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52 lines
2.3 KiB
52 lines
2.3 KiB
<?php include_once APP_PATH.'template/business/tplblocks/header.php';?>
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<div class="section section-white">
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<div class="container">
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<div class="row">
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<div class="col-md-8 offset-md-2">
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<form action="<?php echo htmlentities($_SERVER['REQUEST_URI']);?>" method="post">
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<div class="form-group">
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<label class="control-label" for="vote5"><?php echo $jkl["g29"];?></label>
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<div id="star-container">
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<i class="fa fa-star fa-2x star star-checked" id="star-1"></i>
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<i class="fa fa-star fa-2x star star-checked" id="star-2"></i>
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<i class="fa fa-star fa-2x star star-checked" id="star-3"></i>
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<i class="fa fa-star fa-2x star star-checked" id="star-4"></i>
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<i class="fa fa-star fa-2x star star-checked" id="star-5"></i>
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</div>
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<input type="hidden" name="fbvote" id="fbvote" value="5">
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</div>
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<div class="row">
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<div class="col-sm-6">
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<div class="form-group">
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<label class="control-label" for="name"><?php echo $jkl["g4"];?></label>
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<input type="text" name="name" id="name" class="form-control" value="<?php echo $row["name"];?>">
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</div>
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</div>
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<div class="col-sm-6">
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<div class="form-group">
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<label class="control-label" for="email"><?php echo $jkl["g5"];?></label>
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<input type="email" name="email" id="email" class="form-control" value="<?php echo $row["email"];?>">
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</div>
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</div>
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</div>
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<div class="form-group">
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<label class="control-label" for="feedback"><?php echo $jkl["g24"];?></label>
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<textarea name="message" id="feedback" rows="5" class="form-control"></textarea>
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</div>
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<div class="form-actions">
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<button type="submit" class="btn btn-primary btn-block ls-submit"><?php echo $jkl["g25"];?></button>
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</div>
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<input type="hidden" name="action" value="support_rating">
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<input type="hidden" name="ticketid" value="<?php echo $row["id"];?>">
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</form>
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</div>
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</div>
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</div>
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</div>
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<?php include_once APP_PATH.'template/business/tplblocks/footer.php';?>
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