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171 lines
5.2 KiB
PHP
171 lines
5.2 KiB
PHP
<link href="https://data.asiahighlights.com/min/?f=/css/lantern-form-pc.css" rel="stylesheet">
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<body>
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<div class="wholeWrap">
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<div class="col-md-3 col-sm-3">
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</div>
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<div class="col-md-7 col-sm-7 hidden-xs">
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<div class="row">
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<div class="workingSteps">
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<div class="col-md-6 col-sm-6">
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<div class="stepLogo">
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<img src="https://data.asiahighlights.com/image/ticket-select.png" alt="select ticket type">
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</div>
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</div>
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<div class="col-md-18 col-sm-18">
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<div class="detailedSteps">
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<div class="stepText">
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Select services, ticket Type, quantity and date
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</div>
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</div>
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</div><div class="dotted"></div>
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</div>
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<div class="workingSteps">
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<div class="col-md-6 col-sm-6">
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<div class="stepLogo">
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<img src="https://data.asiahighlights.com/image/ticket-fill-form.png"
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alt="select ticket type">
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</div>
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</div>
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<div class="col-md-18 col-sm-18">
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<div class="detailedSteps">
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<div class="stepText">
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<strong>
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Provide your personal information
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</strong>
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</div>
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</div>
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</div><div class="dotted"></div>
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</div>
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<div class="workingSteps">
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<div class="col-md-6 col-sm-6">
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<div class="stepLogo">
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<img src="https://data.asiahighlights.com/image/ticket-pay.png" alt="select ticket type">
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</div>
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</div>
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<div class="col-md-18 col-sm-18">
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<div class="detailedSteps">
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<div class="stepText">
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Make a payment
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</div>
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</div>
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</div><div class="dotted"></div>
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</div>
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<div class="workingSteps">
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<div class="col-md-6 col-sm-6">
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<div class="stepLogo">
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<img src="https://data.asiahighlights.com/image/ticket-get.png" alt="select ticket type">
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</div>
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</div>
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<div class="col-md-18 col-sm-18">
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<div class="detailedSteps">
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<div class="stepText">
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We get in touch with you within 24 hours with confirmation
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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<div class="col-md-14 col-sm-14">
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<form action="/orders/lantern_save" method="post" id="form_lantern" name="form_lantern">
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<div id="inquiryBox">
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<h2>
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Your Details...
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</h2>
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<div class="genderSelection">
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<form action="" method="GET">
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<div class="checkboxGender">
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<input type="radio" value="100001" id="male" name="gender">
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<label for="male">
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Mr.
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</label>
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</div>
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<div class="checkboxGender">
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<input type="radio" value="100003" id="female" name="gender">
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<label for="female">
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Ms.
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</label>
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</div>
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<div class="checkboxGender">
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<input type="radio" value="100004" id="neutural" name="gender">
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<label for="neutural">
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Mx.
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</label>
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</div>
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</form>
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</div>
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<div class="inputTerm">
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<input type="text" name="fullname" required>
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<label>
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Full Name *
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</label>
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</div>
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<div class="inputTerm">
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<input type="email" name="email" required>
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<label>
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Email Address *
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</label>
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</div>
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<div class="formMemo">
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All your ticket issues will be sent to your mailbox.
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</div>
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<div class="inputTerm">
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<input type="text" name="Nationality" required>
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<label>
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Nationality / Region *
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</label>
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</div>
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<div class="inputTerm">
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<input type="text" name="PhoneNo">
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<label>
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Phone number (Area code + number. Only call if you ask.)
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</label>
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</div>
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<div class="checkYes">
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<input type="checkbox" value="Available on WhatsApp" name="whatsapp" id="whatsapp" class="checkBorder">
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<label for="whatsapp">
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This number is available on WhatsApp
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</label>
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</div>
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<textarea id="additionalrequirements" name="additionalrequirements" style="resize:none;" placeholder="ADDITIONAL REQUESTS... "></textarea>
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<div class="settleBlock">
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<div class="settlePart">
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<div class="settleItems">
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Location: <span class="totalPrice"><?php echo $location;?></span>
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</div>
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<div class="settleItems">
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Ticket Type: <span class="totalPrice"><?php echo $ticketonlyselection;?></span>
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</div>
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<div class="settleItems">
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Date of event: <span class="totalPrice"><?php echo $date;?></span>
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</div>
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<div class="settleItems">
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Number of people: <span class="totalPrice"><?Php echo $travelNumber;?></span>
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</div>
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</div>
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<div class="settleMponey">
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Total Price:
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<span class="totalPrice">
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USD <?php echo $totalprice;?>
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</span>
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</div>
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</div>
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<div class="clear">
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</div>
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<div class="inquiryBtn">
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<input type="submit" value="Pay Now">
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</div>
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<input type="hidden" name="location" value="<?php echo $location;?>"/>
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<input type="hidden" name="ticketype" value="<?php echo $ticketonlyselection;?>"/>
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<input type="hidden" name="date" value="<?php echo $date;?>"/>
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<input type="hidden" name="travelNumber" value="<?php echo $travelNumber;?>"/>
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<input type="hidden" name="totalprice" value="<?php echo $totalprice;?>"/>
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<input type="hidden" name="cli_sn" value="13349"/>
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<input type="hidden" name="url" value="<?php echo $orderfrom;?>" />
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</div>
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</form>
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</div>
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<div class="clear">
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</div>
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</div>
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</body>
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