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- <html class="whatinput-types-initial whatinput-types-keyboard whatinput-types-mouse" lang="en" dir="ltr" data-whatinput="mouse" data-whatintent="mouse"><head>
- <meta charset="utf-8">
- <meta http-equiv="x-ua-compatible" content="ie=edge">
- <meta name="viewport" content="width=device-width, initial-scale=1.0">
- <title>Ajax Address Book</title>
- <link rel="stylesheet" href="css/foundation.css">
- <link rel="stylesheet" href="css/custom.css">
- <link rel="stylesheet" href="css/app.css">
- <meta class="foundation-mq"></head>
- <body>
- <div class="row">
- <div class="large-6 columns">
- <h1>Ajax Address Book</h1>
- </div>
- <div class="large-6 columns">
- <a class="add-btn button float-right small" data-open="addModal" aria-controls="addModal" aria-haspopup="true" tabindex="0">Add
- Contact</a>
- </div>
- </div>
- <!-- Loading Image -->
- <div id="loaderImage" style="display: none;">
- <img src="img/ajax-loader.gif">
- </div>
- <!-- Table Goes HERE / contacts.php / Main Content-->
- <div id="pageContent">
- <div class="row">
- <div class="large-12 columns">
- <table>
- <thead>
- <tr>
- <th width="200">Name</th>
- <th width="130">Phone</th>
- <th width="200">Email</th>
- <th width="250">Address</th>
- <th width="100">Group</th>
- <th width="150">Actions</th>
- </tr>
- </thead>
- <tbody>
- <tr>
- <td><a href="contact.html">John Doen</a></td>
- <td>(978) 555-1111</td>
- <td>jdoe@gmail.com</td>
- <td>
- <ul>
- <li>223 Massachusetts Ave</li>
- <li></li>
- <li>Cambridge, MA 02136</li>
- </ul>
- </td>
- <td>Business</td>
- <td>
- <ul class="button-group">
- <li>
- <a class="button tiny" data-open="editModal1" data-contact-id="1">Edit</a>
- <div class="reveal editModal" id="editModal1" data-cid="1" data-reveal="">
- <h2>Edit Contact</h2>
- <form id="editContact" action="#" method="post">
- <div class="row">
- <div class="large-6 columns">
- <label>First Name
- <input name="first_name" type="text" placeholder="Enter First Name" value="John">
- </label>
- </div>
- <div class="large-6 columns">
- <label>Last Name
- <input name="last_name" type="text" placeholder="Enter Last Name" value="Doen">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-4 columns">
- <label>Email
- <input name="email" type="email" placeholder="Enter Email Address" value="jdoe@gmail.com">
- </label>
- </div>
- <div class="large-4 columns">
- <label>Phone Number
- <input name="phone" type="text" placeholder="Enter Phone Number" value="(978) 555-1111">
- </label>
- </div>
- <div class="large-4 columns">
- <label>Contact Group
- <select name="contact_group">
- <option value="Family">Family</option>
- <option value="Friends">Friends</option>
- <option value="Business" selected="">Business</option>
- </select>
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-6 columns">
- <label>Address 1
- <input name="address1" type="text" placeholder="Enter Address 1" value="223 Massachusetts Ave">
- </label>
- </div>
- <div class="large-6 columns">
- <label>Address 2
- <input name="address2" type="text" placeholder="Enter Address 2" value="">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-4 columns">
- <label>City
- <input name="city" type="text" placeholder="Enter Your City" value="Cambridge">
- </label>
- </div>
- <div class="large-4 columns">
- <label>State
- <select name="state">
- <option value="AL">Alabama</option>
- <option value="AK">Alaska</option>
- <option value="AZ">Arizona</option>
- <option value="AR">Arkansas</option>
- <option value="CA">California</option>
- <option value="CO">Colorado</option>
- <option value="CT">Connecticut</option>
- <option value="DE">Delaware</option>
- <option value="DC">District of Columbia</option>
- <option value="FL">Florida</option>
- <option value="GA">Georgia</option>
- <option value="HI">Hawaii</option>
- <option value="ID">Idaho</option>
- <option value="IL">Illinois</option>
- <option value="IN">Indiana</option>
- <option value="IA">Iowa</option>
- <option value="KS">Kansas</option>
- <option value="KY">Kentucky</option>
- <option value="LA">Louisiana</option>
- <option value="ME">Maine</option>
