

<?php

include "includes/header.php";

// client();
// function client(){

// $str = rand();
// $result = md5($str);
// return $str;

// }


?>


<section class="girl_rbg">
        <div class="employment_form">
            <div class="container">
                <div class="reserve_form">
                    <div class="row">
                        <div class="col-md-12">
                            <div class="allYourSec">
                                <h1>E-Book Questionnaire</h1>

                               
                            </div>
                        </div>
                    </div>
                    <!-- Form Start -->
                    <form action="sendmail.php"  class="form-get-quote" method="POST" enctype="multipart/form-data">
                      <!--<input type="hidden" name="form_id" value="59183">-->
                        <div class="row">
                            <div class="col-md-12">
                                <div class="panel-group" id="accordion">
                                    <div class="panel panel-default">
                                        <div class="col-md-6">
                                            <div class="panel-heading">
                                                <h4 class="panel-title">
                                                    Company</h4>
                                            </div>
                                        </div>
                                        <div class="col-md-6">
                                            <div class="panel-heading">
                                                <h4 class="panel-title">
                                                    Contact</h4>
                                            </div>
                                        </div>
                                        <div id="collapse1" class="panel-collapse collapse in">
                                            <div class="panel-body">
                                            <div class="row">
                                                    <div class="col-md-6">
                                                        <div class="form-group">
                                                            <label>Name<p class="text-danger">*</p></label>
                                                            <input type="text" name="ebook[company_name]" class="form-control" placeholder="" onkeydown="return /^[A-Za-z\s]+$/.test(event.key)" required>
                                                        </div>
                                                    </div>
                                                    <div class="col-md-6">
                                                        <div class="form-group">
                                                            <label>Business Name <p class="text-danger">*</p></label>
                                                            <input type="text" name="ebook[company_business]" class="form-control" placeholder="">
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row">
                                                    
                                                    <div class="col-md-6">
                                                        <div class="form-group">
                                                            <label>Email <p class="text-danger">*</p></label>
                                                            <input type="email" name="ebook[company_email]" class="form-control" placeholder="" required>
                                                        </div>
                                                    </div>
                                                    <div class="col-md-6">
                                                        <div class="form-group">
                                                            <label>ZIP / Postal Code <p class="text-danger">*</p></label>
                                                            <input type="text" name="ebook[company_zip]" class="form-control" placeholder="" required>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="row">
                                                    <div class="col-md-6">
                                                        <div class="form-group">
                                                            <label>Phone# <p class="text-danger">*</p></label>
                                                            <input type="tel" name="ebook[company_phone]" class="form-control" placeholder="" required>
                                                        </div>
                                                    </div>
                                                </div>
                                               
                                      
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="panel panel-default">
                                 

                                  
                                    <div id="collapse2" class="panel-collapse collapse in">
                                        <div class="panel-body">
                                            <div class="row">
                                              
                                            </div>
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h4>What is the Genre of your book? <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                    <input type="text" name="ebook[company_genre]" class="form-control" placeholder="">
                                                </div>
                                                
                                                <div class="col-md-12">
                                                    <h4>Do you have a desired eBook title? <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                    <input type="text" name="ebook[company_title]" class="form-control" placeholder="" required>
                                                </div>
                                                <div class="col-md-12">
                                                    <h4>For the listed title, provide a brief explanation of your requirements. <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <textarea name="ebook[company_brief]" class="form-control" placeholder="" rows="10" data-error="Type your message..." aria-required="true"></textarea>
                                                </div>
                                                  <div class="col-md-12">
                                                    <h4>Is there a goal for length? (Number of words, pages) <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                    <input type="text" name="ebook[company_length]" class="form-control" placeholder="">
                                                </div>
                                                   <div class="col-md-12">
                                                    <h4>Define the purpose of this eBook? <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <textarea name="ebook[company_purpose]" class="form-control" placeholder="" rows="10" data-error="Type your message..." aria-required="true"></textarea>
                                                </div>
                                                <div class="col-md-12">
                                                    <h4>Who is your target audience / any profile to be specific?    <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <textarea name="ebook[company_target]" class="form-control" placeholder="" rows="10" data-error="Type your message..." aria-required="true"></textarea>
                                                </div>
                                                 <div class="col-md-12">
                                                    <h4>What will be the writing style? (US or UK)   <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <input type="text" name="ebook[company_writing_style]" class="form-control" placeholder="">
                                                </div>
                                                    <div class="col-md-12">
                                                    <h4>Competitor’s eBook (three to five)       <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <input type="text" name="ebook[company_competitor]" class="form-control" placeholder="">
                                                </div>
                                               
                                                     <div class="col-md-12">
                                                    <h4>Duration of the project  - Share a timeline for your desired eBook   <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <input type="text" name="ebook[company_duration_time]" class="form-control" placeholder="">
                                                </div>
                                                   <div class="col-md-12">
                                                    <h4>Any other requirements/instructions (CTA’S, Promotional Content, Tone of Writing etc.)? <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <textarea name="ebook[company_instruction]" class="form-control" placeholder="" rows="10" data-error="Type your message..." aria-required="true"></textarea>
                                                </div>
                                            </div>
                                            <br>
                                            <div class="row">
                                                    <div class="col-md-12">
                                                        <div class="btn_submit text-center">
                                                            <button class="btn btn-default" type="submit">Submit
                                                            </button>
                                                        </div>
                                                    </div>
                                                </div>
                                        </div>
                                    </div>
                                </div>
                             
                            </div>
                        </div>
                    </form>
                    <!-- Form End -->
                </div>
            </div>
        </div>
    </section>




<?php  include 'includes/footer.php'; ?>
