information-system/application/views/mobile_first/gh-tour-form.php

<div class="all_width_content">
        <div class="ghwhyus">
            <p class="contactus">Start planning your tailor-made tour now. Your 1:1 travel consultant will reply within
                1 working day.</p>
            <form action="/forms/inquiry_save" id="bottomInquiryForm" method="post">
                <div class="InquiryFormBox">
                    <div class="FieldSet">
                        <textarea id="additionalrequirements" name="additional_requirements" placeholder="Tell us your travel requirements here: anniversary, honeymoon, family trip, birthday travel, beach, food... (optional)" style="margin-bottom:20px;"></textarea>
                        <p><input class="FullName" data-required="Please enter your fullname" id="realname" name="name" placeholder="Your name *" required="" type="text"></p>
                        <p><input class="EmailAddress" data-required="Please enter your e-mail address" data-pattern="Expecting an e-mail address" id="email" name="email" pattern="^[\w\-\.]+@[\w\-\.]+(\.\w+)+$" placeholder="Email *" required="" type="text"></p>
                        <p><input class="InquiryCalendar form-control input" placeholder="Starting date *" required="" tabindex="0" type="text" readonly="readonly" id='starting_date' name="date_start"></p>
                        <p>
                            <select class="country_code" name="country_code">
                                <option style="font-weight: 600;" value="United States +1">United States&nbsp; &nbsp;+1</option>
                                <option style="font-weight: 600;" value="United Kingdom +44">United Kingdom&nbsp; &nbsp;+44</option>
                                <option style="font-weight: 600;" value="Australia +61">Australia&nbsp; &nbsp;+61</option>
                                <option style="font-weight: 600;" value="Canada +1">Canada&nbsp; &nbsp;+1</option>
                                <option style="font-weight: 600;" value="France +33">France&nbsp; &nbsp;+33</option>
                                <option style="font-weight: 600;" value="Germany +49">Germany&nbsp; &nbsp;+49</option>
                                <option style="font-weight: 600; " value="Italy +39">Italy&nbsp; &nbsp;+39</option>
                                <option style="font-weight: 600; " value="Mexico +52">Mexico&nbsp; &nbsp;+52</option>
                                <option style="font-weight: 600; " value="Netherlands +31">Netherlands&nbsp; &nbsp;+31</option>
                                <option style="font-weight: 600; " value="Singapore +65">Singapore&nbsp; &nbsp;+65</option>
                                <option value="Afghanistan +93">Afghanistan &nbsp; &nbsp;+93</option>
                                <option value="Albania +355">Albania &nbsp; &nbsp;+355</option>
                                <option value="Algeria +213">Algeria&nbsp; &nbsp;+213</option>
                                <option value="American Samoa +1">American Samoa&nbsp; &nbsp;+1684</option>
                                <option value="Andorra +376">Andorra&nbsp; &nbsp;+376</option>
                                <option value="Angola +244">Angola&nbsp; &nbsp;+244</option>
                                <option value="Anguilla +1">Anguilla&nbsp; &nbsp;+1264</option>
                                <option value="Australia +61">Australia&nbsp; &nbsp;+61</option>
                                <option value="Antigua and Barbuda +1">Antigua and Barbuda&nbsp; &nbsp;+1268</option>
                                <option value="Argentina +54">Argentina&nbsp; &nbsp;+54</option>
                                <option value="Armenia +374">Armenia &nbsp; &nbsp;+374</option>
                                <option value="Aruba +297">Aruba&nbsp; &nbsp;+297</option>
                                <option value="Ascension Island +247">Ascension Island&nbsp; &nbsp;+247</option>
                                <option value="Austria +43">Austria&nbsp; &nbsp;+43</option>
                                <option value="Azerbaijan +994">Azerbaijan&nbsp; &nbsp;+994</option>
                                <option value="Bahamas +1">Bahamas&nbsp; &nbsp;+1242</option>
                                <option value="Bahrain +973">Bahrain&nbsp; &nbsp;+973</option>
                                <option value="Bangladesh +880">Bangladesh&nbsp; &nbsp;+880</option>
                                <option value="Barbados +1">Barbados&nbsp; &nbsp;+1246</option>
                                <option value="Belarus +375">Belarus&nbsp; &nbsp;+375</option>
                                <option value="Belgium +32">Belgium&nbsp; &nbsp;+32</option>
                                <option value="Belize +501">Belize&nbsp; &nbsp;+501</option>
