</option> <option value="Cuba">Cuba</option> <option value="Cyprus">Cyprus</option> <option value="Czech Republic">Czech Republic</option> <option value="Denmark">Denmark</option> <option value="Djibouti">Djibouti</option> <option value="Dominica">Dominica</option> <option value="Dominican Republic">Dominican Republic</option> <option value="Ecuador">Ecuador</option> <option value="Egypt">Egypt</option> <option value="El Salvador">El Salvador</option> <option value="Equatorial Guinea">Equatorial Guinea</option> <option value="Eritrea">Eritrea</option> <option value="Estonia">Estonia</option> <option value="Ethiopia">Ethiopia</option> <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option> <option value="Faroe Islands">Faroe Islands</option> <option value="Fiji">Fiji</option> <option value="Finland">Finland</option> <option value="France">France</option> <option value="French Guiana">French Guiana</option> <option value="French Polynesia">French Polynesia</option> <option value="French Southern Territories">French Southern Territories</option> <option value="Gabon">Gabon</option> <option value="Gambia">Gambia</option> <option value="Georgia">Georgia</option> <option value="Germany">Germany</option> <option value="Ghana">Ghana</option> <option value="Gibraltar">Gibraltar</option> <option value="Greece">Greece</option> <option value="Greenland">Greenland</option> <option value="Grenada">Grenada</option> <option value="Guadeloupe">Guadeloupe</option> <option value="Guam">Guam</option> <option value="Guatemala">Guatemala</option> <option value="Guernsey">Guernsey</option> <option value="Guinea">Guinea</option> <option value="Guinea-Bissau">Guinea-Bissau</option> <option value="Guyana">Guyana</option> <option value="Haiti">Haiti</option> <option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option> <option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option> <option value="Honduras">Honduras</option> <option value="Hong Kong">Hong Kong</option> <option value="Hungary">Hungary</option> <option value="Iceland">Iceland</option> <option value="India">India</option> <option value="Indonesia">Indonesia</option> <option value="Iran, Islamic Republic of">Iran, Islamic Republic of</option> <option value="Iraq">Iraq</option> <option value="Ireland">Ireland</option> <option value="Isle of Man">Isle of Man</option> <option value="Israel">Israel</option> <option value="Italy">Italy</option> <option value="Jamaica">Jamaica</option> <option value="Japan">Japan</option> <option value="Jersey">Jersey</option> <option value="Jordan">Jordan</option> <option value="Kazakhstan">Kazakhstan</option> <option value="Kenya">Kenya</option> <option value="Kiribati">Kiribati</option> <option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option> <option value="Korea, Republic of">Korea, Republic of</option> <option value="Kuwait">Kuwait</option> <option value="Kyrgyzstan">Kyrgyzstan</option> <option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option> <option value="Latvia">Latvia</option> <option value="Lebanon">Lebanon</option> <option value="Lesotho">Lesotho</option> <option value="Liberia">Liberia</option> <option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option> <option value="Liechtenstein">Liechtenstein</option> <option value="Lithuania">Lithuania</option> <option value="Luxembourg">Luxembourg</option> <option value="Macao">Macao</option> <option value="Macedonia, The Former Yugoslav Republic of">Macedonia, The Former Yugoslav Republic of</option> <option value="Madagascar">Madagascar</option> <option value="Malawi">Malawi</option> <option value="Malaysia">Malaysia</option> <option value="Maldives">Maldives</option> <option value="Mali">Mali</option> <option value="Malta">Malta</option> <option value="Marshall Islands">Marshall Islands</option> <option value="Martinique">Martinique</option> <option value="Mauritania">Mauritania</option> <option value="Mauritius">Mauritius</option> <option value="Mayotte">Mayotte</option> <option value="Mexico">Mexico</option> <option value="Micronesia, Federated States of">Micronesia, Federated States of</option> <option value="Moldova, Republic of">Moldova, Republic of</option> <option value="Monaco">Monaco</option> <option value="Mongolia">Mongolia</option> <option value="Montenegro">Montenegro</option> <option value="Montserrat">Montserrat</option> <option value="Morocco">Morocco</option> <option value="Mozambique">Mozambique</option> <option value="Myanmar">Myanmar</option> <option value="Namibia">Namibia</option> <option value="Nauru">Nauru</option> <option value="Nepal">Nepal</option> <option value="Netherlands">Netherlands</option> <option value="Netherlands Antilles">Netherlands Antilles</option> <option value="New Caledonia">New Caledonia</option> <option value="New Zealand">New Zealand</option> <option value="Nicaragua">Nicaragua</option> <option value="Niger">Niger</option> <option value="Nigeria">Nigeria</option> <option value="Niue">Niue</option> <option value="Norfolk Island">Norfolk Island</option> <option value="Northern Mariana Islands">Northern Mariana Islands</option> <option value="Norway">Norway</option> <option value="Oman">Oman</option> <option value="Pakistan">Pakistan</option> <option value="Palau">Palau</option> <option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option> <option value="Panama">Panama</option> <option value="Papua New Guinea">Papua New Guinea</option> <option value="Paraguay">Paraguay</option> <option value="Peru">Peru</option> <option value="Philippines">Philippines</option> <option value="Pitcairn">Pitcairn</option> <option value="Poland">Poland</option> <option value="Portugal">Portugal</option> <option value="Puerto Rico">Puerto Rico</option> <option