- <option value="MD">Maryland</option>
- <option value="MA">Massachusetts</option>
- <option value="MI">Michigan</option>
- <option value="MN">Minnesota</option>
- <option value="MS">Mississippi</option>
- <option value="MO">Missouri</option>
- <option value="MT">Montana</option>
- <option value="NE">Nebraska</option>
- <option value="NV">Nevada</option>
- <option value="NH">New Hampshire</option>
- <option value="NJ">New Jersey</option>
- <option value="NM">New Mexico</option>
- <option value="NY">New York</option>
- <option value="NC">North Carolina</option>
- <option value="ND">North Dakota</option>
- <option value="OH">Ohio</option>
- <option value="OK">Oklahoma</option>
- <option value="OR">Oregon</option>
- <option value="PA">Pennsylvania</option>
- <option value="RI">Rhode Island</option>
- <option value="SC">South Carolina</option>
- <option value="SD">South Dakota</option>
- <option value="TN">Tennessee</option>
- <option value="TX">Texas</option>
- <option value="UT">Utah</option>
- <option value="VT">Vermont</option>
- <option value="VA">Virginia</option>
- <option value="WA">Washington</option>
- <option value="WV">West Virginia</option>
- <option value="WI">Wisconsin</option>
- <option value="WY">Wyoming</option>
- </select>
- </label>
- </div>
- <div class="large-4 columns">
- <label>Zipcode
- <input name="zipcode" type="text" placeholder="Enter Zipcode" value="02136">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-12 columns">
- <label>Notes
- <textarea name="notes" placeholder="Enter Optional Notes"></textarea>
- </label>
- </div>
- </div>
- <input type="hidden" name="id" value="1">
- <input name="submit" type="submit" class="add-btn button right small" value="Submit">
- <button class="close-button" data-close="" aria-label="Close reveal" type="button">
- <span aria-hidden="true">×</span>
- </button>
- </form>
- </div>
- </li>
- <li><a href="#" class="button tiny alert">Delete</a></li>
- </ul>
- </td>
- </tr>
- <tr>
- <td><a href="contact.html">Mark Jackson</a></td>
- <td>(978) 555-2222</td>
- <td>markjax@yahoo.com</td>
- <td>
- <ul>
- <li>566 Main St</li>
- <li>Unit 4</li>
- <li>Haverhill, MA 01830</li>
- </ul>
- </td>
- <td>Business</td>
- <td>
- <ul class="button-group">
- <li>
- <a class="button tiny" data-open="editModal2" data-contact-id="2">Edit</a>
- <div class="reveal editModal" id="editModal2" data-cid="2" data-reveal="">
- <h2>Edit Contact</h2>
- <form id="editContact" action="#" method="post">
- <div class="row">
- <div class="large-6 columns">
- <label>First Name
- <input name="first_name" type="text" placeholder="Enter First Name" value="Mark">
- </label>
- </div>
- <div class="large-6 columns">
- <label>Last Name
- <input name="last_name" type="text" placeholder="Enter Last Name" value="Jackson">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-4 columns">
- <label>Email
- <input name="email" type="email" placeholder="Enter Email Address" value="markjax@yahoo.com">
- </label>
- </div>
- <div class="large-4 columns">
- <label>Phone Number
- <input name="phone" type="text" placeholder="Enter Phone Number" value="(978) 555-2222">
- </label>
- </div>
- <div class="large-4 columns">
- <label>Contact Group
- <select name="contact_group">
- <option value="Family">Family</option>
- <option value="Friends">Friends</option>
- <option value="Business" selected="">Business</option>
- </select>
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-6 columns">
- <label>Address 1
- <input name="address1" type="text" placeholder="Enter Address 1" value="566 Main St">
- </label>
- </div>
- <div class="large-6 columns">
- <label>Address 2
- <input name="address2" type="text" placeholder="Enter Address 2" value="Unit 4">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-4 columns">
- <label>City
- <input name="city" type="text" placeholder="Enter Your City" value="Haverhill">
- </label>
- </div>
- <div class="large-4 columns">
- <label>State
- <select name="state">
- <option value="AL">Alabama</option>
- <option value="AK">Alaska</option>
- <option value="AZ">Arizona</option>
- <option value="AR">Arkansas</option>
- <option value="CA">California</option>
