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  1. <!DOCTYPE html>
  2. <html>
  3. <head>
  4. <meta charset="utf-8">
  5. <meta http-equiv="X-UA-Compatible" content="IE=edge">
  6. <title><?= $data['title'] ?></title>
  7. <meta name="viewport" content="width=device-width, initial-scale=1">
  8. <link href="css/create.css" rel="stylesheet">
  9. <script src="https://kit.fontawesome.com/69362e78c5.js" crossorigin="anonymous"></script>
  10. <script src="https://code.jquery.com/jquery-3.5.1.min.js"></script>
  11. <script src="https://cdn.jsdelivr.net/npm/[email protected]/dist/js/bootstrap.bundle.min.js"></script>
  12. <?php require_once __DIR__ . '/header.phtml'; ?>
  13. </head>
  14. <script>
  15. $(document).ready(function(){
  16. $('a[data-bs-toggle="tab"]').on("shown.bs.tab", function(e){
  17. console.log(e.target); // newly activated tab
  18. console.log(e.relatedTarget); // previous active tab
  19. });
  20. });
  21. </script>
  22.  
  23. <body>
  24. <?php if(isset($data['extra_css'])): ?>
  25. <link href="css/<?= $data['extra_css']; ?>" rel="stylesheet">
  26. <?php endif; ?>
  27. <div class="container">
  28. <form class="row g-3" action="<?= $data['action'] ?>" method="post">
  29.  
  30. <?php if(isset($data['record']['id'])): ?>
  31. <input type="hidden" name="id" value="<?= $data['record']['id'] ?>" />
  32. <?php endif; ?>
  33. <?php if(isset($data['currentPage'])): ?>
  34. <input type="hidden" name="page" value="<?= $data['currentPage'] ?>" />
  35. <?php endif; ?>
  36. <?php if(isset($data['hash'])): ?>
  37. <input type="hidden" name="hash" value="<?= $data['hash'] ?>" />
  38. <?php endif; ?>
  39.  
  40. <ul class="nav nav-tabs"> <!--Using a list to create the tabs -->
  41. <li class="nav-item">
  42. <a href="#contact-tab" class="nav-link active" data-bs-toggle="tab">Contact Details</a>
  43. </li>
  44. <li class="nav-item">
  45. <a href="#questions-tab" class="nav-link" data-bs-toggle="tab">Questions</a>
  46. </li>
  47. <li class="nav-item">
  48. <a href="#delivery-tab" class="nav-link" data-bs-toggle="tab">Delivery Info</a>
  49. </li>
  50. </ul>
  51. <!------------------------------------------------------------------------------------------------------------------------------------------------- -->
  52. <div class="tab-content"> <!-- This involves the tav content -->
  53. <div class="tab-pane fade show active" id="contact-tab">
  54. <div class="col-md-7">
  55. <label for="site_name" class="form-label">Site Name*</label>
  56. <input type="text"
  57. class="form-control"
  58. id="site_name"
  59. name="site_name"
  60. value="<?= $data['record']['site_name'] ?? '' ?>"
  61. placeholder="Enter Site Name"
  62. required><br>
  63. </div>
  64.  
  65. <div class="col-md-5">
  66. <label for="poNum" class="form-label">PO Number*</label>
  67. <input type="text"
  68. class="form-control"
  69. id="poNum"
  70. name="poNum"
  71. value="<?= $data['record']['poNum'] ?? '' ?>"
  72. placeholder="Enter PO Num (Given in Email)"
  73. required>
  74. </div>
  75.  
  76. <div class="col-md-5">
  77. <label for="customer_name" class="form-label">Contact Name*</label>
  78. <input type="text"
  79. class="form-control"
  80. id="customer_name"
  81. name="customer_name"
  82. value="<?= $data['record']['customer_name'] ?? '' ?>"
  83. placeholder="Enter Contact Name"
  84. required>
  85. </div>
  86.  
  87. <div class="col-md-7">
  88. <label for="customer_email" class="form-label">Email Address*</label>
  89. <input type="email"
  90. class="form-control"
  91. id="customer_email"
  92. name="customer_email"
  93. value="<?= $data['record']['customer_email'] ?? '' ?>"
  94. placeholder="Enter Email"
  95. required>
  96. <br>
  97. </div>
  98.  
  99. <div class="col-4">
  100. <label for="customer_mobile" class="form-label">Contact Number*</label>
  101. <input type="tel"
  102. class="form-control"
  103. id="customer_mobile"
  104. name="customer_mobile"
  105. value="<?= $data['record']['customer_mobile'] ?? '' ?>"
  106. placeholder="Enter Contact Number"
  107. required> <br>
  108. </div>
  109.  
  110. <div class="col-8">
  111. <label for="street1" class="form-label">Address*</label>
  112. <input type="text"
  113. class="form-control"
  114. id="street1"
  115. name="street1"
  116. value="<?= $data['record']['street1'] ?? '' ?>"
  117. placeholder="Address"
  118. required>
  119. </div>
  120.  
