<?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>Brief Questionnaire</h1>

                                <p>Please take your time and answer ALL of the questions. Web design and development is
                                    a collaborative process and needs your involvement in all stages. </p>
                            </div>
                        </div>
                    </div>
                    <!-- Form Start -->
                    <form action="sendmail.php" id="web-form" class="form 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="company[company_name]" class="form-control"
                                                                   placeholder=""
                                                                   value="" 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="company[company_business]" class="form-control"
                                                                   placeholder=""
                                                                   value="" required>
                                                        </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="company[company_email]" class="form-control"
                                                                   placeholder=""
                                                                   value="" 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="company[company_zip]" class="form-control"
                                                                   placeholder=""
                                                                   value="" required>
                                                        </div>
                                                    </div>
                                                </div>
                                              
                                                <div class="row radio_area">
                                                    <div class="col-md-6">
                                                        <h4>Are there other decision makers? Please specify.</h4>
                                                        <input type="text" name="company[company_makers]" class="form-control"
                                                               placeholder="If not available, you can contact.."
                                                               value="">
                                                    </div>
                                                    <div class="col-md-6">
                                                        <h4>Website Address – or Desired Domain(s)</h4>
                                                        <input type="text" name="company[company_domain]" class="form-control"
                                                               placeholder="www.demo.com"
                                                               value="">
                                                    </div>
                                                  
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="panel panel-default">
                                    <div class="panel-heading">
                                        <h4 class="panel-title">
                                            Tell me about Your Company
                                        </h4>

                                        <div class="col-md-12 panel-body">
                                            <h4>Please give me a brief overview of the company, what you do or produce? <span class="text-danger">*</span></h4>
                                            <textarea name="company[company_brief]" class="form-control" placeholder="" rows="10" data-error="Type your message..." aria-required="true"></textarea>
                                        </div>

                                    </div>
                                    <div id="collapse2" class="panel-collapse collapse in">
                                        <div class="panel-body">
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h4>What is the purpose of this site?<span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error">
                                                        <p>
                                                            <input class="" id="styled-checkbox-1" type="checkbox"
                                                                   value="Explain your products and services"
                                                                   name="company[company_overview][]" >
                                                            <label for="styled-checkbox-1">Explain your products and
                                                                services </label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-2" type="checkbox"
                                                                   value="Bring in new clients to your business"
                                                                   name="company[company_overview][]" >
                                                            <label for="styled-checkbox-2">Bring in new clients to your
                                                                business </label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-3" type="checkbox"
                                                                   value="Provide your customers with information on a certain subject"
                                                                   name="company[company_overview][]" >
                                                            <label for="styled-checkbox-3">Provide your customers with
                                                                information on a certain subject</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-4" type="checkbox"
                                                                   value="Deliver news or calendar of events"
                                                                   name="company[company_overview][]" >
                                                            <label for="styled-checkbox-4">Deliver news or calendar of
                                                                events </label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-5" type="checkbox"
                                                                   value="Create a blog that addresses specific topics or interests"
                                                                   name="company[company_overview][]" >
                                                            <label for="styled-checkbox-5">Create a blog that addresses
                                                                specific topics or interests </label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-6" type="checkbox"
                                                                   value="Sell a product or products online"
                                                                   name="company[company_overview][]" >
                                                            <label for="styled-checkbox-6">Sell a product or products
                                                                online </label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-7" type="checkbox"
                                                                   value="Provide support for current clients"
                                                                   name="company[company_overview][]" >
                                                            <label for="styled-checkbox-7">Provide support for current
                                                                clients </label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-8" type="checkbox"
                                                                   value="Others"
                                                                   name="company[company_overview][]" >
                                                            <label for="styled-checkbox-8"> Others </label>
                                                        </p>
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h4>Do you have a time frame or deadline to get this site
                                                        online? <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                    <input type="text" name="company[company_timeframe]" class="form-control"
                                                           placeholder=""
                                                           value="">
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="panel panel-default">
                                    <div class="panel-heading">
                                        <h4 class="panel-title">
                                            Target market
                                        </h4>
                                    </div>
                                    <div id="collapse3" class="panel-collapse collapse in">
                                        <div class="panel-body">
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h4>Who will visit this site? Describe your potential clients. <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error">
                                                        <textarea name="company[company_target_aud]" class="form-control" placeholder="" rows="10" data-error="Type your message..." aria-required="true"></textarea>
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h4>Why do you believe site visitors should do business with you
                                                        rather than with a competitor? What problem are you solving for
                                                        them? <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error">
                                                        <textarea name="company[company_target_business]" class="form-control" placeholder="" rows="10" data-error="Type your message..." aria-required="true"></textarea>
                                                    </div>
                                                </div>
                             