- <option value="CO">Colorado</option>
- <option value="CT">Connecticut</option>
- <option value="DE">Delaware</option>
- <option value="DC">District of Columbia</option>
- <option value="FL">Florida</option>
- <option value="GA">Georgia</option>
- <option value="HI">Hawaii</option>
- <option value="ID">Idaho</option>
- <option value="IL">Illinois</option>
- <option value="IN">Indiana</option>
- <option value="IA">Iowa</option>
- <option value="KS">Kansas</option>
- <option value="KY">Kentucky</option>
- <option value="LA">Louisiana</option>
- <option value="ME">Maine</option>
- <option value="MD">Maryland</option>
- <option value="MA">Massachusetts</option>
- <option value="MI">Michigan</option>
- <option value="MN">Minnesota</option>
- <option value="MS">Mississippi</option>
- <option value="MO">Missouri</option>
- <option value="MT">Montana</option>
- <option value="NE">Nebraska</option>
- <option value="NV">Nevada</option>
- <option value="NH">New Hampshire</option>
- <option value="NJ">New Jersey</option>
- <option value="NM">New Mexico</option>
- <option value="NY">New York</option>
- <option value="NC">North Carolina</option>
- <option value="ND">North Dakota</option>
- <option value="OH">Ohio</option>
- <option value="OK">Oklahoma</option>
- <option value="OR">Oregon</option>
- <option value="PA">Pennsylvania</option>
- <option value="RI">Rhode Island</option>
- <option value="SC">South Carolina</option>
- <option value="SD">South Dakota</option>
- <option value="TN">Tennessee</option>
- <option value="TX">Texas</option>
- <option value="UT">Utah</option>
- <option value="VT">Vermont</option>
- <option value="VA">Virginia</option>
- <option value="WA">Washington</option>
- <option value="WV">West Virginia</option>
- <option value="WI">Wisconsin</option>
- <option value="WY">Wyoming</option>
- </select>
- </label>
- </div>
- <div class="large-4 columns">
- <label>Zipcode
- <input name="zipcode" type="text" placeholder="Enter Zipcode" value="01830">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-12 columns">
- <label>Notes
- <textarea name="notes" placeholder="Enter Optional Notes"></textarea>
- </label>
- </div>
- </div>
- <input type="hidden" name="id" value="2">
- <input name="submit" type="submit" class="add-btn button right small" value="Submit">
- <button class="close-button" data-close="" aria-label="Close reveal" type="button">
- <span aria-hidden="true">×</span>
- </button>
- </form>
- </div>
- </li>
- <li><a href="#" class="button tiny alert">Delete</a></li>
- </ul>
- </td>
- </tr>
- <tr>
- <td><a href="contact.html">Samuel Smith</a></td>
- <td>(978) 555-3333</td>
- <td>samsmith@gmail.com</td>
- <td>
- <ul>
- <li>23 Elm St</li>
- <li></li>
- <li>Amesbury, MA 01913</li>
- </ul>
- </td>
- <td>Friends</td>
- <td>
- <ul class="button-group">
- <li>
- <a class="button tiny" data-open="editModal3" data-contact-id="3">Edit</a>
- <div class="reveal editModal" id="editModal3" data-cid="3" data-reveal="">
- <h2>Edit Contact</h2>
- <form id="editContact" action="#" method="post">
- <div class="row">
- <div class="large-6 columns">
- <label>First Name
- <input name="first_name" type="text" placeholder="Enter First Name" value="Samuel">
- </label>
- </div>
- <div class="large-6 columns">
- <label>Last Name
- <input name="last_name" type="text" placeholder="Enter Last Name" value="Smith">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-4 columns">
- <label>Email
- <input name="email" type="email" placeholder="Enter Email Address" value="samsmith@gmail.com">
- </label>
- </div>
- <div class="large-4 columns">
- <label>Phone Number
- <input name="phone" type="text" placeholder="Enter Phone Number" value="(978) 555-3333">
- </label>
- </div>
- <div class="large-4 columns">
- <label>Contact Group
- <select name="contact_group">
- <option value="Family">Family</option>
- <option value="Friends" selected="">Friends</option>
- <option value="Business">Business</option>
- </select>
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-6 columns">
- <label>Address 1
- <input name="address1" type="text" placeholder="Enter Address 1" value="23 Elm St">
- </label>
