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May 14th, 2018
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  1. <div class="form-contact">
  2. <div class="form-group">
  3. <p> <label class="control-label gcore-label-left gcore-label-checkbox">FAHRZEUG </label></p>
  4. <div class="gcore-display-table">
  5. <div class="gcore-single-column">
  6. [radio radio-group class:gcore-radio-item label_first use_label_element "TAXI&nbsp;&nbsp;" "BUS&nbsp;&nbsp;&nbsp;" "LIMOUSINE&nbsp;&nbsp;&nbsp;" "KRANKENTRANSPORTER&nbsp;&nbsp;&nbsp;"]
  7. </div>
  8. </div>
  9. <div class="form-group">
  10. <p> <label class="control-label gcore-label-left required_label">UHRZEIT </label></p>
  11. <div class="gcore-display-table" >
  12. [text* hours 60/ class:form-control]
  13. </div>
  14. </div>
  15. <div class="form-group">
  16. <p><label class="control-label gcore-label-left">ABFAHRT </label></p>
  17. <div class="gcore-display-table">
  18. [text* start_destination 60/ class:form-control]
  19. </div>
  20. </div>
  21. <div class="form-group">
  22. <p><label class="control-label gcore-label-left">ZIEL </label></p>
  23. <div class="gcore-display-table">
  24. [text* end_destination 60/ class:form-control]
  25. </div>
  26. </div>
  27. <div class="form-group">
  28. <p><label class="control-label gcore-label-left">DATUM </label></p>
  29. <div class="gcore-display-table">
  30. <span class="wpcf7-form-control-wrap date_time"><input type="date" aria-invalid="false" aria-required="true" id="date-time" class="wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date form-control" value="" name="date_time" size="60"></span>
  31. </div>
  32. </div>
  33. </div>
  34. <div class="form-group">
  35. <p><label class="control-label gcore-label-left">TELFONNUMMER </label></p>
  36. <div class="gcore-display-table">
  37. [tel phone_number 60/11 class:phone-number]
  38. </div>
  39. </div>
  40. <div class="form-group">
  41. <div class="gcore-display-table">
  42. [submit class:btn "jetzt anfragen"]
  43. </div>
  44. </div>
  45. </div>
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