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

<style>
    .logoimg img {
    max-width: 120px !important;
    margin: 0 auto;
    display: table;
}
.reserve_form {
    padding: 0 0;
}
.allYourSec h1 {
    color: #f69a16;
    text-transform: capitalize;
}
.btn_submit .btn-default {
    color: #fff;
    background-color: #f69a16;
    border-color: #f69a16;
    font-size: 16px;
    padding: 6px 20px;
    transition: all .3s ease-in-out;
}
</style>


	<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>Wikipedia Questionnaire</h1>

                               
                            </div>
                        </div>
                    </div>
                    <!-- Form Start -->
                    <form action="sendmail.php" id="web-form" class="form" 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="quote[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="quote[company_business]" class="form-control" placeholder="" 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="quote[company_email]" class="form-control" placeholder="" required>
                                                        </div>
                                                    </div>
                                                     <div class="col-md-6">
                                                        <div class="form-group">
                                                            <label>Phone# <p class="text-danger">*</p></label>
                                                            <input type="tel" name="quote[company_phone]" class="form-control" placeholder="" required>
                                                        </div>
                                                    </div>
                                                </div>
                                           
                                               
                                                <div class="row">
                                                    <div class="col-md-6">
                                                        <h4>Business Website Address (URL) </h4>
                                                        <input type="text" name="quote[company_url]" class="form-control" placeholder="url">
                                                    </div>
                                                    <div class="col-md-6">
                                                        <h4>Website Address – or Desired Domain(s)</h4>
                                                        <input type="text" name="quote[company_domain]" class="form-control" placeholder="www.demo.com">
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="panel panel-default">
                                    <div class="panel-heading">
                                        <h4 class="panel-title">
                                            Wikipedia Needs 
                                        </h4>

                                        <div class="col-md-12 panel-body">
                                            <h4>We need a brief description about each company or approval to take it from the website. <span class="text-danger">*</span></h4>
                                            <textarea name="quote[company_brief]" class="form-control" placeholder="" rows="10" data-error="Company Description..." 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>Please write a brief note about yourself or simply voice record it so that we can create a profile about you. <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                    <textarea name="quote[company_brief_note]" class="form-control" placeholder="" rows="10" data-error="Breif Note About Your Self..." aria-required="true"></textarea>
                                                </div>
                                                
                                                <div class="col-md-12">
                                                    <h4>Need permission to take information about you from your linked in and the current websites in order to create your profile for Wikipedia.<span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                     <textarea name="quote[company_permission]" class="form-control" placeholder="" rows="10" data-error="permission..." aria-required="true"></textarea>
                                                </div>
                                               
                                                 
                                                <div class="col-md-12">
                                                    <h4>Please provide us a few of your achievements <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <textarea name="quote[company_achievements]" class="form-control" placeholder="" rows="10" data-error="Achievements..." aria-required="true"></textarea>
                                                </div>
                                                  <div class="col-md-12">
                                                    <h4>Suggestions for article topics for each of the company and yourself, anything that you prefer to be posted about yourself online. <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <textarea name="quote[company_article_topics]" class="form-control" placeholder="" rows="10" data-error="Article Topics..." aria-required="true"></textarea>
                                                </div>
                                                   <div class="col-md-12">
                                                    <h4>Any current digital or print articles that you are aware of. <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <textarea name="quote[company_digital_print]" class="form-control" placeholder="" rows="10" data-error="digital or print article..." aria-required="true"></textarea>
                                                </div>
                                                <div class="col-md-12">
                                                    <h4>Additional comments for the writer   <span class="text-danger">*</span></h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <textarea name="quote[company_comments]" class="form-control" placeholder="" rows="10" data-error="Writer Comments..." aria-required="true"></textarea>
                                                </div>
                                                
                                                <div class="col-md-12">
                                                    <h4>Click Here to Upload File   </h4>
                                                </div>
                                                <div class="col-md-12">
                                                   <input class="form-control" type="file" name="image[]" multiple value="" />
                                                </div>
                                                <br><br>
                                              
                                                <div class="commentsbox">
                                                      <div class="col-md-12">
                                                    <p>These questions are simply to ensure that we use the information you want, usually we always have everything we need online, however, we always confirm from the client ensuring they approve it.<br>If you find any question irrelevant, feel free to leave it be and in case there is any information you think we should have, please add it.</p>
                                                  
                                                     </div>
                                                </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'; ?>