mirror of
https://github.com/ookangzheng/blahdns.git
synced 2025-12-16 22:25:37 +07:00
60 lines
2.0 KiB
HTML
Executable File
60 lines
2.0 KiB
HTML
Executable File
<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="UTF-8" />
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<meta name="viewport" content="width=device-width, initial-scale=1.0" />
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<meta http-equiv="X-UA-Compatible" content="ie=edge" />
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<link rel="stylesheet" href="../static/style.css" />
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<title>Blahdns feedback</title>
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</head>
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<body>
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<div class="container">
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<h3>Blahdns feedback</h3>
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{% if message %}
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<h3 class="message">{{ message | safe }}</h3>
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{% endif %}
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<form action="/" method="POST">
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<div class="form-group">
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<h3>Name **</h3>
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<input
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type="text"
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name="customer"
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placeholder="Name of vehicle owner"
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required
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/>
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</div>
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<div class="form-group">
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<h3>Email **</h3>
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<input required type="email" name="email" placeholder="abc@abc.com" />
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</div>
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<div class="form-group">
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<h3>Please rate **</h3>
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<input type="radio" name="rating" value="1" /> 1
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<input type="radio" name="rating" value="2" /> 2
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<input type="radio" name="rating" value="3" /> 3
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<input type="radio" name="rating" value="4" /> 4
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<input type="radio" name="rating" value="5" /> 5
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<input type="radio" name="rating" value="6" /> 6
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<input type="radio" name="rating" value="7" /> 7
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<input type="radio" name="rating" value="8" /> 8
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<input type="radio" name="rating" value="9" /> 9
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<input type="radio" name="rating" value="10" checked /> 10
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</div>
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<div class="form-group">
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<h3>Comments about your experience **</h3>
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<textarea
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required
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name="comments"
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cols="30"
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rows="10"
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placeholder="Tell us what you liked and/or did not like"
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></textarea>
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</div>
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<br />
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<p>** required</p>
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<input type="submit" value="Submit" class="btn" />
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</form>
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</div>
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</body>
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</html>
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