                                <option value="Benin +229">Benin&nbsp; &nbsp;+229</option>
                                <option value="Bermuda +1">Bermuda&nbsp; &nbsp;+1441</option>
                                <option value="Bhutan +975">Bhutan&nbsp; &nbsp;+975</option>
                                <option value="Bolivia +591">Bolivia&nbsp; &nbsp;+591</option>
                                <option value="Bosnia and Herzegovina +387">Bosnia and Herzegovina&nbsp; &nbsp;+387</option>
                                <option value="Botswana +267">Botswana&nbsp; &nbsp;+267</option>
                                <option value="Brazil +55">Brazil&nbsp; &nbsp;+55</option>
                                <option value="British Indian Ocean Territory +246">British Indian Ocean Territory&nbsp; &nbsp;+246</option>
                                <option value="British Virgin Islands +1">British Virgin Islands&nbsp; &nbsp;+1284</option>
                                <option value="Brunei +673">Brunei&nbsp; &nbsp;+673</option>
                                <option value="Bulgaria +359">Bulgaria &nbsp; &nbsp;+359</option>
                                <option value="Burkina Faso +226">Burkina Faso&nbsp; &nbsp;+226</option>
                                <option value="Burundi +257">Burundi&nbsp; &nbsp;+257</option>
                                <option value="Cambodia +855">Cambodia&nbsp; &nbsp;+855</option>
                                <option value="Cameroon +237">Cameroon&nbsp; &nbsp;+237</option>
                                <option value="Canada +1">Canada&nbsp; &nbsp;+1</option>
                                <option value="Cape Verde +238">Cape Verde&nbsp; &nbsp;+238</option>
                                <option value="Caribbean Netherlands +599">Caribbean Netherlands&nbsp; &nbsp;+599</option>
                                <option value="Cayman Islands +1">Cayman Islands&nbsp; &nbsp;+1345</option>
                                <option value="Central African Republic +236">Central African Republic&nbsp; &nbsp;+236</option>
                                <option value="Chad +235">Chad&nbsp; &nbsp;+235</option>
                                <option value="Chile +56">Chile&nbsp; &nbsp;+56</option>
                                <option value="China +86">China&nbsp; &nbsp;+86</option>
                                <option value="Christmas Island +61">Christmas Island&nbsp; &nbsp;+6189164</option>
                                <option value="Cocos Islands +61">Cocos Islands&nbsp; &nbsp;+6189162</option>
                                <option value="Colombia +57">Colombia&nbsp; &nbsp;+57</option>
                                <option value="Comoros +269">Comoros&nbsp; &nbsp;+269</option>
                                <option value="Congo +243">Congo (DRC)&nbsp; &nbsp;+243</option>
                                <option value="Congo +242">Congo (Republic)&nbsp; &nbsp;+242</option>
                                <option value="Cook Islands +682">Cook Islands&nbsp; &nbsp;+682</option>
                                <option value="Costa Rica +506">Costa Rica&nbsp; &nbsp;+506</option>
                                <option value="Côte d'Ivoire +225">Côte d'Ivoire&nbsp; &nbsp;+225</option>
                                <option value="Croatia +385">Croatia&nbsp; &nbsp;+385</option>
                                <option value="Cuba +53">Cuba&nbsp; &nbsp;+53</option>
                                <option value="Curaçao +599">Curaçao&nbsp; &nbsp;+599</option>
                                <option value="Cyprus +357">Cyprus&nbsp; &nbsp;+357</option>
                                <option value="Czech Republic +420">Czech Republic&nbsp; &nbsp;+420</option>
                                <option value="Denmark +45">Denmark&nbsp; &nbsp;+45</option>
                                <option value="Djibouti +253">Djibouti&nbsp; &nbsp;+253</option>
                                <option value="Dominica +1">Dominica&nbsp; &nbsp;+1767</option>
                                <option value="Dominican Republic +1">Dominican Republic&nbsp; &nbsp;+1809</option>
                                <option value="Ecuador +593">Ecuador&nbsp; &nbsp;+593</option>
                                <option value="Egypt +20">Egypt&nbsp; &nbsp;+20</option>
                                <option value="El Salvador +503">El Salvador&nbsp; &nbsp;+503</option>
                                <option value="Equatorial Guinea +240">Equatorial Guinea&nbsp; &nbsp;+240</option>
                                <option value="Eritrea +291">Eritrea&nbsp; &nbsp;+291</option>
                                <option value="Estonia +372">Estonia&nbsp; &nbsp;+372</option>