  121. <div class="col-md-5">
  122. <label for="city" class="form-label">City/Town*</label>
  123. <input type="text"
  124. class="form-control"
  125. id="city"
  126. name="city"
  127. value="<?= $data['record']['city'] ?? '' ?>"
  128. placeholder="City/Town"
  129. required>
  130. </div>
  131.  
  132. <div class="col-md-5">
  133. <label for="county" class="form-label">County</label>
  134. <input type="text"
  135. class="form-control"
  136. id="county"
  137. name="county"
  138. value="<?= $data['record']['county'] ?? '' ?>"
  139. placeholder="County">
  140. </div>
  141.  
  142. <div class="col-md-2">
  143. <label for="postcode" class="form-label">Postcode*</label>
  144. <input type="text"
  145. class="form-control"
  146. id="postcode"
  147. name="postcode"
  148. value="<?= $data['record']['postcode'] ?? '' ?>"
  149. placeholder="Postcode"
  150. required> <br>
  151. </div>
  152. </div>
  153.  
  154. <div class="tab-pane fade" id="questions-tab">
  155. <div class="col-12">
  156. <label for="current_machine">What is your Current Machine?</label>
  157. <input type="text"
  158. class="form-control"
  159. id="current_machine"
  160. name="current_machine"
  161. value="<?= $data['record']['current_machine'] ?? '' ?>"
  162. placeholder="Leave blank if none"><br>
  163. </div>
  164. <div class="col-12">
  165. <label for="ordered_machine">What Machine did you Order?*</label>
  166. <input type="text"
  167. class="form-control"
  168. id="ordered_machine"
  169. name="ordered_machine"
  170. value="<?= $data['record']['ordered_machine'] ?? '' ?>"
  171. placeholder="Leave blank if none"
  172. required> <br>
  173. </div>
  174. <div class="col-12">
  175. <h6 for="q1">1. Are you aware of the Dimensions of the Machine(s) Ordered?
  176. <a href="img/size-reference.pdf#page=1" target="_blank"><i class="fas fa-question-circle"></i> </a></h6>
  177. <select class="form-select form-select-sm" name="q1">
  178. <option selected>--Select--</option>
  179. <option value="YES"<?= isset($data['record']['q1']) && $data['record']['q1'] === "YES" ? ' selected' : '' ?>>Yes</option>
  180. <option value="NO"<?= isset($data['record']['q1']) && $data['record']['q1'] === "NO" ? ' selected' : '' ?>>No</option>
  181. </select><br><br>
  182. </div>
  183.  
  184. <div class="col-12">
  185. <h6 for="q2">2. Are you aware of the Capacity of the Machine(s) Ordered?
  186. <a href="img/website-resources.pdf#page=1" target="_blank"><i class="fas fa-question-circle"></i> </a></h6>
  187. <select class="form-select form-select-sm" name="q2">
  188. <option selected>--Select--</option>
  189. <option value="YES"<?= isset($data['record']['q2']) && $data['record']['q2'] === "YES" ? ' selected' : '' ?>>Yes</option>
  190. <option value="NO"<?= isset($data['record']['q2']) && $data['record']['q2'] === "NO" ? ' selected' : '' ?>>No</option>
  191. </select><br><br>
  192. </div>
  193. <div class="col-12">
  194. <h6 for="q3">3. Are you aware that the Maximum Drain Height is <i>600mm</i> up from the bottom of Machine(s)?
  195. <a href="img/website-resources.pdf#page=2" target="_blank"><i class="fas fa-question-circle"></i> </a></h6>
  196. <select class="form-select form-select-sm" name="q3">
  197. <option selected>--Select--</option>
  198. <option value="YES"<?= isset($data['record']['q3']) && $data['record']['q3'] === "YES" ? ' selected' : '' ?>>Yes</option>
  199. <option value="NO"<?= isset($data['record']['q3']) && $data['record']['q3'] === "NO" ? ' selected' : '' ?>>No</option>
  200. </select><br><br>
  201. </div>
  202. <div class="col-12">
  203. <h6 for="q4">4. Are you aware of the Power Supply required for the Machine(s)?
  204. <a href="img/website-resources.pdf#page=3" target="_blank"><i class="fas fa-question-circle"></i> </a></h6>
  205. <select class="form-select form-select-sm" name="q4">
  206. <option selected>--Select--</option>
  207. <option value="YES"<?= isset($data['record']['q4']) && $data['record']['q4'] === "YES" ? ' selected' : '' ?>>Yes</option>
  208. <option value="NO"<?= isset($data['record']['q4']) && $data['record']['q4'] === "NO" ? ' selected' : '' ?>>No</option>
  209. </select><br><br>
  210. </div>
  211. <div class="col-12">
  212. <h6 for="q5">5. Is there a suitable Water Supply & Waste within <i>1metre</i> of the location?