- </div>
- <div class="large-6 columns">
- <label>Address 2
- <input name="address2" type="text" placeholder="Enter Address 2" value="">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-4 columns">
- <label>City
- <input name="city" type="text" placeholder="Enter Your City" value="Amesbury">
- </label>
- </div>
- <div class="large-4 columns">
- <label>State
- <select name="state">
- <option value="AL">Alabama</option>
- <option value="AK">Alaska</option>
- <option value="AZ">Arizona</option>
- <option value="AR">Arkansas</option>
- <option value="CA">California</option>
- <option value="CO">Colorado</option>
- <option value="CT">Connecticut</option>
- <option value="DE">Delaware</option>
- <option value="DC">District of Columbia</option>
- <option value="FL">Florida</option>
- <option value="GA">Georgia</option>
- <option value="HI">Hawaii</option>
- <option value="ID">Idaho</option>
- <option value="IL">Illinois</option>
- <option value="IN">Indiana</option>
- <option value="IA">Iowa</option>
- <option value="KS">Kansas</option>
- <option value="KY">Kentucky</option>
- <option value="LA">Louisiana</option>
- <option value="ME">Maine</option>
- <option value="MD">Maryland</option>
- <option value="MA">Massachusetts</option>
- <option value="MI">Michigan</option>
- <option value="MN">Minnesota</option>
- <option value="MS">Mississippi</option>
- <option value="MO">Missouri</option>
- <option value="MT">Montana</option>
- <option value="NE">Nebraska</option>
- <option value="NV">Nevada</option>
- <option value="NH">New Hampshire</option>
- <option value="NJ">New Jersey</option>
- <option value="NM">New Mexico</option>
- <option value="NY">New York</option>
- <option value="NC">North Carolina</option>
- <option value="ND">North Dakota</option>
- <option value="OH">Ohio</option>
- <option value="OK">Oklahoma</option>
- <option value="OR">Oregon</option>
- <option value="PA">Pennsylvania</option>
- <option value="RI">Rhode Island</option>
- <option value="SC">South Carolina</option>
- <option value="SD">South Dakota</option>
- <option value="TN">Tennessee</option>
- <option value="TX">Texas</option>
- <option value="UT">Utah</option>
- <option value="VT">Vermont</option>
- <option value="VA">Virginia</option>
- <option value="WA">Washington</option>
- <option value="WV">West Virginia</option>
- <option value="WI">Wisconsin</option>
- <option value="WY">Wyoming</option>
- </select>
- </label>
- </div>
- <div class="large-4 columns">
- <label>Zipcode
- <input name="zipcode" type="text" placeholder="Enter Zipcode" value="01913">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-12 columns">
- <label>Notes
- <textarea name="notes" placeholder="Enter Optional Notes"></textarea>
- </label>
- </div>
- </div>
- <input type="hidden" name="id" value="3">
- <input name="submit" type="submit" class="add-btn button right small" value="Submit">
- <button class="close-button" data-close="" aria-label="Close reveal" type="button">
- <span aria-hidden="true">×</span>
- </button>
- </form>
- </div>
- </li>
- <li><a href="#" class="button tiny alert">Delete</a></li>
- </ul>
- </td>
- </tr>
- <tr>
- <td><a href="contact.html">Jennifer Sheehan</a></td>
- <td>9783848273</td>
- <td>jen.irish@hotmail.com</td>
- <td>
- <ul>
- <li>44 Birchmeadow rd</li>
- <li></li>
- <li>Amesbury, MA 01913</li>
- </ul>
- </td>
- <td>Family</td>
- <td>
- <ul class="button-group">
- <li>
- <a class="button tiny" data-open="editModal8" data-contact-id="8">Edit</a>
- <div class="reveal editModal" id="editModal8" data-cid="8" data-reveal="">
- <h2>Edit Contact</h2>
- <form id="editContact" action="#" method="post">
- <div class="row">
- <div class="large-6 columns">
- <label>First Name
- <input name="first_name" type="text" placeholder="Enter First Name" value="Jennifer">
- </label>
- </div>
- <div class="large-6 columns">
- <label>Last Name
- <input name="last_name" type="text" placeholder="Enter Last Name" value="Sheehan">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-4 columns">
- <label>Email
- <input name="email" type="email" placeholder="Enter Email Address" value="jen.irish@hotmail.com">
- </label>