                                            </div>
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h4>What action(s) should the user perform when visiting your site?
                                                        Please put an X next to the ones that apply to you (OR) Bold
                                                        Fonts. <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error">
                                                        <p>
                                                            <input class="" id="styled-checkbox-30" type="checkbox"
                                                                   value="Call you"
                                                                   name="company[company_target_actions][]" >
                                                            <label for="styled-checkbox-30">Call you</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-31" type="checkbox"
                                                                   value="Fill out a contact form"
                                                                   name="company[company_target_actions][]" >
                                                            <label for="styled-checkbox-31">Fill out a contact
                                                                form</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-32" type="checkbox"
                                                                   value="Fill out a quote form"
                                                                   name="company[company_target_actions][]" >
                                                            <label for="styled-checkbox-32">Fill out a quote
                                                                form</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-33" type="checkbox"
                                                                   value="Sign up for your mailing list"
                                                                   name="company[company_target_actions][]" >
                                                            <label for="styled-checkbox-33">Sign up for your mailing
                                                                list</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-506" type="checkbox"
                                                                   value="Search for information"
                                                                   name="company[company_target_actions][]" >
                                                            <label for="styled-checkbox-506">Search for
                                                                information</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-507" type="checkbox"
                                                                   value="Purchase a product(s)"
                                                                   name="company[company_target_actions][]" >
                                                            <label for="styled-checkbox-507">Purchase a
                                                                product(s)</label>
                                                        </p>
                                                        <p>
                                                            <input class="" id="styled-checkbox-508" type="checkbox"
                                                                   value="Others"
                                                                   name="company[company_target_actions][]" >
                                                            <label for="styled-checkbox-508"> Others </label>
                                                        </p>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="panel panel-default">
                                    <div class="panel-heading">
                                        <h4 class="panel-title">
                                            Content
                                        </h4>
                                    </div>
                                    <div id="collapse4" class="panel-collapse collapse in">
                                        <div class="panel-body">
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h4>What are you offering? Make a list of all the sections/pages you
                                                        think that you'll need. (Samples below are just an example to
                                                        get you started, please fill this out completely.) <span class="text-danger">*</span></h4>

                                                    <textarea name="company[company_content_offer]" class="form-control" placeholder="" rows="10" data-error="Type your message..." aria-required="true"></textarea>
                                                    <br/>
                                                </div>

                                                <div class="col-md-12">
                                                    <h4>Do you have the written content and images/photographs prepared
                                                        for these pages? </h4>

                                                    <div class="form-group custom-error-2">
                                                        <p>
                                                            <input class="" id="styled-checkbox-50" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_content_written]" >
                                                            <label for="styled-checkbox-50">Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-51" type="radio"
                                                                   value="No"
                                                                   name="company[company_content_written]" checked>
                                                            <label for="styled-checkbox-51">No</label>
                                                        </p>
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <h4>If not, will you need copywriting and photography services?</h4>

                                                    <div class="form-group custom-error-2">
                                                        <p>
                                                            <input class="" id="" type="radio" value="Yes"
                                                                   name="company[company_content_copywriting]" >
                                                            <label for="">Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="" type="radio" value="No"
                                                                   name="company[company_content_copywriting]" checked>
                                                            <label for="">No</label>
                                                        </p>
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <h4>Are you willing to commit time/effort into learning how to use
                                                        Content Management System (CMS) and edit your site?</h4>

                                                    <div class="form-group custom-error-2">
                                                        <p>
                                                            <input class="" id="styled-checkbox-503" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_content_cms]" >
                                                            <label for="styled-checkbox-503">Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-504" type="radio"
                                                                   value="No"
                                                                   name="company[company_content_cms]" checked>
                                                            <label for="styled-checkbox-504">No</label>
                                                        </p>
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <h4>Is this a site re-design?</h4>

