www.chun-shing-services.com Open in urlscan Pro
8.210.187.176  Public Scan

Form analysis
1 forms found in the DOM

POST /

<form action="/" role="form" id="EventRecordEventsReservationForm" enctype="multipart/form-data" method="post" accept-charset="utf-8">
  <div style="display:none;"><input type="hidden" name="_method" value="POST"></div>
  <fieldset>
    <div class="label-require">*寫必須填</div>
    <div class="form-group">
      <label class="form-label form-label-tc"> 姓名<span class="required-mark">*</span>
      </label>
      <div class="input text"><input name="data[EventRecord][name]" class="form-control" placeholder="姓名" required="required" type="text" id="EventRecordName"></div>
    </div>
    <div class="form-group">
      <label class="form-label form-label-tc"> 聯絡電話<span class="required-mark">*</span>
      </label>
      <div class="input tel"><input name="data[EventRecord][phone]" class="form-control" placeholder="聯絡電話" required="required" type="tel" id="EventRecordPhone"></div>
    </div>
    <div class="form-group">
      <label class="form-label form-label-tc"> 電郵地址<span class="required-mark">*</span>
      </label>
      <div class="input email"><input name="data[EventRecord][email]" class="form-control" placeholder="電郵地址" required="required" type="email" id="EventRecordEmail"></div>
    </div>
    <div class="form-group">
      <label class="form-label form-label-tc"> 查詢類別<span class="required-mark">*</span>
      </label>
      <div class="input select"><select name="data[EventRecord][cat_id]" class="form-control" required="required" id="EventRecordCatId">
          <option value="">查詢類別</option>
          <option value="1">一般查詢</option>
          <option value="2">IT 支援</option>
          <option value="3">清潔</option>
          <option value="4">保安</option>
          <option value="5">客戶服務</option>
          <option value="6">其他</option>
        </select></div>
    </div>
    <div class="form-group">
      <label class="form-label form-label-tc"> 查詢內容<span class="required-mark">*</span>
      </label>
      <textarea name="data[EventRecord][content]" class="form-control" required="required" empty="查詢內容" style="resize: vertical; height: 320px;" id="EventRecordContent"></textarea>
    </div>
    <div class="form-group" style="text-align: center;">
      <input class="btn btn-large btn-custom btn-form-submit" type="submit" value="下一步">
    </div>
  </fieldset>
</form>

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*寫必須填
姓名*

聯絡電話*

電郵地址*

查詢類別*
查詢類別 一般查詢 IT 支援 清潔 保安 客戶服務 其他
查詢內容*

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