| Server IP : 103.161.17.216 / Your IP : 216.73.216.1 Web Server : nginx/1.18.0 System : Linux tipsysaigoncharming 5.4.0-216-generic #236-Ubuntu SMP Fri Apr 11 19:53:21 UTC 2025 x86_64 User : www-data ( 33) PHP Version : 7.4.3-4ubuntu2.29 Disable Function : pcntl_alarm,pcntl_fork,pcntl_waitpid,pcntl_wait,pcntl_wifexited,pcntl_wifstopped,pcntl_wifsignaled,pcntl_wifcontinued,pcntl_wexitstatus,pcntl_wtermsig,pcntl_wstopsig,pcntl_signal,pcntl_signal_get_handler,pcntl_signal_dispatch,pcntl_get_last_error,pcntl_strerror,pcntl_sigprocmask,pcntl_sigwaitinfo,pcntl_sigtimedwait,pcntl_exec,pcntl_getpriority,pcntl_setpriority,pcntl_async_signals,pcntl_unshare, MySQL : OFF | cURL : ON | WGET : ON | Perl : ON | Python : OFF | Sudo : ON | Pkexec : ON Directory : /var/www/thanhtraspa.vn/public/frontend/ajax-load/ |
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<section class="">
<div class="container position-relative p-0 mt-90" style="max-width: 700px;">
<h3 class="bg-theme-colored1 p-15 mb-0 text-white">Appointment Form</h3>
<div class="section-content bg-white p-30">
<div class="row">
<div class="col-md-12">
<!-- Reservation Form Start-->
<form id="appointment_form_popup" name="appointment_form" class="appointment-form" method="post" action="includes/appointment.php">
<h3 class="mt-0">Get A Free Service<span class="text-theme-colored1 font-weight-600"> Now!</span></h3>
<p class="">Lorem ipsum dolor sit amet, consectetur elit.</p>
<div class="row">
<div class="col-sm-6">
<div class="form-group mb-30">
<input placeholder="Enter Name" type="text" name="form_name" class="form-control required">
</div>
</div>
<div class="col-sm-6">
<div class="form-group mb-30">
<input placeholder="Email" type="text" name="form_email" class="form-control required">
</div>
</div>
<div class="col-sm-6">
<div class="form-group mb-30">
<input placeholder="Phone" type="text" name="form_phone" class="form-control required">
</div>
</div>
<div class="col-sm-6">
<select name="form_service" class="form-control required">
<option value=""> --- Choose Service --- </option>
<option value="Service 1">Service 1</option>
<option value="Service 2">Service 2</option>
<option value="Service 3">Service 3</option>
<option value="Service 4">Service 4</option>
</select>
</div>
<div class="col-sm-6">
<div class="form-group mb-30">
<input name="form_date" class="form-control required date-picker" type="text" placeholder="Date">
</div>
</div>
<div class="col-sm-6">
<div class="form-group mb-30">
<input name="form_time" class="form-control required time-picker" type="text" placeholder="Time">
</div>
</div>
<div class="col-sm-12">
<div class="form-group">
<textarea name="form_message" class="form-control required" rows="5" placeholder="Enter Message"></textarea>
</div>
</div>
<div class="col-sm-12">
<div class="form-group mb-0 mt-0">
<input name="form_botcheck" class="form-control" type="hidden" value="">
<button type="submit" class="btn btn-theme-colored1 btn-round" data-loading-text="Please wait...">Submit Now</button>
</div>
</div>
</div>
</form>
<!-- Reservation Form End-->
<!-- Reservation Form Validation Start-->
<script>
(function($) {
$("#appointment_form_popup").validate({
submitHandler: function(form) {
var form_btn = $(form).find('button[type="submit"]');
var form_result_div = '#form-result';
$(form_result_div).remove();
form_btn.before('<div id="form-result" class="alert alert-success" role="alert" style="display: none;"></div>');
var form_btn_old_msg = form_btn.html();
form_btn.html(form_btn.prop('disabled', true).data("loading-text"));
$(form).ajaxSubmit({
dataType: 'json',
success: function(data) {
if( data.status == 'true' ) {
$(form).find('.form-control').val('');
}
form_btn.prop('disabled', false).html(form_btn_old_msg);
$(form_result_div).html(data.message).fadeIn('slow');
setTimeout(function(){ $(form_result_div).fadeOut('slow') }, 6000);
}
});
}
});
})(jQuery);
</script>
<!-- Reservation Form Validation Start -->
</div>
</div>
</div>
<button title="Close (Esc)" type="button" class="mfp-close mt-10">×</button>
</div>
</section>
<!-- Footer Scripts -->
<script>
//reload date and time picker
THEMEMASCOT.initialize.TM_datePicker();
</script>