                                                    <div class="form-group custom-error-2">
                                                        <p>
                                                            <input class="" id="styled-checkbox-52" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_content_is_redesign]" >
                                                            <label for="styled-checkbox-52">Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-53" type="radio"
                                                                   value="No"
                                                                   name="company[company_content_is_redesign]" checked>
                                                            <label for="styled-checkbox-53">No</label>
                                                        </p>
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <h4>If yes, can you please explain what is working and not working
                                                        on your current site?</h4>
                                                    <textarea name="company[company_content_working_site]" class="form-control"
                                                              placeholder="" rows="10" data-error="Type your message..."
                                                              aria-required="true"></textarea>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group">
                                                        <label>Are you going to need?</label>
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error-2">
                                                        <p>
                                                            <input class="" id="styled-checkbox-55" type="checkbox"
                                                                   value="Ecommerce (sell products)"
                                                                   name="company[company_content_web_other][]">
                                                            <label for="styled-checkbox-55">Ecommerce (sell
                                                                products)</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-56" type="checkbox"
                                                                   value="Membership of any kind"
                                                                   name="company[company_content_web_other][]">
                                                            <label for="styled-checkbox-56">Membership of any
                                                                kind</label>
                                                        </p>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="panel panel-default">
                                    <div class="panel-heading">
                                        <h4 class="panel-title">
                                            Design
                                        </h4>
                                    </div>
                                    <div id="collapse5" class="panel-collapse collapse in">
                                        <div class="panel-body">
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h4>People are coming to your new site for the first time. How do
                                                        you want them to feel about your company? <span class="text-danger">*</span></h4>
                                                    <textarea name="company[company_design_company]" class="form-control" placeholder=""
                                                              rows="10" data-error="Type your message..."
                                                              aria-required="true"></textarea>
                                                </div>
                                                <div class="col-md-12">
                                                  
                                                    <div class="form-group custom-error-2">
                                                        <h4>If you do not already have a logo, are you going to need one
                                                            designed?</h4>

                                                        <p>
                                                            <input class="" id="styled-checkbox-60" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_design_logo_req]" >
                                                            <label for="styled-checkbox-60">Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-62" type="radio"
                                                                   value="No"
                                                                   name="company[company_design_logo_req]" checked>
                                                            <label for="styled-checkbox-62">No</label>
                                                        </p>
                                                    </div>
                                                    <div class="form-group custom-error-2">
                                                        <h4>Is there a specific look and feel that you have in
                                                            mind? <p class="text-danger">*</p></h4>

                                                        <p>
                                                            <input class="" id="styled-checkbox-63" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_design_idea]" >
                                                            <label for="styled-checkbox-63">Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-64" type="radio"
                                                                   value="No"
                                                                   name="company[company_design_idea]" checked>
                                                            <label for="styled-checkbox-64">No</label>
                                                        </p>
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <h3>Websites of your closest competition</h3>
                                                    <h4>Please include at least 3 links of sites of your competition.
                                                        What do you like and don't like about them? What would you like to do differently?</h4>
                                                </div>
                                                <div class="col-md-6">
                                                    <div class="form-group">
                                                        <label>Links 1</label>
                                                        <input type="text" name="company[company_design_link_1]" class="form-control"
                                                               placeholder=""
                                                               value="">
                                                    </div>
                                                </div>
                                                <div class="col-md-6">
                                                    <div class="form-group">
                                                        <label>Links 2</label>
                                                        <input type="text" name="company[company_design_link_2]" class="form-control"
                                                               placeholder=""
                                                               value="">
                                                    </div>
                                                </div>
                                                <div class="col-md-6">
                                                    <div class="form-group">
                                                        <label>Links 3</label>
                                                        <input type="text" name="company[company_design_link_3]" class="form-control"
                                                               placeholder=""
                                                               value="">
                                                    </div>
                                                </div>
                                                <div class="col-md-6">
                                                    <div class="form-group">
                                                        <label>Links 4</label>
                                                        <input type="text" name="company[company_design_link_4]" class="form-control"
                                                               placeholder="">
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <label>Description about website you like <span class="text-danger">*</span></label>
                                                    <textarea id="form_message" name="company[company_design_desc_web]"
                                                              class="form-control" placeholder="" rows="10"
                                                              data-error="Type your message..."></textarea>
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="panel panel-default">
                                    <div class="panel-heading">
                                        <h4 class="panel-title">
                                            Marketing The Site
                                        </h4>
                                    </div>
                                    <div id="collapse5" class="panel-collapse collapse in">
                                        <div class="panel-body">
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h4>How do people find out about your business right now?</h4>
                                                    <input type="text" name="company[company_market_business]" class="form-control"
                                                           placeholder=""
                                                           value="">
                                                </div>
                                                <div class="col-md-12">
                                                    <h4>Have you thought about how you're going to market this
                                                        site?</h4>
                                                    <input type="text" name="company[company_market_tought]" class="form-control"
                                                           placeholder=""
                                                           value="">
                                                </div>
                                                <div class="col-md-12">
                                                    <h4>Do you have any social network accounts setup? </h4>

