blob: 6aff74f4e530e36a5b588da88d98595fafc62fbd (
plain)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
|
<#include "/macros/common.ftl">
<#include "/macros/common-page.ftl">
<@commonpage>
<@noticebox>
</@noticebox>
<@content class="text">
<h1>Contact Us</h1>
<p>
If you have any questions about GROW, please complete the following
form and we will be in touch soon, or call us at 253-848-9111.
</p>
<form action="${dynamicRoot}/contactus" method="post">
<p><label for="firstnameField">First Name:</label> <input id="firstnameField" type="text" name="firstname" /></p>
<p><label for="lastnameField">Last Name:</label> <input id="lastnameField" type="text" name="lastname" /></p>
<p><label for="emailField">Email:</label> <input id="emailField" type="text" name="email" /></p>
<p><label for="phoneField">Phone:</label> <input id="phoneField" type="text" name="phone" /></p>
<p>
Foursquare Member:
<label><input type="radio" name="member" value="yes" id="memberYes"> Yes</label>
<label><input type="radio" name="member" value="no" id="memberNo"> No</label>
</p>
<p>
Question:<br />
<textarea name="question" rows="10" cols="80"></textarea>
</p>
<p><input type="submit" value="Send" /></p>
</form>
</@content>
</@commonpage>
|
