| 1 | |
| 2 | |
| 3 | export default function Appointment1() { |
| 4 | return ( |
| 5 | <> |
| 6 | <section className="appointment-area pt-115"> |
| 7 | <div className="container"> |
| 8 | <div className="row"> |
| 9 | <div className="col-lg-12"> |
| 10 | <div className="section-title white-title mb-60"> |
| 11 | <span className="sub-title">Your roof require professional attention</span> |
| 12 | <h2 className="title">Book Your Appointment</h2> |
| 13 | </div> |
| 14 | </div> |
| 15 | </div> |
| 16 | <div className="appointment-inner" data-background="/assets/img/bg/appointment_bg.jpg"> |
| 17 | <div className="row"> |
| 18 | <div className="col-xl-7"> |
| 19 | <div className="appointment-form"> |
| 20 | <form action="#"> |
| 21 | <div className="row"> |
| 22 | <div className="col-md-6"> |
| 23 | <div className="form-grp"> |
| 24 | <input id="name" type="text" placeholder="Fast Name" /> |
| 25 | <label htmlFor="name"><i className="fas fa-user" /></label> |
| 26 | </div> |
| 27 | </div> |
| 28 | <div className="col-md-6"> |
| 29 | <div className="form-grp"> |
| 30 | <input id="lastName" type="text" placeholder="Last Name" /> |
| 31 | <label htmlFor="lastName"><i className="fas fa-user" /></label> |
| 32 | </div> |
| 33 | </div> |
| 34 | <div className="col-md-6"> |
| 35 | <div className="form-grp"> |
| 36 | <input id="phone" type="text" placeholder="Phone Number" /> |
| 37 | <label htmlFor="phone"><i className="fas fa-phone-alt" /></label> |
| 38 | </div> |
| 39 | </div> |
| 40 | <div className="col-md-6"> |
| 41 | <div className="form-grp"> |
| 42 | <input id="email" type="text" placeholder="Email Address" /> |
| 43 | <label htmlFor="email"><i className="fas fa-envelope" /></label> |
| 44 | </div> |
| 45 | </div> |
| 46 | <div className="col-md-12"> |
| 47 | <div className="form-grp"> |
| 48 | <input id="location" type="text" placeholder="Address" /> |
| 49 | <label htmlFor="location"><i className="fas fa-map-marker-alt" /></label> |
| 50 | </div> |
| 51 | </div> |
| 52 | <div className="col-md-6"> |
| 53 | <div className="form-grp select-grp"> |
| 54 | <select name="city" className="orderby"> |
| 55 | <option value="City / Town">City / Town</option> |
| 56 | <option value="Dhaka, Bangladesh">Dhaka, Bangladesh</option> |
| 57 | <option value="Baltimore, MD">Baltimore, MD</option> |
| 58 | <option value="New York, NY">New York, NY</option> |
| 59 | <option value="New Orleans, LA">New Orleans, LA</option> |
| 60 | </select> |
| 61 | </div> |
| 62 | </div> |
| 63 | <div className="col-md-6"> |
| 64 | <div className="form-grp select-grp"> |
| 65 | <select name="state" className="orderby"> |
| 66 | <option value="State">State</option> |
| 67 | <option value="Dhaka, Bangladesh">Dhaka, Bangladesh</option> |
| 68 | <option value="Baltimore, MD">Baltimore, MD</option> |
| 69 | <option value="New York, NY">New York, NY</option> |
| 70 | <option value="New Orleans, LA">New Orleans, LA</option> |
| 71 | </select> |
| 72 | </div> |
| 73 | </div> |
| 74 | </div> |
| 75 | <div className="form-grp"> |
| 76 | <textarea name="message" placeholder="Message" /> |
| 77 | </div> |
| 78 | <button type="submit" className="btn">Request Submit Now</button> |
| 79 | </form> |
| 80 | </div> |
| 81 | </div> |
| 82 | <div className="col-xl-5"> |
| 83 | <div className="appointment-img"> |
| 84 | <img src="/assets/img/images/appointment_img.png" alt="" /> |
| 85 | </div> |
| 86 | </div> |
| 87 | </div> |
| 88 | </div> |
| 89 | </div> |
| 90 | </section> |
| 91 | |
| 92 | </> |
| 93 | ) |
| 94 | } |
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