                                                    <div class="form-group">
                                                        <p>
                                                            <input class="" id="styled-checkbox-99" type="checkbox"
                                                                   value="Facebook"
                                                                   name="company[company_market_social_acc][]" >
                                                            <label for="styled-checkbox-99">Facebook </label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-100" type="checkbox"
                                                                   value="Twitter"
                                                                   name="company[company_market_social_acc][]" >
                                                            <label for="styled-checkbox-100">Twitter</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-101" type="checkbox"
                                                                   value="Others"
                                                                   name="company[company_market_social_acc][]" >
                                                            <label for="styled-checkbox-101">Others</label>
                                                        </p>
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error-2">
                                                        <h4>Do you want links to those accounts on your site?</h4>

                                                        <p>
                                                            <input class="" id="styled-checkbox-101" type="radio"
                                                                   value="Yes" name="company[company_market_social_is_link]" >
                                                            <label for="styled-checkbox-101">Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-102" type="radio"
                                                                   value="No" name="company[company_market_social_is_link]" checked>
                                                            <label for="styled-checkbox-102">No</label>
                                                        </p>
                                                    </div>
                                                    <div class="form-group custom-error-2">
                                                        <h4>Do you have a mail service account? </h4>

                                                        <p>
                                                            <input class="" id="styled-checkbox-103" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_market_mail_service]" >
                                                            <label for="styled-checkbox-103"> Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-104" type="radio"
                                                                   value="No"
                                                                   name="company[company_market_mail_service]" checked>
                                                            <label for="styled-checkbox-104">No</label>
                                                        </p>
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error-2">
                                                        <h4>Will you want to build your mailing list and use it for
                                                            advertising & newsletters?</h4>

                                                        <p>
                                                            <input class="" id="styled-checkbox-105" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_market_advert]" >
                                                            <label for="styled-checkbox-105"> Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-106" type="radio"
                                                                   value="No"
                                                                   name="company[company_market_advert]" checked>
                                                            <label for="styled-checkbox-106">No</label>
                                                        </p>
                                                    </div>
                                                </div>

                                                <div class="col-md-12">
                                                    <div class="form-group custom-error-2">
                                                        <h4>Will you want printed materials (business cards, catalog,
                                                            etc.) produced as well?</h4>

                                                        <p>
                                                            <input class="" id="styled-checkbox-107" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_market_printed_material]" >
                                                            <label for="styled-checkbox-107"> Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-108" type="radio"
                                                                   value="No"
                                                                   name="company[company_market_printed_material]" checked>
                                                            <label for="styled-checkbox-108">No</label>
                                                        </p>
                                                    </div>
                                                </div>
                                            </div>
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h3>Domain and Hosting</h3>
                                                    <h4>Do you already own a domain name(s)? </h4>
                                                    <input type="text" name="company[company_market_is_domain]" class="form-control"
                                                           placeholder="" value="">
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error-2">
                                                        <h4>Do you have a hosting account already? </h4>

                                                        <p>
                                                            <input class="" id="styled-checkbox-205" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_market_is_hosting]" >
                                                            <label for="styled-checkbox-205"> Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-206" type="radio"
                                                                   value="No"
                                                                   name="company[company_market_is_hosting]" checked>
                                                            <label for="styled-checkbox-206">No</label>
                                                        </p>
                                                    </div>
                                                </div>