                                <option value="Eswatini +268">Eswatini&nbsp; &nbsp;+268</option>
                                <option value="Ethiopia +251">Ethiopia&nbsp; &nbsp;+251</option>
                                <option value="Falkland Islands +500">Falkland Islands&nbsp; &nbsp;+500</option>
                                <option value="Faroe Islands +298">Faroe Islands&nbsp; &nbsp;+298</option>
                                <option value="Fiji +679">Fiji&nbsp; &nbsp;+679</option>
                                <option value="Finland +358">Finland&nbsp; &nbsp;+358</option>
                                <option value="France +33">France&nbsp; &nbsp;+33</option>
                                <option value="French Guiana +594">French Guiana&nbsp; &nbsp;+594</option>
                                <option value="French Polynesia +689">French Polynesia&nbsp; &nbsp;+689</option>
                                <option value="Gabon +241">Gabon&nbsp; &nbsp;+241</option>
                                <option value="Gambia +220">Gambia&nbsp; &nbsp;+220</option>
                                <option value="Georgia +995">Georgia&nbsp; &nbsp;+995</option>
                                <option value="Germany +49">Germany&nbsp; &nbsp;+49</option>
                                <option value="Ghana +233">Ghana&nbsp; &nbsp;+233</option>
                                <option value="Gibraltar +350">Gibraltar&nbsp; &nbsp;+350</option>
                                <option value="Greece +30">Greece&nbsp; &nbsp;+30</option>
                                <option value="Greenland +299">Greenland&nbsp; &nbsp;+299</option>
                                <option value="Grenada +1">Grenada&nbsp; &nbsp;+1473</option>
                                <option value="Guadeloupe +590">Guadeloupe&nbsp; &nbsp;+590</option>
                                <option value="Guam +1">Guam&nbsp; &nbsp;+1671</option>
                                <option value="Guatemala +502">Guatemala&nbsp; &nbsp;+502</option>
                                <option value="Guernsey +44">Guernsey&nbsp; &nbsp;+441481</option>
                                <option value="Guinea +224">Guinea&nbsp; &nbsp;+224</option>
                                <option value="Guinea-Bissau +245">Guinea-Bissau&nbsp; &nbsp;+245</option>
                                <option value="Guyana +592">Guyana&nbsp; &nbsp;+592</option>
                                <option value="Haiti +509">Haiti&nbsp; &nbsp;+509</option>
                                <option value="Honduras +504">Honduras&nbsp; &nbsp;+504</option>
                                <option value="Hong Kong +852">Hong Kong&nbsp; &nbsp;+852</option>
                                <option value="Hungary +36">Hungary&nbsp; &nbsp;+36</option>
                                <option value="Iceland +354">Iceland&nbsp; &nbsp;+354</option>
                                <option value="India +91">India&nbsp; &nbsp;+91</option>
                                <option value="Indonesia +62">Indonesia&nbsp; &nbsp;+62</option>
                                <option value="Iran +98">Iran&nbsp; &nbsp;+98</option>
                                <option value="Iraq +964">Iraq&nbsp; &nbsp;+964</option>
                                <option value="Ireland +353">Ireland&nbsp; &nbsp;+353</option>
                                <option value="Isle of Man +44">Isle of Man&nbsp; &nbsp;+44</option>
                                <option value="Israel +972">Israel&nbsp; &nbsp;+972</option>
                                <option value="Italy +39">Italy&nbsp; &nbsp;+39</option>
                                <option value="Jamaica +1">Jamaica&nbsp; &nbsp;+1876</option>
                                <option value="Japan +81">Japan&nbsp; &nbsp;+81</option>
                                <option value="Jersey +44">Jersey&nbsp; &nbsp;+44</option>
                                <option value="Jordan +962">Jordan&nbsp; &nbsp;+962</option>
                                <option value="Kazakhstan +7">Kazakhstan &nbsp; &nbsp;+7</option>
                                <option value="Kenya +254">Kenya&nbsp; &nbsp;+254</option>
                                <option value="Kiribati +686">Kiribati&nbsp; &nbsp;+686</option>
                                <option value="Kosovo +383">Kosovo&nbsp; &nbsp;+383</option>
                                <option value="Kuwait +965">Kuwait&nbsp; &nbsp;+965</option>
                                <option value="Kyrgyzstan +996">Kyrgyzstan &nbsp; &nbsp;+996</option>
                                <option value="Laos +856">Laos&nbsp; &nbsp;+856</option>
                                <option value="Latvia +371">Latvia &nbsp; &nbsp;+371</option>
                                <option value="Lebanon +961">Lebanon&nbsp; &nbsp;+961</option>
