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/srv/data/web/vhosts/www.chauffagiste-essonne.com/htdocs/pages/
/srv/data/web/vhosts/www.chauffagiste-essonne.com/htdocs/pages/devis.php
 <?php
	//start_block('title','keywords','description')
	start_block('','','');
?>
<div id="wrap-section">
  <section class="container">
  	<article class="col-xs-9">
  	<span class="border"></span>
	<h1 id="formD"><b>Devis</b></h1>

	<div class="row">
		<div class="col-sm-12">
			<form action="https://formspree.io/f/xkgbjbqr" method="post" enctype="multipart/form-data">
			
				<div class="row">
					<div class="col-sm-5">
						<fieldset>
							<legend>Coordonnées</legend>
							<div class="form-group">
								<label for="entreprise">Entreprise</label>
								<input type="text" name="entreprise" id="entreprise" class="form-control" placeholder="Entreprise" autofocus>
							</div>
							<div class="row">
								<div class="col-sm-6">
									<div class="form-group">
										<label for="prenom">Prénom *</label>
										<input type="text" name="prenom" id="prenom" class="form-control" placeholder="Prénom" required>
									</div>
								</div>
								<div class="col-sm-6">
									<div class="form-group">
										<label for="nom">NOM *</label>
										<input type="text" name="nom" id="nom" class="form-control" placeholder="NOM" required>
									</div>
								</div>
							</div>
							
							<div class="form-group">
								<label for="adresse">Adresse *</label>
								<input type="text" name="adresse" id="adresse" class="form-control" placeholder="Adresse" required>
							</div>
							<div class="row">
								<div class="col-sm-5">
									<div class="form-group">
										<label for="code_postal">Code postal *</label>
										<input type="text" name="code_postal" id="code_postal" class="form-control" placeholder="75001" required>
									</div>
								</div>
								<div class="col-sm-7">
									<div class="form-group">
										<label for="ville">Ville *</label>
										<input type="text" name="ville" id="ville" class="form-control" placeholder="Ville" required>
									</div>
								</div>
							</div>
							<div class="form-group">
								<label for="email">E-mail *</label>
								<input type="email" name="email" id="email" class="form-control" placeholder="text@exemple.fr" required>
							</div>
							<div class="form-group">
								<label for="telephone">Téléphone *</label>
								<input type="tel" name="telephone" id="telephone" class="form-control" placeholder="06 00 00 00 00" required>
							</div>
						</fieldset>
						
					</div>
					<div class="col-sm-6 col-sm-offset-1">
						<fieldset>
							<legend>Demande</legend>
							<div class="form-group">
								<label for="type_prestation">Type de prestation</label>
								<select name="type_prestation" id="type_prestation" class="form-control">
									<option value="Chauffagiste">Chauffagiste</option>
									<option value="Energie Renouvelable">Energie Renouvelable</option>
									<option value="Plomberie">Plomberie</option>
									<option value="Ventilation">Ventilation</option>
								</select>
							</div>
							<div class="form-group">
								<label>Type d'intervention</label>
								<div class="checkbox" style="margin-top: 0;">
									<label><input type="checkbox" name="installation" value="Oui"> Installation</label>
								</div>
								<div class="checkbox" style="margin-top: 0;">
									<label><input type="checkbox" name="maintenance" value="Oui"> Maintenance</label>
								</div>
								<div class="checkbox" style="margin-top: 0;">
									<label><input type="checkbox" name="depannage" value="Oui"> Dépannage</label>
								</div>
								
							</div>
							
							<div class="form-group">
                                <label for="piece_jointe">Pièce jointe</label>
                                <input type="file" name="piece_jointe" id="piece_jointe">
                                <p class="help-block">Indication sur la pièce jointe attendue (5 Mo maximum).</p>
                            </div>
						</fieldset>
					</div>
				</div>
				<div class="form-group">
					<label for="informations_complementaires">Informations complémentaires (facultatif)</label>
					<textarea name="informations_complementaires" id="informations_complementaires" class="form-control" rows="6"></textarea>
				</div>
				<br>
				<div class="text-center">
					<button type="reset" class="btn btn-default">Annuler</button>
					<button type="submit" class="btn btn-success">Envoyer</button>
				</div>
			</form>
		</div>
	</div>
	</article>
	<?php include "modules/aside.php"; ?>
  </section>
</div>
<?php end_block(); ?>