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Form analysis
1 forms found in the DOM

Name: template-contactform — POST include/cccemail.php

<form class="nobottommargin" id="template-contactform" name="template-contactform" action="include/cccemail.php" method="post" enctype="multipart/form-data" novalidate="novalidate">
  <div class="form-process"></div>
  <div class="col_half">
    <label for="template-contactform-name">Name <small>*</small></label>
    <input type="text" id="template-contactform-name" name="template-contactform-name" value="" class="sm-form-control required">
  </div>
  <div class="col_half col_last">
    <label for="template-contactform-email">Email <small>*</small></label>
    <input type="email" id="template-contactform-email" name="template-contactform-email" value="" class="required email sm-form-control">
  </div>
  <div class="col_half">
    <label for="template-contactform-company">Company<small>*</small></label>
    <input type="text" id="template-contactform-company" name="template-contactform-company" value="" class="required  sm-form-control">
  </div>
  <div class="col_half col_last">
    <label for="template-contactform-phone">Phone<small>*</small></label>
    <input type="text" id="template-contactform-phone" name="template-contactform-phone" value="" class="sm-form-control required">
  </div>
  <div class="clear"></div>
  <div class="col_half">
    <label for="template-contactform-how">How did you find us?<small>*</small></label>
    <select id="template-contactform-how" name="template-contactform-how" class="sm-form-control required">
      <option value="">-- Please Choose --</option>
      <option value="Google/Online Search">Google/Online Search</option>
      <option value="Referral">Referral</option>
      <option value="Online Advertisement">Tradeshow/Networking Event</option>
      <option value="Facebook/Instagram">Social Media</option>
      <option value="Other">Other</option>
    </select>
  </div>
  <div class="col_half col_last">
    <label for="template-contactform-message">Inquiry <small>*</small></label>
    <textarea class="required sm-form-control" id="template-contactform-message" name="template-contactform-message" rows="2" cols="30"></textarea>
  </div>
  <div class="col_full hidden">
    <input type="text" id="template-contactform-botcheck" name="template-contactform-botcheck" value="" class="sm-form-control">
  </div>
  <div class="col_full">
    <button class="button button-3d nomargin" type="submit" id="template-contactform-submit" name="template-contactform-submit" value="submit">Send Message</button>
  </div>
</form>

Text Content

 * Epoxy Coatings & Traffic Toppings
 * Polished Concrete
 * Concrete Restoration
 * Contact
 * 905.799.0330
 * 
 * 
 * 


CONTACT CONCRETE COATINGS CANADA


TELL US MORE ABOUT YOUR PROJECT - WE'RE HERE TO HELP!

Name *
Email *
Company*
Phone*

How did you find us?* -- Please Choose -- Google/Online Search Referral
Tradeshow/Networking Event Social Media Other
Inquiry *

Send Message






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