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- <!DOCTYPE html>
- <html>
- <head>
- <meta charset="utf-8">
- <title>Heinrich KG Weiden</title>
- <link rel="stylesheet" href="styles/bootstrap.min.css">
- <script src="scripts/bootstrap.min.js"></script>
- <script src="scripts/jquery.min.js"></script>
- <script src="scripts/popper.min.js"></script>
- </head>
- <body>
- <div id="navbar"></div>
- <div class="container">
- <h1 id="header_1">Anmeldung zum Newsletter der Heinrich KG</h1>
- <br>
- <form action="newsletter.php" method="post">
- <div class="form-group">
- <label for="vorname">Vorname</label>
- <input name="vorname" type="vorname" class="form-control" id="vorname" placeholder="Vorname">
- </div>
- <div class="form-group">
- <label for="nachname">Nachname</label>
- <input name="nachname" type="nachname" class="form-control" id="nachname" placeholder="Nachname">
- </div>
- <div class="form-group">
- <label for="email">Email address</label>
- <input name="email" type="email" class="form-control" id="email" aria-describedby="emailHelp" placeholder="Enter email">
- <small id="emailHelp" class="form-text text-muted">We'll never share your email with anyone else.</small>
- </div>
- <div class="form-group">
- <label for="attention">Wie sind Sie auf die Heinrich KG in Weiden aufmerksam geworden?</label>
- <select name="attention[]" multiple class="form-control" id="attention">
- <option>Freunde oder Bekannte</option>
- <option>Zeitschrift</option>
- <option>Internet</option>
- <option>Werbung</option>
- </select>
- </div>
- <label for="next">Wann haben Sie Ihre nächste Bestellung für Büromöbel und Zubehör geplant?</label>
- <div class="form-check">
- <input class="form-check-input" type="radio" name="next" id="next1" value="option1">
- <label class="form-check-label" for="next1">in ca. 1-3 Monaten</label>
- </div>
- <div class="form-check">
- <input class="form-check-input" type="radio" name="next" id="next2" value="option2">
- <label class="form-check-label" for="next2">in ca. 6 Monaten</label>
- </div>
- <div class="form-check">
- <input class="form-check-input" type="radio" name="next" id="next3" value="option2">
- <label class="form-check-label" for="next3">im Jahr 2019 nicht mehr</label>
- </div>
- <br>
- <div class="form-group">
- <label for="text">Wenn Sie uns etwas mitteilen möchten, so finden Sie hier Platz dafür:</label>
- <textarea class="form-control" id="text" rows="4"></textarea>
- </div>
- <button type="submit" class="btn btn-primary">Abschicken</button>
- </form>
- </div>
- </body>
- <script>
- $(document).ready(function() {
- $('#navbar').load('navbar.html');
- });
- </script>
- </html>
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