<div class="container margin_60_35">
<div class="row justify-content-center">
<div class="col-xl-5 col-lg-6 pr-xl-5" id="formdiv">
<div class="main_title_3">
<span></span>
<h2>Send us a message</h2>
<p>Please enter the following information</p>
</div>
<div id="message-contact"></div>
<form
method="post"
id="contactform"
autocomplete="off"
onsubmit="SubmitContact(); return false;"
>
<input type="hidden" id="web_page" name="web_page" value="@System.Configuration.ConfigurationManager.AppSettings["companyDomain"]/Home/contact" />
<div class="form-group">
<label>Name</label>
<input class="form-control" type="text" id="first_name" name="first_name" required>
</div>
<div class="form-group">
<label>Last name</label>
<input class="form-control" type="text" id="last_name" name="last_name" required>
</div>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>Email</label>
<input class="form-control" type="email" id="email_address" name="email_address" required>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Telephone</label>
<input class="form-control" type="text" id="phone_number" name="phone_number" required>
</div>
</div>
</div>
<!-- /row -->
<input type="hidden" value="none" id="webpage_name" name="webpage_name" />
<div class="form-group">
<label>Message</label>
<textarea class="form-control" id="message_contact" name="message_infor" style="height:120px;"></textarea>
</div>
<p class="add_top_30"><input type="submit" value="Submit" class="btn_1" id="submit-contact"></p>
</form>
</div>
<div class="col-xl-5 col-lg-6 pl-xl-5">
<div class="box_contacts">
<i class="ti-support"></i>
<h2>Need Help?</h2>
<a target="_blank" href="tel:@System.Configuration.ConfigurationManager.AppSettings["WebsitePhoneNo"]">@System.Configuration.ConfigurationManager.AppSettings["WebsitePhoneNo"]</a> - <a target="_blank" href="mailto:@System.Configuration.ConfigurationManager.AppSettings["WebsiteEmail"]">@System.Configuration.ConfigurationManager.AppSettings["WebsiteEmail"]</a>
</div>
<div class="box_contacts">
<i class="ti-help-alt"></i>
<h2>Questions?</h2>
<a target="_blank" href="tel:@System.Configuration.ConfigurationManager.AppSettings["WebsitePhoneNo"]">@System.Configuration.ConfigurationManager.AppSettings["WebsitePhoneNo"]</a> - <a target="_blank" href="mailto:@System.Configuration.ConfigurationManager.AppSettings["WebsiteEmail"]">@System.Configuration.ConfigurationManager.AppSettings["WebsiteEmail"]</a>
</div>
<div class="box_contacts">
<i class="ti-home"></i>
<h2>Office Address</h2>
<a href="#0">
@System.Configuration.ConfigurationManager.AppSettings["WebsiteAddress"]
<br />
@System.Configuration.ConfigurationManager.AppSettings["WebsiteCity"],
@System.Configuration.ConfigurationManager.AppSettings["WebsiteState"]
@System.Configuration.ConfigurationManager.AppSettings["WebsiteZip"]
</a>
</div>
</div>
</div>
</div>
<!-- /container -->
<script>
function SubmitContact()
{
$('#contactform').submit(function (e)
{
var apiurl = '@System.Configuration.ConfigurationManager.AppSettings["companyDomain"]' + "/Api/ReceiveJson";
var stagecompleted = '@System.Configuration.ConfigurationManager.AppSettings["StageCompletedLabel"]';
var successmsg = "Thank You. We will contact you soon.";
var emailsubject = "Contact Us Request";
var emailaddress = document.getElementById("email_address").value;
e.preventDefault();
SubmitAPI(apiurl, stagecompleted, successmsg, emailsubject, emailaddress);
}
);
}
document.getElementById('phone_number').addEventListener('input', function (e) {
var x = e.target.value.replace(/\D/g, '').match(/(\d{0,3})(\d{0,3})(\d{0,4})/);
e.target.value = !x[2] ? x[1] : '(' + x[1] + ') ' + x[2] + (x[3] ? '-' + x[3] : '');
});
</script>
<script>
function SubmitAPI(apiurl_value, stagecompleted_value, successmsg_value, emailsubject_value, emailaddress_value) {
var x = $('#formdiv *').serializeArray();
var data = {};
var apiurl = apiurl_value;
var stagecompleted = stagecompleted_value;
var successmsg = successmsg_value;
var emailsubject = emailsubject_value;
$.each(x, function (i, field) {
data[field.name] = field.value;
});
var jsondata = JSON.stringify(data);
$.ajax({
url: apiurl,
type: "POST",
data: { 'message': jsondata.replace(/\"/g, "'"), 'email': emailaddress_value, 'emailsubject': emailsubject },
dataType: 'json',
success: function (data) {
if (data.stage == stagecompleted) {
alert(successmsg);
document.location.reload();
}
},
error: function (msg) { alert(msg); }
});
return false;
}
</script>
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