  213. <a href="img/website-resources.pdf#page=2" target="_blank"><i class="fas fa-question-circle"></i> </a></h6>
  214. <select class="form-select form-select-sm" name="q5">
  215. <option selected>--Select--</option>
  216. <option value="YES"<?= isset($data['record']['q5']) && $data['record']['q5'] === "YES" ? ' selected' : '' ?>>Yes</option>
  217. <option value="NO"<?= isset($data['record']['q5']) && $data['record']['q5'] === "NO" ? ' selected' : '' ?>>No</option>
  218. </select><br><br>
  219. </div>
  220. <br>
  221. <div class="col-12">
  222. <h6 for="q6">6. Is your Site located in a Hard Water area?
  223. <a href="https://www.aquacure.co.uk/knowledge-base/uk-hard-water-map/" target="_blank"><i class="fas fa-question-circle"></i> </a></h6>
  224. <select class="form-select form-select-sm" name="q6">
  225. <option selected>--Select--</option>
  226. <option value="YES"<?= isset($data['record']['q6']) && $data['record']['q6'] === "YES" ? ' selected' : '' ?>>Yes</option>
  227. <option value="NO"<?= isset($data['record']['q6']) && $data['record']['q6'] === "NO" ? ' selected' : '' ?>>No</option>
  228. </select><br>
  229. </div>
  230. </div>
  231.  
  232. <div class="tab-pane fade" id="delivery-tab">
  233. <div class="col-12">
  234. <h6 for="q7">7. What floor is the Machine(s) going to be located on?</h6>
  235. <input type="text"
  236. class="form-control"
  237. id="q7"
  238. name="q7"
  239. value="<?= $data['record']['q7'] ?? '' ?>"
  240. placeholder="Please enter what floor your machine will be located on"> <br><br>
  241. </div>
  242. <div class="col-12">
  243. <h6 for="q8">8. Does the Machine Require lifting over a Bar/Countertop?</h6>
  244. <select class="form-select form-select-sm" name="q8">
  245. <option selected>--Select--</option>
  246. <option value="YES"<?= isset($data['record']['q8']) && $data['record']['q8'] === "YES" ? ' selected' : '' ?>>Yes</option>
  247. <option value="NO"<?= isset($data['record']['q8']) && $data['record']['q8'] === "NO" ? ' selected' : '' ?>>No</option>
  248. </select><br><br>
  249. </div>
  250. <div class="col-12">
  251. <h6 for="q9">9. Is there clear Access to the position of the Machine(s)&nbsp&nbsp&nbsp(e.g. Access through doors)</h6>
  252. <select class="form-select form-select-sm" name="q9">
  253. <option selected>--Select--</option>
  254. <option value="YES"<?= isset($data['record']['q9']) && $data['record']['q9'] === "YES" ? ' selected' : '' ?>>Yes</option>
  255. <option value="NO"<?= isset($data['record']['q9']) && $data['record']['q9'] === "NO" ? ' selected' : '' ?>>No</option>
  256. </select><br><br>
  257. </div>
  258. <div class="col-12">
  259. <h6 for="q10">10. Are you aware or do you accept that Delivery will be the day <u>before</u> Install and collection of any old machine will be the day <u>after</u> install?</h6>
  260. <select class="form-select form-select-sm" name="q10">
  261. <option selected>--Select--</option>
  262. <option value="YES"<?= isset($data['record']['q10']) && $data['record']['q10'] === "YES" ? ' selected' : '' ?>>Yes</option>
  263. <option value="NO"<?= isset($data['record']['q10']) && $data['record']['q10'] === "NO" ? ' selected' : '' ?>>No</option>
  264. </select><br><br>
  265. </div>
  266. <div class="col-12">
  267. <h6 for="q11">11. Can you accept Delivery/Install between 8am & 6pm on Weekdays?</h6>
  268. <select class="form-select form-select-sm" name="q11">
  269. <option selected>--Select--</option>
  270. <option value="YES"<?= isset($data['record']['q11']) && $data['record']['q11'] === "YES" ? ' selected' : '' ?>>Yes</option>
  271. <option value="NO"<?= isset($data['record']['q11']) && $data['record']['q11'] === "NO" ? ' selected' : '' ?>>No</option>
  272. </select><br><br>
  273. </div>
  274. <div class="col-12">
  275. <h6 for="q12">12. Are there any Restrictions on Vehicle Size or Time restrictions in the area? (If Yes, Please Elaborate)</h6>
  276. <input type="text"
  277. class="form-control"
  278. id="q12"
  279. name="q12"
  280. value="<?= $data['record']['q12'] ?? '' ?>"
  281. placeholder="Please enter any restrictions to your site">
  282. </div>
  283. <div class="col-12">
  284. <hr>
  285. <h4 for="suggestions">Added Notes / Suggestions</h4>
  286. <input type="text"
  287. class="form-control"
  288. id="suggestions"
  289. name="suggestions"
  290. value="<?= $data['record']['suggestions'] ?? '' ?>"
  291. placeholder="Leave blank if none"><br>
  292. </div>
  293. </div>
  294. </div>
  295. </form>
  296. </div>
  297. </body>
  298. <?php require_once __DIR__ . '/footer.phtml'; ?>
  299.  
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