- </div>
- <div class="large-4 columns">
- <label>Phone Number
- <input name="phone" type="text" placeholder="Enter Phone Number" value="9783848273">
- </label>
- </div>
- <div class="large-4 columns">
- <label>Contact Group
- <select name="contact_group">
- <option value="Family" selected="">Family</option>
- <option value="Friends">Friends</option>
- <option value="Business">Business</option>
- </select>
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-6 columns">
- <label>Address 1
- <input name="address1" type="text" placeholder="Enter Address 1" value="44 Birchmeadow rd">
- </label>
- </div>
- <div class="large-6 columns">
- <label>Address 2
- <input name="address2" type="text" placeholder="Enter Address 2" value="">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-4 columns">
- <label>City
- <input name="city" type="text" placeholder="Enter Your City" value="Amesbury">
- </label>
- </div>
- <div class="large-4 columns">
- <label>State
- <select name="state">
- <option value="AL">Alabama</option>
- <option value="AK">Alaska</option>
- <option value="AZ">Arizona</option>
- <option value="AR">Arkansas</option>
- <option value="CA">California</option>
- <option value="CO">Colorado</option>
- <option value="CT">Connecticut</option>
- <option value="DE">Delaware</option>
- <option value="DC">District of Columbia</option>
- <option value="FL">Florida</option>
- <option value="GA">Georgia</option>
- <option value="HI">Hawaii</option>
- <option value="ID">Idaho</option>
- <option value="IL">Illinois</option>
- <option value="IN">Indiana</option>
- <option value="IA">Iowa</option>
- <option value="KS">Kansas</option>
- <option value="KY">Kentucky</option>
- <option value="LA">Louisiana</option>
- <option value="ME">Maine</option>
- <option value="MD">Maryland</option>
- <option value="MA">Massachusetts</option>
- <option value="MI">Michigan</option>
- <option value="MN">Minnesota</option>
- <option value="MS">Mississippi</option>
- <option value="MO">Missouri</option>
- <option value="MT">Montana</option>
- <option value="NE">Nebraska</option>
- <option value="NV">Nevada</option>
- <option value="NH">New Hampshire</option>
- <option value="NJ">New Jersey</option>
- <option value="NM">New Mexico</option>
- <option value="NY">New York</option>
- <option value="NC">North Carolina</option>
- <option value="ND">North Dakota</option>
- <option value="OH">Ohio</option>
- <option value="OK">Oklahoma</option>
- <option value="OR">Oregon</option>
- <option value="PA">Pennsylvania</option>
- <option value="RI">Rhode Island</option>
- <option value="SC">South Carolina</option>
- <option value="SD">South Dakota</option>
- <option value="TN">Tennessee</option>
- <option value="TX">Texas</option>
- <option value="UT">Utah</option>
- <option value="VT">Vermont</option>
- <option value="VA">Virginia</option>
- <option value="WA">Washington</option>
- <option value="WV">West Virginia</option>
- <option value="WI">Wisconsin</option>
- <option value="WY">Wyoming</option>
- </select>
- </label>
- </div>
- <div class="large-4 columns">
- <label>Zipcode
- <input name="zipcode" type="text" placeholder="Enter Zipcode" value="01913">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-12 columns">
- <label>Notes
- <textarea name="notes" placeholder="Enter Optional Notes"></textarea>
- </label>
- </div>
- </div>
- <input type="hidden" name="id" value="8">
- <input name="submit" type="submit" class="add-btn button right small" value="Submit">
- <button class="close-button" data-close="" aria-label="Close reveal" type="button">
- <span aria-hidden="true">×</span>
- </button>
- </form>
- </div>
- </li>
- <li><a href="#" class="button tiny alert">Delete</a></li>
- </ul>
- </td>
- </tr>
- </tbody>
- </table>
- </div>
- </div></div>
- <script src="js/vendor/jquery.js"></script>
- <script src="js/vendor/what-input.js"></script>
- <script src="js/vendor/foundation.js"></script>
- <script src="js/app.js"></script><div class="reveal-overlay"><div class="reveal large" id="addModal" data-reveal="q9pxiz-reveal" role="dialog" aria-hidden="true" data-yeti-box="addModal" data-resize="addModal">
- <h2>Add Contact</h2>