                                <option value="Lesotho +266">Lesotho&nbsp; &nbsp;+266</option>
                                <option value="Liberia +231">Liberia&nbsp; &nbsp;+231</option>
                                <option value="Libya +218">Libya&nbsp; &nbsp;+218</option>
                                <option value="Liechtenstein +423">Liechtenstein&nbsp; &nbsp;+423</option>
                                <option value="Lithuania +370">Lithuania&nbsp; &nbsp;+370</option>
                                <option value="Luxembourg +352">Luxembourg&nbsp; &nbsp;+352</option>
                                <option value="Macau +853">Macau&nbsp; &nbsp;+853</option>
                                <option value="Macedonia +389">Macedonia&nbsp; &nbsp;+389</option>
                                <option value="Madagascar +261">Madagascar&nbsp; &nbsp;+261</option>
                                <option value="Malawi +265">Malawi&nbsp; &nbsp;+265</option>
                                <option value="Malaysia +60">Malaysia&nbsp; &nbsp;+60</option>
                                <option value="Maldives +960">Maldives&nbsp; &nbsp;+960</option>
                                <option value="Mali +223">Mali&nbsp; &nbsp;+223</option>
                                <option value="Malta +356">Malta&nbsp; &nbsp;+356</option>
                                <option value="Marshall +692">Marshall Islands&nbsp; &nbsp;+692</option>
                                <option value="Martinique +596">Martinique&nbsp; &nbsp;+596</option>
                                <option value="Mauritania +222">Mauritania&nbsp; &nbsp;+222</option>
                                <option value="Mauritius +230">Mauritius&nbsp; &nbsp;+230</option>
                                <option value="Mayotte +262">Mayotte&nbsp; &nbsp;+262</option>
                                <option value="Micronesia +691">Micronesia&nbsp; &nbsp;+691</option>
                                <option value="Moldova +373">Moldova&nbsp; &nbsp;+373</option>
                                <option value="Monaco +377">Monaco&nbsp; &nbsp;+377</option>
                                <option value="Mongolia +976">Mongolia&nbsp; &nbsp;+976</option>
                                <option value="Montenegro +382">Montenegro&nbsp; &nbsp;+382</option>
                                <option value="Montserrat +1">Montserrat&nbsp; &nbsp;+1664</option>
                                <option value="Morocco +212">Morocco&nbsp; &nbsp;+212</option>
                                <option value="Mozambique +258">Mozambique&nbsp; &nbsp;+258</option>
                                <option value="Myanmar +95">Myanmar &nbsp; &nbsp;+95</option>
                                <option value="Namibia +264">Namibia&nbsp; &nbsp;+264</option>
                                <option value="Nauru +674">Nauru&nbsp; &nbsp;+674</option>
                                <option value="Nepal +977">Nepal&nbsp; &nbsp;+977</option>
                                <option value="New Caledonia +687">New Caledonia&nbsp; &nbsp;+687</option>
                                <option value="New Zealand +64">New Zealand&nbsp; &nbsp;+64</option>
                                <option value="Nicaragua +505">Nicaragua&nbsp; &nbsp;+505</option>
                                <option value="Niger +227">Niger&nbsp; &nbsp;+227</option>
                                <option value="Nigeria +234">Nigeria&nbsp; &nbsp;+234</option>
                                <option value="Niue +683">Niue&nbsp; &nbsp;+683</option>
                                <option value="Norfolk Island +672">Norfolk Island&nbsp; &nbsp;+6723</option>
                                <option value="North Korea +850">North Korea&nbsp; &nbsp;+850</option>
                                <option value="Northern Mariana Islands +1">Northern Mariana Islands&nbsp; &nbsp;+1670</option>
                                <option value="Norway +47">Norway&nbsp; &nbsp;+47</option>
                                <option value="Oman +968">Oman&nbsp; &nbsp;+968</option>
                                <option value="Pakistan +92">Pakistan&nbsp; &nbsp;+92</option>
                                <option value="Palau +680">Palau&nbsp; &nbsp;+680</option>
                                <option value="Palestine +970">Palestine &nbsp; &nbsp;+970</option>
                                <option value="Panama +507">Panama &nbsp; &nbsp;+507</option>
                                <option value="Papua New Guinea 675">Papua New Guinea&nbsp; &nbsp;+675</option>
                                <option value="Paraguay +595">Paraguay&nbsp; &nbsp;+595</option>
                                <option value="Peru +51">Peru &nbsp; &nbsp;+51</option>
