Linux SRV-16 6.18.44-paas #1 SMP PREEMPT_DYNAMIC Thu Aug 13 10:08:12 UTC 2026 x86_64
/srv/data/trash/vhost_www.glodie-evenements.com_1516803304/htdocs/modules/
/srv/data/trash/vhost_www.glodie-evenements.com_1516803304/htdocs/modules/pre-devis.php
 <?php include "functions/devis-ligne.php"; ?>
 
      <!--   <h2>Ne perdez plus de temps, réservez votre chauffeur ! </h2> -->
<?=form_open($routes['home']) ?>
  <div class=" col-sm-12">
 <div class="row pad1">
    <div class="col-sm-12 ">
      <div class="form-group has-feedback <?=$data['lastname']['status']?>">
        
        <input type="text" class="form-control " id="lastname" name="lastname" value="<?=$data['lastname']['value']?>" placeholder="Nom">
        <?php if($form_is_submitted)echo"<span class='fa ".(($data['lastname']['status']=="has-success")?"fa-check":"fa-times" )." form-control-feedback'></span>" ?>
      </div>
    </div>

      <div class="col-sm-12">
      <div class="form-group has-feedback <?=$data['phone']['status']?>">
        
        <input type="text" class="form-control " id="phone" name="phone" value="<?=$data['phone']['value']?>" placeholder="Téléphone">
        <?php if($form_is_submitted)echo"<span class='fa ".(($data['phone']['status']=="has-success")?"fa-check":"fa-times" )." form-control-feedback'></span>" ?>
      </div>
    </div>


   
    <div class="col-sm-12">
      <div class="form-group has-feedback <?=$data['email']['status']?>">
        <input type="text" class="form-control " id="email" name="email" value="<?=$data['email']['value']?>" placeholder="Mail">
        <?php if($form_is_submitted)echo"<span class='fa ".(($data['email']['status']=="has-success")?"fa-check":"fa-times" )." form-control-feedback'></span>" ?>
      </div>
    </div>
    <div class="col-sm-12">
      <div class="form-group has-feedback <?=$data['date1']['status']?>">
        <div class="input-group bootstrap-datepicker">
          <input type="text" class="form-control " id="date1"  name="date1" value="<?=$data['date1']['value']?>" placeholder="  Date souhaitée ">
            <span class="input-group-addon"><span class="fa fa-calendar fa-fw"></span></span>
        </div>
      </div>
    </div>
    <div class="col-sm-12">
      <div class="form-group has-feedback <?=$data['select1']['status']?>">
        <?=form_select('select1',$data['select1']['value'],array("Type d’évènement :","Particulier","Professionnel "),array('class'=>'form-control'))?>
      </div>
    </div>
     <div class="col-sm-12">
      <div class="form-group has-feedback <?=$data['select2']['status']?>">
        <?=form_select('select2',$data['select2']['value'],array("Type de prestation :","Mariage ","Baptême ","Anniversaire","Séminaire ","Soirée d’entreprise","Autre "),array('class'=>'form-control'))?>
      </div>
    </div>
  
 



 </div>
     <div class="col-sm-12 text-center">
          <button type='submit' name="devis" class='button '>Je réserve   </button>
    </div>
    </div>

    
  



<?=form_close()?>