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.protection-voiture.fr_1509353638/htdocs/modules/
/srv/data/trash/vhost_www.protection-voiture.fr_1509353638/htdocs/modules/pre-devis.php
 <?php include "functions/devis-ligne.php"; ?>
   <div class="pre-devis col-sm-12 ">
      <!--   <h2>Ne perdez plus de temps, réservez votre chauffeur ! </h2> -->
<?=form_open($routes['home']) ?>
 <div class="row pad1">
    <div class="col-sm-3">
      <div class="form-group has-feedback <?=$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>" ?>
       <!--    <label for="lastname">Nom</label> -->
      </div>
    </div>
   
    <div class="col-sm-2">
      <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 ".(($data['email']['status']=="has-success")?"fa-check":"fa-times" )." form-control-feedback'></span>" ?>
       <!--    <label for="email">E-mail</label> -->
      </div>
    </div>
    <div class="col-sm-2">
      <div class="form-group has-feedback <?=$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>" ?>
        <!-- <label for="phone">Téléphone</label> -->
      </div>
    </div>
  

    <div class="col-sm-3">
      <div class="form-group has-feedback <?=$data['select1']['status']?>">
       <!--  <?=form_label($data['select1']['label'],'select1')?> -->
        <?=form_select('select1',$data['select1']['value'],array("Type de prestation :","Films de protection avant","Films de protection arrière ","Films de protection avant + arrière","Protections jantes "),array('class'=>'form-control'))?>
      </div>
    </div>

      <div class="col-sm-2">
      <div class="form-group has-feedback <?=$data['model']['status']?>">
        <?=form_text('model',$data['model']['value'],array('class'=>'form-control','placeholder'=>'Modèle véhicule '))?>
        <?=form_feedback($form_is_submitted,$data['model']['status'])?>
      </div>
    </div>

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

 </div>
<?=form_close()?>