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Filename : request-certificate.php
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<?php
include("admin/includes/functions.php");
?>
<!DOCTYPE html>
<html lang="zxx">
<head>
        <!-- meta tag -->
        <meta charset="utf-8">
        <title>Certificate | Bismilsoft</title>
        <meta name="description" content="Choose your Options - Request your Certificate, Certificate Status, and Track Certificate">
        <!-- responsive tag -->
        <meta http-equiv="x-ua-compatible" content="ie=edge">
        <meta name="viewport" content="width=device-width, initial-scale=1">
          <link rel="apple-touch-icon" sizes="57x57" href="icon/apple-icon-57x57.png">
<link rel="apple-touch-icon" sizes="60x60" href="icon/apple-icon-60x60.png">
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<link rel="apple-touch-icon" sizes="76x76" href="icon/apple-icon-76x76.png">
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<link rel="apple-touch-icon" sizes="120x120" href="icon/apple-icon-120x120.png">
<link rel="apple-touch-icon" sizes="144x144" href="icon/apple-icon-144x144.png">
<link rel="apple-touch-icon" sizes="152x152" href="icon/apple-icon-152x152.png">
<link rel="apple-touch-icon" sizes="180x180" href="icon/apple-icon-180x180.png">
<link rel="icon" type="image/png" sizes="192x192"  href="icon/android-icon-192x192.png">
<link rel="icon" type="image/png" sizes="32x32" href="icon/favicon-32x32.png">
<link rel="icon" type="image/png" sizes="96x96" href="icon/favicon-96x96.png">
<link rel="icon" type="image/png" sizes="16x16" href="icon/favicon-16x16.png">
        <!-- favicon -->
           <link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/font-awesome/4.5.0/css/font-awesome.min.css">

        <!-- bootstrap v4 css -->
        <link rel="stylesheet" type="text/css" href="css/bootstrap.min.css">
        <!-- font-awesome css -->
        <link rel="stylesheet" type="text/css" href="css/font-awesome.min.css">
        <!-- animate css -->
        <link rel="stylesheet" type="text/css" href="css/animate.css">
        <!-- owl.carousel css -->
        <link rel="stylesheet" type="text/css" href="css/owl.carousel.css">
        <!-- slick css -->
        <link rel="stylesheet" type="text/css" href="css/slick.css">
        <!-- magnific popup css -->
        <link rel="stylesheet" type="text/css" href="css/magnific-popup.css">
        <!-- Offcanvas CSS -->
        <link rel="stylesheet" type="text/css" href="css/off-canvas.css">
        <!-- flaticon css  -->
        <link rel="stylesheet" type="text/css" href="fonts/flaticon.css">
        <!-- flaticon2 css  -->
        <link rel="stylesheet" type="text/css" href="fonts/fonts2/flaticon.css">
        <!-- rsmenu CSS -->
        <link rel="stylesheet" type="text/css" href="css/rsmenu-main.css">
        <!-- rsmenu transitions CSS -->
        <link rel="stylesheet" type="text/css" href="css/rsmenu-transitions.css">
        <!-- style css -->
        <link rel="stylesheet" type="text/css" href="style.css">
        <link rel="stylesheet" href="css/style.css">
        <!-- responsive css -->
        <link rel="stylesheet" type="text/css" href="css/responsive.css">
        <!--[if lt IE 9]>
            <script src="https://oss.maxcdn.com/html5shiv/3.7.2/html5shiv.min.js"></script>
            <script src="https://oss.maxcdn.com/respond/1.4.2/respond.min.js"></script>
        <![endif]-->  
        <?php  include("google_analytics.php"); ?>   
    </head>
    <body class="home1">    
        <!--Full width header Start-->
    <?php include("header.php"); ?>   
        <!-- rs-check-out Here-->
        <div class="rs-check-out sec-spacer">
            <div class="container">
                <div class="row">
                    <div class="col-lg-8 col-md-12">
                        <div class="abt-title">
                            <h2>Request Your Certificate</h2>
                        </div>
                        <div class="check-out-box">
                            <form id="contact-form" method="post" action="certificate-send.php">
                                <fieldset>
                                    <div class="row">                                      
                                        <div class="col-lg-6 col-md-12">
                                            <div class="form-group">
                                                <label>Name*</label>
                                                <input id="name" name="name" placeholder="Enter Name" class="form-control" type="name" required="">
                                            </div>
                                        </div>
                                        <div class="col-lg-6 col-md-12">
                                            <div class="form-group">
                                                <label>Mobile Phone*</label>
                                                <input name="phone" class="form-control" placeholder="Enter Mobile Phone" type="number" required="">
                                            </div>
                                        </div>
                                    </div>
                                    <div class="row">
                                        <div class="col-lg-6 col-md-12">
                                            <div class="form-group">
                                                <label>Email*</label>
                                                <input id="email" name="email" class="form-control" placeholder="Enter Email" type="email" required="">
                                            </div>
                                        </div>
                                        <div class="col-lg-6 col-md-12">
                                            <div class="form-group">
                                                <label>Course Name*</label>
                                                <input name="phone" class="form-control" type="text" placeholder="Enter Course Name" required="">
                                            </div>
                                        </div>
                                    </div>
                                    <div class="row">
                                        <div class="col-lg-6 col-md-12">
                                            <div class="form-group">
                                                <label>Time Period From*</label>
                                                <input id="email" name="timefrom"  class="form-control" type="date" required="">
                                            </div>
                                        </div>
                                        <div class="col-lg-6 col-md-12">
                                            <div class="form-group">
                                                <label>Time Period To*</label>
                                                <input name="timeto"  class="form-control" type="date" required="">
                                            </div>
                                        </div>
                                    </div>
                                    <div class="row "> 
                                        <div class="col-md-12 col-sm-12 col-xs-12">    
                                            <div class="form-group mb-0">
                                                <textarea name="remark" placeholder="Remark" rows="4" cols="100" required=""></textarea>
                                            </div>
                                        </div>
                                    </div>
                                    <?php include('mathcaptcha.php');?> <input name="captcha" type="text" required="">
                                    <div class="form-group mt-3">
                                    <button id="rc1" type="submit" class="btn btn-primary btn-block" style="color:#ffffff;background-color:#ff3115;height:50px;" name="submit">SEND </button>
                                </div>  
                                </fieldset>
                            </form> 
                        </div><!-- .check-out-box end -->     
                    </div>
                </div>
            </div>
        </div>
        <!-- rs-check-out End Here-->
        <!-- Partner Start -->
        <div id="rs-partner" class="rs-partner pt-70 pb-70">
            <div class="container">
                <div class="rs-carousel owl-carousel" data-loop="true" data-items="5" data-margin="80" data-autoplay="true" data-autoplay-timeout="5000" data-smart-speed="2000" data-dots="false" data-nav="false" data-nav-speed="false" data-mobile-device="2" data-mobile-device-nav="false" data-mobile-device-dots="false" data-ipad-device="4" data-ipad-device-nav="false" data-ipad-device-dots="false" data-md-device="5" data-md-device-nav="false" data-md-device-dots="false">
                    <div class="partner-item">
                        <a href="#"><img src="images/partners/birlasofft.png" alt="Partner Image"></a>
                    </div>
                    <div class="partner-item">
                        <a href="#"><img src="images/partners/evws.png" alt="Partner Image"></a>
                    </div>
                    <div class="partner-item">
                        <a href="#"><img src="images/partners/guideline_based1.png" alt="Partner Image"></a>
                    </div>
                    <div class="partner-item">
                        <a href="#"><img src="images/partners/NIIT.png" alt="Partner Image"></a>
                    </div>
                    <div class="partner-item">
                        <a href="#"><img src="images/partners/tech-mahindra.png" alt="Partner Image"></a>
                    </div>
                    