                                <option value="Philippines +63">Philippines&nbsp; &nbsp;+63</option>
                                <option value="Poland +48">Poland&nbsp; &nbsp;+48</option>
                                <option value="Portugal +351">Portugal&nbsp; &nbsp;+351</option>
                                <option value="Puerto Rico +1">Puerto Rico&nbsp; &nbsp;+1787</option>
                                <option value="Qatar +974">Qatar&nbsp; &nbsp;+974</option>
                                <option value="Réunion +262">Réunion&nbsp; &nbsp;+262</option>
                                <option value="Romania +40">Romania&nbsp; &nbsp;+40</option>
                                <option value="Russia +7">Russia&nbsp; &nbsp;+7</option>
                                <option value="Rwanda +250">Rwanda&nbsp; &nbsp;+250</option>
                                <option value="Saint Barthélemy +590">Saint Barthélemy&nbsp; &nbsp;+590</option>
                                <option value="Saint Helena +290">Saint Helena&nbsp; &nbsp;+290</option>
                                <option value="Saint Kitts and Nevis +1">Saint Kitts and Nevis&nbsp; &nbsp;+1869</option>
                                <option value="Saint Lucia +1">Saint Lucia&nbsp; &nbsp;+1758</option>
                                <option value="Saint Martin +590">Saint Martin&nbsp; &nbsp;+590</option>
                                <option value="Saint Pierre and Miquelon +508">Saint Pierre and Miquelon&nbsp; &nbsp;+508</option>
                                <option value="Saint Vincent and the Grenadines +1">Saint Vincent and the Grenadines&nbsp; &nbsp;+1784</option>
                                <option value="Samoa +685">Samoa&nbsp; &nbsp;+685</option>
                                <option value="San Marino +378">San Marino&nbsp; &nbsp;+378</option>
                                <option value="São Tomé and Príncipe +239">São Tomé and Príncipe&nbsp; &nbsp;+239</option>
                                <option value="Saudi Arabia +966">Saudi Arabia &nbsp; &nbsp;+966</option>
                                <option value="Senegal +221">Senegal &nbsp; &nbsp;+221</option>
                                <option value="Serbia +381">Serbia&nbsp; &nbsp;+381</option>
                                <option value="Seychelles +248">Seychelles&nbsp; &nbsp;+248</option>
                                <option value="Sierra Leone +232">Sierra Leone&nbsp; &nbsp;+232</option>
                                <option value="Sint Maarten +1">Sint Maarten&nbsp; &nbsp;+1721</option>
                                <option value="Slovakia +421">Slovakia&nbsp; &nbsp;+421</option>
                                <option value="Slovenia +386">Slovenia&nbsp; &nbsp;+386</option>
                                <option value="Solomon Islands +677">Solomon Islands&nbsp; &nbsp;+677</option>
                                <option value="Somalia +252">Somalia&nbsp; &nbsp;+252</option>
                                <option value="South Africa +27">South Africa&nbsp; &nbsp;+27</option>
                                <option value="South Korea +82">South Korea&nbsp; &nbsp;+82</option>
                                <option value="South Sudan +211">South Sudan&nbsp; &nbsp;+211</option>
                                <option value="Spain +34">Spain&nbsp; &nbsp;+34</option>
                                <option value="Sri Lanka +94">Sri Lanka &nbsp; &nbsp;+94</option>
                                <option value="Sudan +249">Sudan&nbsp; &nbsp;+249</option>
                                <option value="Suriname">Suriname&nbsp; &nbsp;+597</option>
                                <option value="Svalbard and Jan Mayen +47">Svalbard and Jan Mayen&nbsp; &nbsp;+47</option>
                                <option value="Sweden +46">Sweden&nbsp; &nbsp;+46</option>
                                <option value="Switzerland +41">Switzerland&nbsp; &nbsp;+41</option>
                                <option value="Syria +963">Syria &nbsp; &nbsp;+963</option>
                                <option value="Taiwan +886">Taiwan&nbsp; &nbsp;+886</option>
                                <option value="Tajikistan +992">Tajikistan&nbsp; &nbsp;+992</option>
                                <option value="Tanzania +255">Tanzania&nbsp; &nbsp;+255</option>
                                <option value="Thailand +66">Thailand&nbsp; &nbsp;+66</option>
                                <option value="Timor-Leste +670">Timor-Leste&nbsp; &nbsp;+670</option>
                                <option value="Togo +228">Togo&nbsp; &nbsp;+228</option>
                                <option value="Tokelau +690">Tokelau&nbsp; &nbsp;+690</option>
                                <option value="Tonga +676">Tonga&nbsp; &nbsp;+676</option>
