Current File : //home/tradevaly/public_html/storage/framework/views/07c3360394818644a7f03d1680cae43ffe40f40d.php

<h6> <?php echo e(translate('Tell Us What You')); ?> <span><?php echo e(translate('NEED')); ?></span> </h6> 
                <form method="POST" name="quoteForm" action="<?php echo e(route('contact')); ?>" novalidate="novalidate"><?php echo csrf_field(); ?>
                    <div class="form-row mt-3" style="padding-left:10px !important;">
                        <div class="col-sm-12"> 
                            <input type="text" name="question" class="form-control" placeholder="<?php echo e(translate('Enter product/service name')); ?>" title="<?php echo e(translate('Comma seperated keywords')); ?>" autocomplete="off" required aria-required="true"> 
                        </div>
                        <div class="col-lg-6 col-md-12 col-sm-6">
                        <input type="text" name="name" class="form-control" placeholder="<?php echo e(translate('Enter Your Full Name')); ?>" title="<?php echo e(translate('Please enter your Full Name here')); ?>" autocomplete="name" required aria-required="true"> 
                        </div>
                        <div class="col-lg-6 col-md-12 col-sm-6">
                            <input type="email" name="email" class="form-control" placeholder="<?php echo e(translate('Enter Your email')); ?>" title="<?php echo e(translate('Please enter your Email Address here')); ?>" autocomplete="email" required aria-required="true">
                        </div>
                        <div class="col-lg-12 col-md-12 col-sm-6">
                            <input type="text" name="company" class="form-control" placeholder="<?php echo e(translate('Enter Your Company Name')); ?>" title="<?php echo e(translate('Please enter your Company Name here')); ?>" autocomplete="organization" required aria-required="true"> 
                        </div>
                        <div class="col-lg-6 col-md-12 col-sm-6">
                            <div class="form-group">
                                <?php
                                $category = \App\Models\Category::where('parent_id', 0)->where('status', 1)->where('home', 1)->take(9)->get();
                                ?>
                               <select class="form-control" name="category_id">
                                    <option value=""><?php echo e(translate('Select a Category *')); ?></option>
                                      <?php $__currentLoopData = $category; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $cat): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                                          <option value="<?php echo e($cat->id); ?>"><?php echo e($cat->name); ?></option>
                                      <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                                </select>
                            </div>
                        </div>
                         <?php
                                $my_ip = ip_country('103.122.29.214')->country_code;

                                $my_country = \App\Models\Country::where('iso', $my_ip)->first();
                                
                                $countrylist = \App\Models\Country::all();
                                ?>
                                <div class="col-lg-6 mb-2">
                                    <select class="form-control country_id" name="country_id" required>
                                        <option value="">Choose Your Country</option>
                                        <?php $__currentLoopData = $countrylist; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $country): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                                        <option value="<?php echo e($country->id); ?>" <?php if($country->id == $my_country->id): ?> selected <?php endif; ?>><?php echo e($country->name); ?></option>
                                        <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                                    </select>
                                </div>
                        <div class="col-lg-6 mb-2">
                            <input type="tel" class="form-control regphone" name="phone"  placeholder="<?php echo e(translate('+00')); ?>" required="required" value="+<?php echo e($my_country->phonecode); ?>">       	
                            <input id="phone" type='hidden'>
                         </div>
                        <div class="col-md-6"> 
                            <select class="form-control valid" name="role" required aria-required="true" aria-invalid="false"> 
                                <option value="" selected=""><?php echo e(translate('Select a role')); ?></option> 
                                <option value="seller" selected=""><?php echo e(translate('Seller')); ?></option> 
                                <option value="buyer"><?php echo e(translate('Buyer')); ?></option>
                             </select>
                        </div>
                        <div class="col-lg-6 mb-2">
                            <input type="tel" class="form-control" name="password"  placeholder="Passwrod" required="required">       	
                            
                         </div>
                        <div class="col-md-6"> 
                            <input type="tel" class="form-control" name="confirm_password"  placeholder="Confirm Passwrod" required="required"> 
                        </div>
                        <div class="col-lg-6 <?php echo e($errors->has('g-recaptcha-response') ? ' has-error' : ''); ?> custom_captha">
                                     <?php echo app('captcha')->display(); ?>

                                <?php if($errors->has('g-recaptcha-response')): ?>
                                    <span class="help-block">
                                        <strong><?php echo e($errors->first('g-recaptcha-response')); ?></strong>
                                    </span>
                                <?php endif; ?>
                                </div> 

                        <div class="col-12 form-p-0 text-center">
                            <button type="submit" class="btn btn-outline-danger"><?php echo e(translate('Submit')); ?></button> 
                        </div>
                        <p class="text-center"><span>*</span> <?php echo e(translate('To achieve our mission we provide all the necessary functionalities to buyers and sellers that help them in developing the voice of their business and to expand worldwide.')); ?></p>
                    </div>
                </form><?php /**PATH /home/tradevaly/public_html/resources/views/frontend/utils/tellus.blade.php ENDPATH**/ ?>