                </div>
            </div>
        </div>
        <!-- Partner End -->
        <?php include("whatsapp_api.php"); ?>
       
        <!-- Footer Start -->
        <?php include("footer.php"); ?>
        <div aria-hidden="true" class="modal fade search-modal" role="dialog" tabindex="-1">
            <button type="button" class="close" data-dismiss="modal" aria-label="Close">
              <span aria-hidden="true" class="fa fa-close"></span>
            </button>
            <div class="modal-dialog modal-dialog-centered">
                <div class="modal-content">
                    <div class="search-block clearfix">
                        <form>
                            <div class="form-group">
                                <input class="form-control" placeholder="eg: Computer Technology" type="text">
                            </div>
                        </form>
                    </div>
                </div>
            </div>
        </div>
        <!-- Search Modal End --> 
        
        <!-- modernizr js -->
        <script src="js/modernizr-2.8.3.min.js"></script>
        <!-- jquery latest version -->
        <script src="js/jquery.min.js"></script>
        <!-- bootstrap js -->
        <script src="js/bootstrap.min.js"></script>
        <!-- owl.carousel js -->
        <script src="js/owl.carousel.min.js"></script>
        <!-- slick.min js -->
        <script src="js/slick.min.js"></script>
        <!-- isotope.pkgd.min js -->
        <script src="js/isotope.pkgd.min.js"></script>
        <!-- imagesloaded.pkgd.min js -->
        <script src="js/imagesloaded.pkgd.min.js"></script>
        <!-- wow js -->
        <script src="js/wow.min.js"></script>
        <!-- counter top js -->
        <script src="js/waypoints.min.js"></script>
        <script src="js/jquery.counterup.min.js"></script>
        <!-- magnific popup -->
        <script src="js/jquery.magnific-popup.min.js"></script>
        <!-- rsmenu js -->
        <script src="js/rsmenu-main.js"></script>
        <!-- plugins js -->
        <script src="js/plugins.js"></script>
         <!-- main js -->
        <script src="js/main.js"></script>
         <?php //include("all_onloadpopup.php"); ?>
         <?php include("searchpopup.php"); ?>
        <script>
    /*$(document).ready(function(){
        $("#Modal").modal('show');
    }); */
</script>

    </body>


</html>