- <form id="addContact" action="#" method="post">
- <div class="row">
- <div class="large-6 columns">
- <label>First Name <input name="first_name" type="text" placeholder="Enter First Name">
- </label>
- </div>
- <div class="large-6 columns">
- <label>Last Name <input name="last_name" type="text" placeholder="Enter Last Name">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-4 columns">
- <label>Email <input name="email" type="email" placeholder="Enter Email Address">
- </label>
- </div>
- <div class="large-4 columns">
- <label>Phone Number <input name="phone" type="text" placeholder="Enter Phone Number">
- </label>
- </div>
- <div class="large-4 columns">
- <label>Contact Group <select name="contact_group">
- <option value="husker">Family</option>
- <option value="starbuck">Friends</option>
- <option value="hotdog">Business</option>
- </select>
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-6 columns">
- <label>Address 1 <input name="address1" type="text" placeholder="Enter Address 1">
- </label>
- </div>
- <div class="large-6 columns">
- <label>Address 2 <input name="address2" type="text" placeholder="Enter Address 2">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-4 columns">
- <label>City <input name="city" type="text" placeholder="Enter Your City">
- </label>
- </div>
- <div class="large-4 columns">
- <label>State <select name="state">
- <option>Select State</option>
- <option value="AL">Alabama</option>
- <option value="AK">Alaska</option>
- <option value="AZ">Arizona</option>
- <option value="AR">Arkansas</option>
- <option value="CA">California</option>
- <option value="CO">Colorado</option>
- <option value="CT">Connecticut</option>
- <option value="DE">Delaware</option>
- <option value="DC">District of Columbia</option>
- <option value="FL">Florida</option>
- <option value="GA">Georgia</option>
- <option value="HI">Hawaii</option>
- <option value="ID">Idaho</option>
- <option value="IL">Illinois</option>
- <option value="IN">Indiana</option>
- <option value="IA">Iowa</option>
- <option value="KS">Kansas</option>
- <option value="KY">Kentucky</option>
- <option value="LA">Louisiana</option>
- <option value="ME">Maine</option>
- <option value="MD">Maryland</option>
- <option value="MA">Massachusetts</option>
- <option value="MI">Michigan</option>
- <option value="MN">Minnesota</option>
- <option value="MS">Mississippi</option>
- <option value="MO">Missouri</option>
- <option value="MT">Montana</option>
- <option value="NE">Nebraska</option>
- <option value="NV">Nevada</option>
- <option value="NH">New Hampshire</option>
- <option value="NJ">New Jersey</option>
- <option value="NM">New Mexico</option>
- <option value="NY">New York</option>
- <option value="NC">North Carolina</option>
- <option value="ND">North Dakota</option>
- <option value="OH">Ohio</option>
- <option value="OK">Oklahoma</option>
- <option value="OR">Oregon</option>
- <option value="PA">Pennsylvania</option>
- <option value="RI">Rhode Island</option>
- <option value="SC">South Carolina</option>
- <option value="SD">South Dakota</option>
- <option value="TN">Tennessee</option>
- <option value="TX">Texas</option>
- <option value="UT">Utah</option>
- <option value="VT">Vermont</option>
- <option value="VA">Virginia</option>
- <option value="WA">Washington</option>
- <option value="WV">West Virginia</option>
- <option value="WI">Wisconsin</option>
- <option value="WY">Wyoming</option>
- </select>
- </label>
- </div>
- <div class="large-4 columns">
- <label>Zipcode <input name="zipcode" type="text" placeholder="Enter Phone Number">
- </label>
- </div>
- </div>
- <div class="row">
- <div class="large-12 columns">
- <label>Notes <textarea name="notes" placeholder="Enter Optional Notes"></textarea>
- </label>
- </div>
- </div>
- <input name="submit" type="submit" class="add-btn button right small" value="Submit">
- <button class="close-button" data-close="" aria-label="Close reveal" type="button">
- <span aria-hidden="true">×</span>
- </button>
- </form>
- </div></div>
- <script src="js/script.js"></script>
- </body></html>
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