<?php include_once APP_PATH.'template/business/tplblocks/header.php';?>

<div class="section section-white">
  <div class="container">
    <div class="row">
      <div class="col-md-8 offset-md-2">

        <form action="<?php echo htmlentities($_SERVER['REQUEST_URI']);?>" method="post">
          <div class="form-group">
            <label class="control-label" for="vote5"><?php echo $jkl["g29"];?></label>
            <div id="star-container">
              <i class="fa fa-star fa-2x star star-checked" id="star-1"></i>
              <i class="fa fa-star fa-2x star star-checked" id="star-2"></i>
              <i class="fa fa-star fa-2x star star-checked" id="star-3"></i>
              <i class="fa fa-star fa-2x star star-checked" id="star-4"></i>
              <i class="fa fa-star fa-2x star star-checked" id="star-5"></i>
            </div>
            <input type="hidden" name="fbvote" id="fbvote" value="5">
          </div>

          <div class="row">
            <div class="col-sm-6">
              <div class="form-group">
                <label class="control-label" for="name"><?php echo $jkl["g4"];?></label>
                <input type="text" name="name" id="name" class="form-control" value="<?php echo $row["name"];?>">
              </div>
            </div>
            <div class="col-sm-6">
              <div class="form-group">
                <label class="control-label" for="email"><?php echo $jkl["g5"];?></label>
                <input type="email" name="email" id="email" class="form-control" value="<?php echo $row["email"];?>">
              </div>
            </div>
          </div>

          <div class="form-group">
            <label class="control-label" for="feedback"><?php echo $jkl["g24"];?></label>
            <textarea name="message" id="feedback" rows="5" class="form-control"></textarea>
          </div>

          <div class="form-actions">
            <button type="submit" class="btn btn-primary btn-block ls-submit"><?php echo $jkl["g25"];?></button>
          </div>
          <input type="hidden" name="action" value="support_rating">
          <input type="hidden" name="ticketid" value="<?php echo $row["id"];?>">
        </form>
      </div>
    </div>
  </div>
</div>

<?php include_once APP_PATH.'template/business/tplblocks/footer.php';?>
