information-system/application/views/mobile_first/chinatravel-form-tourqi.php

<div class="container-details">
    <div class="bookingbox">
        <div class="booking">
            <div class="bookingtitle">
            <div class="booking-top">
			 <p class="text-center"> Price is based on a 2-person tour with 4-star hotels in low season.</p> 
		 </div>
                <div class="bg-triangle"> <span class="bgarrow"></span>
                    <p class="text-center">from US $<span class="js_getTourPrice font36" data="<?php echo $TourCode ?>"></span> p/p</p>
                </div>
            </div>
            <form name="qiform" id="qiform" action="" method="post">
            <div class="quick-inquiry quick-inquiry2">
		<p><strong>*How Many People In Your Group?</strong></p>
		<div class="flex-row form-box">
<div class="flex-col-3 col-label2"><label>Adults <span class="font14 color8">(≥12 years old)</span></label>

<div class="input-group"><a class="input-group-addon js_sub" href="javascript:;">-</a> <input class="form-control addon-num" mindata="1" name="adults" type="" value="2"> <a class="input-group-addon js_Add" href="javascript:;">+</a></div>
</div>

<div class="flex-col-3 col-label2"><label>Children <span class="font14 color8">(2-11 years old)</span></label>

<div class="input-group"><a class="input-group-addon js_sub" href="javascript:;">-</a> <input class="form-control addon-num" name="children" type="" value="0"> <a class="input-group-addon js_Add" href="javascript:;">+</a></div>
</div>

<div class="flex-col-3 col-label2"><label>Infants <span class="font14 color8">(&lt;2 years old)</span></label>