                                                <div class="col-md-6">
                                                    <div class="form-group">
                                                        <label>If yes, do you have the login/IP information? </label>
                                                        <input type="text" name="company[company_market_hosting_info]"
                                                               class="form-control" placeholder=""
                                                               value="">
                                                    </div>
                                                </div>
                                                <div class="col-md-6">
                                                    <div class="form-group">
                                                        <label>If no, what name(s) would you like?</label>
                                                        <input type="text" name="company[company_market_web_name]" class="form-control"
                                                               placeholder=" "
                                                               value="">
                                                    </div>
                                                </div>
                                                <div class="col-md-6">
                                                    <div class="form-group">
                                                        <label>Login/ IP information: what is this? User name and
                                                            password?</label>
                                                        <input type="text" name="company[company_market_hosting_cred]"
                                                               class="form-control" placeholder=""
                                                               value="">
                                                    </div>
                                                </div>
                                              
                                            </div>
                                            <div class="row">
                                                <div class="col-md-12">
                                                    <h3>Maintenance</h3>
                                                    <h4>Will there be sections that need regular updating? </h4>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error-2">
                                                        <p>
                                                            <input class="" id="styled-checkbox-290" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_market_section_maint]" >
                                                            <label for="styled-checkbox-290"> Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-291" type="radio"
                                                                   value="No"
                                                                   name="company[company_market_section_maint]" checked>
                                                            <label for="styled-checkbox-291">No</label>
                                                        </p>
                                                    </div>
                                                </div>

                                                <div class="col-md-12">
                                                    <div class="form-group custom-error-2">
                                                        <h4>Would you like to be able to do most of the updating
                                                            yourself?</h4>

                                                        <p>
                                                            <input class="" id="styled-checkbox-292" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_market_update]" >
                                                            <label for="styled-checkbox-292"> Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-293" type="radio"
                                                                   value="No"
                                                                   name="company[company_market_update]" checked>
                                                            <label for="styled-checkbox-293">No</label>
                                                        </p>
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error-2">
                                                        <h4>If you’re planning on writing a blog do you already have
                                                            several things written?Do you already write on a regular
                                                            basis?</h4>

                                                        <p>
                                                            <input class="" id="styled-checkbox-501" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_market_blog]" >
                                                            <label for="styled-checkbox-501"> Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-502" type="radio"
                                                                   value="No"
                                                                   name="company[company_market_blog]" checked>
                                                            <label for="styled-checkbox-502">No</label>
                                                        </p>
                                                        <br>
                                                        <label>If no,we don't have any..</label>
                                                        <textarea name="company[company_market_blog_desc]" class="form-control"
                                                                  placeholder="" rows="10"
                                                                  data-error="Type your message..."></textarea>
                                                    </div>
                                                </div>
                                                <div class="col-md-12">
                                                    <div class="form-group custom-error-2">
                                                        <h4>Are there any features/pages that you don’t need now but may
                                                            want in the future? Please be as specific and future
                                                            thinking as possible.</h4>

                                                        <p>
                                                            <input class="" id="styled-checkbox-294" type="radio"
                                                                   value="Yes"
                                                                   name="company[company_market_pages]" >
                                                            <label for="styled-checkbox-294"> Yes</label>
                                                        </p>

                                                        <p>
                                                            <input class="" id="styled-checkbox-295" type="radio"
                                                                   value="No"
                                                                   name="company[company_market_pages]" checked>
                                                            <label for="styled-checkbox-295">No</label>
                                                        </p>
                                                        <br>
                                                        <label>If yes,we need.. </label>
                                                        <textarea name="company[company_market_pages_desc]" class="form-control"
                                                                  placeholder="" rows="10"
                                                                  data-error="Type your message..."></textarea>
                                                    </div>
                                                </div>

												<div class="col-md-12"> 
												  
												  <h4>Click Here to Upload File</h4>
												 
                                                <input class="form-control" type="file" name="image[]" multiple value="" />
                                                 
												</div>
												<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>
                        </div>
                         
                                                   
                                             
                    </form>
                    <!-- Form End -->
                </div>
            </div>
        </div>
    </section>
  <?php include "includes/footer.php" ?>