                                <option value="Trinidad and Tobago +1">Trinidad and Tobago&nbsp; &nbsp;+1868</option>
                                <option value="Tunisia +216">Tunisia&nbsp; &nbsp;+216</option>
                                <option value="Turkey +90">Turkey&nbsp; &nbsp;+90</option>
                                <option value="Turkmenistan +993">Turkmenistan&nbsp; &nbsp;+993</option>
                                <option value="Turks and Caicos Islands +1">Turks and Caicos Islands&nbsp; &nbsp;+1649</option>
                                <option value="Tuvalu +688">Tuvalu&nbsp; &nbsp;+688</option>
                                <option value="U.S. Virgin Islands +1">U.S. Virgin Islands&nbsp; &nbsp;+1340</option>
                                <option value="Uganda +256">Uganda&nbsp; &nbsp;+256</option>
                                <option value="Ukraine +380">Ukraine&nbsp; &nbsp;+380</option>
                                <option value="United Arab Emirates +971">United Arab Emirates &nbsp; &nbsp;+971</option>
                                <option value="United Kingdom +44">United Kingdom&nbsp; &nbsp;+44</option>
                                <option value="United States +1">United States&nbsp; &nbsp;+1</option>
                                <option value="Uruguay +598">Uruguay&nbsp; &nbsp;+598</option>
                                <option value="Uzbekistan +998">Uzbekistan&nbsp; &nbsp;+998</option>
                                <option value="Vanuatu +678">Vanuatu&nbsp; &nbsp;+678</option>
                                <option value="Vatican City +39">Vatican City&nbsp; &nbsp;+379</option>
                                <option value="Venezuela +58">Venezuela&nbsp; &nbsp;+58</option>
                                <option value="Vietnam +84">Vietnam&nbsp; &nbsp;+84</option>
                                <option value="Wallis and Futuna +681">Wallis and Futuna&nbsp; &nbsp;+681</option>
                                <option value="Western Sahara +212">Western Sahara &nbsp; &nbsp;+21228</option>
                                <option value="Yemen +967">Yemen&nbsp; &nbsp;+967</option>
                                <option value="Zambia +260">Zambia&nbsp; &nbsp;+260</option>
                                <option value="Zimbabwe +263">Zimbabwe&nbsp; &nbsp;+263</option>
                                <option value="Åland Islands +385">Åland Islands&nbsp; &nbsp;+35818</option>
                            </select>
                            <input class="Inquiryphone" name="PhoneNo" placeholder="Phone number including area code (optional)" type="text">
                        </p>
                        <p style="font-size: 17px;font-style:italic;line-height: 20px; color: #555;">Having a phone
                            number, especially with WhatsApp/iMessage capability will improve communication
                            efficiency.</p>
                        <p style="margin-top: 0;margin-bottom: 10px;padding: 0;color: #000;font-size: 20px;">I prefer to
                            be contacted via:</p>
                        <div class="checkYes" style="color:#000;"> <label for="whatsapp"><input class="checkBorder mgr-primary" id="whatsapp" name="contact_via_WhatsApp" type="checkbox" value="yes" style="width:auto !important;">WhatsApp</label>
                        </div>
                        <div class="checkYes" style="color:#000;"> <label for="iMessage"><input class="checkBorder mgr-primary" id="iMessage" name="contact_via_iMessage" type="checkbox" value="yes" style="width:auto !important;">iMessage</label>
                        </div>
                        <div class="checkYes" style="color:#000;"> <label for="Phone"><input class="checkBorder mgr-primary" id="Phone" name="contact_via_phone_call" type="checkbox" value="yes" style="width:auto !important;">Phone call</label></div>
                        <div class="checkYes" style="color:#000;"> <label for="Video"><input class="checkBorder mgr-primary" id="Video" name="contact_via_video_appointment" type="checkbox" value="yes" style="width:auto !important;">Video appointment</label></div>
                        <input name="nullemail" placeholder="Your alternative email?" type="hidden">
                        <input name="product_code" type="hidden" value="<?php echo $meta_product_code; ?>"/>
                        <input id="sourcetype" name="sourcetype" type="hidden" value="32113">
                        <button class="sendButton" id="bottomFormBtn" type="submit">
                            Send My Inquiry
                        </button>
                    </div>
                </div>
            </form>
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