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@ -33,14 +33,14 @@
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<div class="col-lg-16 col-sm-13 col-lg-offset-3 col-sm-offset-4">
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<div class="navbar-header">
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<div class="col-xs-24 btn-lg"></div>
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<div class="col-xs-24 text-white">Dear Dd</div>
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<div class="col-xs-24 text-white">Reference Number: LYY050317061</div>
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<div class="col-xs-24 text-white">Dear <?php echo $username; ?></div>
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<div class="col-xs-24 text-white">Reference Number: <?php echo $userinfo[0]->COLI_ID; ?></div>
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</div>
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</div>
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<div class="col-lg-5 col-sm-7 hidden-xs pull-right nopadding">
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<div class="tollfree pull-right">
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<div class="currentNo col-sm-24 nopadding"><span class="glyphicon glyphicon-earphone" style="font-size:12px;"></span> +86 773 </div>
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<div class="currentNo col-sm-24 nopadding"><span class="glyphicon glyphicon-earphone" style="font-size:12px;"></span> +86 773<?php echo $userinfo[0]->OPI_Telephone; ?> </div>
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<div class="col-sm-24">
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<div class="currentNo col-sm-24 nopadding"> 800-2682918 (USA/CA)</div>
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<div class="currentNo col-sm-24 nopadding"> 1800-764678 (AU)</div>
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@ -64,10 +64,10 @@
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<h4 class="text-center text-red">Please complete and submit the information below.</h4>
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<a name="passenger_information" id="passenger_information" ></a>
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</div>
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<form id="form-confirm-info " method="post" action="https://www.chinahighlights.com/secureinfoconfirm/confirm/save_confirm_info">
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<form id="form-confirm-info" method="post" action="https://www.chinahighlights.com/secureinfoconfirm/confirm/save_confirm_info">
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<div class="col-xs-24 personinfo-box">
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<div class="panel panel-default form" >
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<div class="panel-body form" >
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<div class="panel panel-default">
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<div class="panel-body">
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<div class="row panel-new-head">
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<h4 class="text-red">Passenger Information <span class="text-muted" style="font-size:15px;">(we need passport info for all the group members)</span><br/>
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@ -399,7 +399,7 @@
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<div class="input-group">
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<label class="visible-xs-block">Occupation</label>
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<select class="form-control input-sm nopadding select_occupation" name="occupation[]" placeholder="Occupation" >
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<option value="null"></option>
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<option value="None">None</option>
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<option value="Retired">Retired</option>
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<option value="Agriculture, Food & Natural Resources">Agriculture, Food & Natural Resources</option>
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<option value="Architecture & Construction">Architecture & Construction</option>
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@ -418,7 +418,7 @@
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<option value="Science, Technology, Engineering & Mathematics">Science, Technology, Engineering & Mathematics</option>
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<option value="Transportation, Distribution & Logistics">Transportation, Distribution & Logistics</option>
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<option value="Housewife">Housewife</option>
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<option value="Other">Other</option>
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</select>
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<span class="input-group-addon" style="background:#fff;border:none;padding:2px 3px;">
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<span class="glyphicon glyphicon-minuss text-danger"></span>
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@ -522,7 +522,7 @@
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</div>
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</div>
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<div class="col-xs-24 SpecialRequest">
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<div class="col-xs-24 ">
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<div class="panel panel-default">
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<div class="panel-body">
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@ -550,7 +550,7 @@
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</div>
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</div>
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<?php if ($userinfo[0]->COLI_CustomerType != 44003) { ?>
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<div class="col-xs-24 EmergencyContactInformation" >
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<div class="col-xs-24 " >
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<div class="panel panel-default">
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<div class="panel-body">
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@ -599,7 +599,7 @@
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</div>
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<?php } ?>
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<div class="col-xs-24 Insurance Information" >
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<div class="col-xs-24 " >
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<div class="panel panel-default">
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<div class="panel-body">
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