Current File : /home/tradevaly/www/resources/views/frontend/utils/tellus.blade.php

<h6> {{ translate('Tell Us What You') }} <span>{{ translate('NEED') }}</span> </h6> 
                <form method="POST" name="quoteForm" action="{{route('contact')}}" novalidate="novalidate">@csrf
                    <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="{{ translate('Enter product/service name') }}" title="{{ 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="{{ translate('Enter Your Full Name') }}" title="{{ 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="{{ translate('Enter Your email') }}" title="{{ 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="{{ translate('Enter Your Company Name') }}" title="{{ 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
                                $category = \App\Models\Category::where('parent_id', 0)->where('status', 1)->where('home', 1)->take(9)->get();
                                @endphp
                               <select class="form-control" name="category_id">
                                    <option value="">{{ translate('Select a Category *') }}</option>
                                      @foreach ($category as $cat)
                                          <option value="{{ $cat->id }}">{{ $cat->name }}</option>
                                      @endforeach
                                </select>
                            </div>
                        </div>
                         @php
                                $my_ip = ip_country('103.122.29.214')->country_code;

                                $my_country = \App\Models\Country::where('iso', $my_ip)->first();
                                
                                $countrylist = \App\Models\Country::all();
                                @endphp
                                <div class="col-lg-6 mb-2">
                                    <select class="form-control country_id" name="country_id" required>
                                        <option value="">Choose Your Country</option>
                                        @foreach($countrylist as $country)
                                        <option value="{{$country->id}}" @if($country->id == $my_country->id) selected @endif>{{$country->name}}</option>
                                        @endforeach
                                    </select>
                                </div>
                        <div class="col-lg-6 mb-2">
                            <input type="tel" class="form-control regphone" name="phone"  placeholder="{{ translate('+00') }}" required="required" value="+{{$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="">{{ translate('Select a role') }}</option> 
                                <option value="seller" selected="">{{ translate('Seller') }}</option> 
                                <option value="buyer">{{ 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 {{ $errors->has('g-recaptcha-response') ? ' has-error' : '' }} custom_captha">
                                     {!! app('captcha')->display() !!}
                                @if ($errors->has('g-recaptcha-response'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('g-recaptcha-response') }}</strong>
                                    </span>
                                @endif
                                </div> 

                        <div class="col-12 form-p-0 text-center">
                            <button type="submit" class="btn btn-outline-danger">{{ translate('Submit') }}</button> 
                        </div>
                        <p class="text-center"><span>*</span> {{ 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>