value="Qatar">Qatar</option> <option value="Reunion">Reunion</option> <option value="Romania">Romania</option> <option value="Russian Federation">Russian Federation</option> <option value="Rwanda">Rwanda</option> <option value="Saint BarthÈlemy">Saint Barthélemy</option> <option value="Saint Helena">Saint Helena</option> <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option> <option value="Saint Lucia">Saint Lucia</option> <option value="Saint Martin">Saint Martin</option> <option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option> <option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option> <option value="Samoa">Samoa</option> <option value="San Marino">San Marino</option> <option value="Sao Tome and Principe">Sao Tome and Principe</option> <option value="Saudi Arabia">Saudi Arabia</option> <option value="Senegal">Senegal</option> <option value="Serbia">Serbia</option> <option value="Seychelles">Seychelles</option> <option value="Sierra Leone">Sierra Leone</option> <option value="Singapore">Singapore</option> <option value="Slovakia">Slovakia</option> <option value="Slovenia">Slovenia</option> <option value="Solomon Islands">Solomon Islands</option> <option value="Somalia">Somalia</option> <option value="South Africa">South Africa</option> <option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option> <option value="Spain">Spain</option> <option value="Sri Lanka">Sri Lanka</option> <option value="Sudan">Sudan</option> <option value="Suriname">Suriname</option> <option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option> <option value="Swaziland">Swaziland</option> <option value="Sweden">Sweden</option> <option value="Switzerland">Switzerland</option> <option value="Syrian Arab Republic">Syrian Arab Republic</option> <option value="Taiwan, Province of China">Taiwan, Province of China</option> <option value="Tajikistan">Tajikistan</option> <option value="Tanzania, United Republic of">Tanzania, United Republic of</option> <option value="Thailand">Thailand</option> <option value="Timor-Leste">Timor-Leste</option> <option value="Togo">Togo</option> <option value="Tokelau">Tokelau</option> <option value="Tonga">Tonga</option> <option value="Trinidad and Tobago">Trinidad and Tobago</option> <option value="Tunisia">Tunisia</option> <option value="Turkey">Turkey</option> <option value="Turkmenistan">Turkmenistan</option> <option value="Turks and Caicos Islands">Turks and Caicos Islands</option> <option value="Tuvalu">Tuvalu</option> <option value="Uganda">Uganda</option> <option value="Ukraine">Ukraine</option> <option value="United Arab Emirates">United Arab Emirates</option> <option value="United Kingdom">United Kingdom</option> <option value="United States Minor Outlying Island">United States Minor Outlying Island</option> <option value="Uruguay">Uruguay</option> <option value="Uzbekistan">Uzbekistan</option> <option value="Vanuatu">Vanuatu</option> <option value="Venezuela">Venezuela</option> <option value="Viet Nam">Viet Nam</option> <option value="Virgin Islands, British">Virgin Islands, British</option> <option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option> <option value="Wallis and Futuna">Wallis and Futuna</option> <option value="Western Sahara">Western Sahara</option> <option value="Yemen">Yemen</option> <option value="Zambia">Zambia</option> <option value="Zimbabwe">Zimbabwe</option> </select> </div> <small data-bv-validator="callback" data-bv-validator-for="C_Country" class="help-block" style="display: none;">Choose one</small></div> <div class="col-sm-6"> <div class="input-group" style="display: none;"> <div class="input-group-addon"> <i class="fa fa-globe"></i> </div> <select data-placeholder="Choose state" class="C_State_Prov_Modal form-control" id="C_State_Prov" name="C_State_Prov"> <option value="" selected="selected">- Not applicable -</option> <option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="DC">District Of Columbia</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PA">Pennsylvania</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VA">Virginia</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> <option value="AB">Alberta</option> <option value="BC">British Columbia</option> <option value="MB">Manitoba</option> <option value="NB">New Brunswick</option> <option value="NL">Newfoundland and Labrador</option> <option value="NS">Nova Scotia</option> <option value="NT">Northwest Territories</option> <option value="NU">Nunavut</option> <option value="ON">Ontario</option> <option value="PE">Prince Edward Island</option> <option value="QC">Quebec</option> <option value="SK">Saskatchewan</option> <option value="YT">Yukon</option> </select> </div> </div> </div> <div class="form-group"> <div class="col-sm-12"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-phone"></i> </div> <input type="text" class="form-control" id="C_BusPhone" placeholder="Phone" name="C_BusPhone"> </div> </div> </div> <div class="form-group"> <div class="col-sm-12"> <div class="input-group"> <div class="input-group-addon"> <i class="fa fa-comment fa-2"></i> </div> <textarea class="form-control" name="Comments" id="Comments" rows="5" style="width:99.9%" placeholder="Enter your message here"></textarea> </div> </div> </div> <div class="form-group"> <div class="col-sm-12"> <button id="contacts-submit" type="submit" class="btn btn-default btn-info">CONTACT US</button> </div> </div> <input type="hidden" value=""></form> </div><!-- end panel-body --> </div><!-- end panel --> <!-- END DOWNLOAD PANEL --> </div><!-- end col-md-8 --> <div class="col-md-2"> </div> </div> </div>
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Questions / Comments:

Thank you this is so nice

Diego () - 1 year ago - Reply 0


nice!

Paco () - 2 years ago - Reply 0