<div class="input-group"><a class="input-group-addon js_sub" href="javascript:;">-</a> <input class="form-control addon-num" name="babies" type="" value="0"> <a class="input-group-addon js_Add" href="javascript:;">+</a></div>
</div>
</div>
		<p><strong>*What's Your Hotel Preference?</strong></p>
        <?php if ($device == "pc")  { ?>
		<div class="flex-row visible-md">
      <div class="flex-col-3 col-label">
        <input class="mgc" id="r9" name="hoteltype" type="radio" value="5-star" />
        <label for="r9">5 Star (Luxury)</label>
      </div>
      <div class="flex-col-3 col-label">
        <input checked="CHECKED" class="mgc" id="r10" name="hoteltype" type="radio" value="4-star" />
        <label for="r10">4 Star (Comfort)</label>
      </div>
      <div class="flex-col-3 col-label">
        <input class="mgc" id="r11" name="hoteltype" type="radio" value="3-Star" />
        <label for="r11">3 Star (Economy)</label>
      </div>      
    </div>
    <?php } else { ?>
		<div class="visible-xs m-bottom20"><select class="form-control" id="Hotel" name="hoteltype">
          <option value="5-star">5 Star (Luxury)</option>
			<option selected="selected" value="4-star">4 Star (Comfort)</option>
			<option value="3-Star">3 Star (Economy)</option>
		</select></div>		
    <?php } ?>
	<textarea rows="2" class="form-control m-bottom15" id="form_additionalrequirements" name="form_additionalrequirements" placeholder="Share your specific needs here, e.g. It's a family trip, anniversary, birthday... "></textarea>
		<div class="flex-row">
		  <div class="flex-col-2 ">
      <div class="input-group margin0"> <span class="input-group-addon"><span class="f-name"></span></span>
        <input class="form-control" name="realname" id="realname" value="" type="text" placeholder="Full Name *">
			  </div></div>
			<div class="flex-col-2">
      <div class="input-group margin0"> <span class="input-group-addon"><span class="f-date"></span></span>
        <input class="form-control" name="starting_date" id="starting_date" value="" type="text" placeholder="Start Date *">
				</div></div></div>      
		<div class="flex-row">
		  <div class="flex-col-2"><div class="input-group margin0"><span class="input-group-addon"><span class="f-nationality"></span></span> <select class="form-control" id="nationality" name="nationality"><option selected="selected" value="">Nationality *</option> <optgroup label="----------------------------"><option value="3">United States</option><option value="7">United Kingdom</option><option value="18">Australia</option><option value="5">Canada</option><option value="1">China</option><option value="8">France</option><option value="6">Germany</option><option value="9">Italy</option><option value="19">Malaysia</option><option value="20">New Zealand</option><option value="23">Philippines</option><option value="27">Singapore</option></optgroup> <optgroup label="----------------------------"><option value="458">Afghanistan</option><option value="459">Albania</option><option value="460">Algeria</option><option value="461">American Samoa</option><option value="462">Andorra</option><option value="463">Angola</option><option value="464">Anguilla</option><option value="465">Antarctica</option><option value="466">Antigua And Barbuda</option><option value="467">Argentina</option><option value="468">Armenia</option><option value="469">Aruba</option><option value="18">Australia</option><option value="470">Austria</option><option value="471">Azerbaijan</option><option value="472">Bahamas</option><option value="473">Bahrain</option><option value="474">Bangladesh</option><option value="671">Barbadian</option><option value="475">Barbados</option><option value="476">Belarus</option><option value="477">Belgium</option><option value="478">Belize</option><option value="479">Benin</option><option value="480">Bermuda</option><option value="481">Bhutan</option><option value="482">Bolivia</option><option value="483">Botswana</option><option value="484">Bouvet Island</option><option value="38">Brazil</option><option value="485">British Indian Ocean Territory</option><option value="486">Brunei Darussalam</option><option value="487">Bulgaria</option><option value="488">Burkina Faso</option><option value="489">Burundi</option><option value="490">Cambodia</option><option value="491">Cameroon</option><option value="5">Canada</option><option value="493">Cape Verde</option><option value="494">Cayman Islands</option><option value="495">Central African Republic</option><option value="496">Chad</option><option value="497">Chile</option><option value="1">China</option><option value="10">China HK</option><option value="499">Christmas Island</option><option value="500">Colombia</option><option value="501">Comoros</option><option value="502">Congo</option><option value="504">Cook Islands</option><option value="505">Costa Rica</option><option value="506">Croatia</option><option value="507">Cuba</option><option value="508">Cyprus</option><option value="509">Czech Republic</option><option value="510">Czechoslovakia</option><option value="511">Denmark</option><option value="512">Djibouti</option><option value="513">Dominica</option><option value="514">Dominican Republic</option><option value="515">East Timor</option><option value="516">Ecuador</option><option value="517">Egypt</option><option value="518">El Salvador</option><option value="520">Equatorial Guinea</option><option value="521">Eritrea</option><option value="522">Estonia</option><option value="523">Ethiopia</option><option value="524">Falkland Islands</option><option value="525">Faroe Islands</option><option value="526">Fiji</option><option value="527">Finland</option><option value="8">France</option><option value="528">French Guiana</option><option value="529">French Polynesia</option><option value="530">Gabon</option><option value="531">Gambia</option><option value="532">Georgia</option><option value="6">Germany</option><option value="533">Ghana</option><option value="534">Gibraltar</option><option value="536">Greece</option><option value="537">Greenland</option><option value="538">Grenada</option><option value="539">Guadeloupe</option><option value="540">Guam</option><option value="670">Guatemala</
			<div class="flex-col-2"><div class="input-group margin0"> <span class="input-group-addon"><span class="f-phone"></span></span>
        <input class="form-control" name="PhoneNo" id="PhoneNo" value="" type="text" placeholder="Phone Number *">
      </div></div>
		</div>
      <div class="input-group"> <span class="input-group-addon"><span class="f-email"></span></span>
        <input class="form-control" name="email" id="email" value="" type="text" placeholder="Email Address *">
      </div>
      <p style="margin-bottom: 5px; margin-top: -8px; line-height: 20px;"> I prefer to be contacted via:</p>
      <div class="flex-row m-bottom20">
<div class="flex-col-4 col-label2"><input class="magic-checkbox" id="c2" name="Contact_Info[]" type="checkbox" value="WhatsApp"><label class="m-bottom10" for="c2">WhatsApp</label></div>

<div class="flex-col-4 col-label2"><input class="magic-checkbox" id="c5" name="Contact_Info[]" type="checkbox" value="Wechat"><label class="m-bottom10" for="c5">Wechat</label></div>

<div class="flex-col-4 col-label2"><input class="magic-checkbox" id="c3" name="Contact_Info[]" type="checkbox" value="Phone_Cal"><label class="m-bottom10" for="c3">Phone call</label></div>

<div class="flex-col-4 col-label2"><input class="magic-checkbox" id="c4" name="Contact_Info[]" type="checkbox" value="Email"><label class="m-bottom10" for="c4">Email</label></div>
</div>
      <p class="text-center"><a href="javascript:;" class="btn-orange font20" id="form_submit">Inquire This Tour <i class="fa fa-angle-right font20" aria-hidden="true"></i></a></p>	
      <input name="TourCode" type="hidden" id="TourCode" value="<?php echo $TourCode ?>">
                    <input name="CLI_SN" type="hidden" id="CLI_SN" value="<?php echo $CLI_SN ?>">
                    <input name="TourName" type="hidden" id="TourName" value="<?php echo $TourName ?>">

      	
	 <p class="text-center m-top20 color6"> <i>Your travel consultant will reach you within 1 working day.</i></p> 
    </div>
            </form>
           
        </div>
    </div>
</div>