<?php include("header.php");?>
<title>Randevu Al | <?php echo $drweb->site_title; ?></title> 
        <!-- Header Area End Here -->
<section class="inner-page-banner bg-common" data-bg-image="trex/assets/img/genel/30770.jpg">
    <div class="container">
        <div class="row">
            <div class="col-12">
                <div class="breadcrumbs-area">
                    <h1>RANDEVU AL</h1>
                    <ul>
                        <li>
                            <a href="anasayfa">Anasayfa</a>
                        </li>
                        <li>RANDEVU AL</li>
                    </ul>
                </div>
            </div>
        </div>
    </div>
</section>
<section class="section-padding-12-9">
    <div class="container">
        <div class="row">

            <div class="col-xl-12 col-lg-12 col-12">
                <div class="about-box-layout2">
                    <h3 class="item-title">RANDEVU KAYIT FORMU</h3>
                    <form class="contact-form-box" action="" method="POST">
                        <div class="row gutters-10">
                            <div class="col-md-6 col-12 form-group">
                                <input type="text" placeholder="Ad Soyad" class="form-control" name="randevu_ad" data-error="Name field is required" required="">
                                <div class="help-block with-errors"></div>
                            </div>
                            <div class="col-md-6 col-12 form-group">
                                <input type="text" placeholder="Telefon" class="form-control" name="randevu_tel" data-error="Phone field is required" required="">
                                <div class="help-block with-errors"></div>
                            </div>
                            <div class="col-12 form-group" required="">
                                <select class="select2" required="" name="randevu_hizmet">
                                    <option value="">Hizmet Seçiniz</option>
                                                                            <option value="APARTMAN TEMİZLİĞİ">APARTMAN TEMİZLİĞİ</option>
                                                                            <option value="TADİLAT SONRASI TEMİZLİK">TADİLAT SONRASI TEMİZLİK</option>
                                                                            <option value="VİLLA TEMİZLİĞİ">VİLLA TEMİZLİĞİ</option>
                                                                            <option value="OFİS TEMİZLİĞİ">OFİS TEMİZLİĞİ</option>
                                                                            <option value="DIŞ CEPHE CAM TEMİZLİĞİ">DIŞ CEPHE CAM TEMİZLİĞİ</option>
                                                                            <option value="EV TEMİZLİĞİ">EV TEMİZLİĞİ</option>
                                                                        <option value="diger">Diğer (Not kisminda detay belirtiniz.)</option>
                                </select>
                            </div>
                            <div class="col-12 form-group ">
                                <textarea placeholder="Not" class="textarea form-control" name="randevu_not" id="form-message" rows="2" cols="20" data-error="Message field is required" required=""></textarea>
                                <div class="help-block with-errors"></div>
                            </div>
                            <div class="col-md-6 form-group datetime-picker">
                                <i class="far fa-calendar-alt"></i>
                                <input type="text" class="form-control rt-date" placeholder="Tarih seç" name="randevu_zamant" id="form-date" data-error="Subject field is required" required/="">
                            </div>
                            <div class="col-md-6 form-group datetime-picker">
                                <i class="far fa-clock"></i>
                                <input type="text" class="form-control rt-time" placeholder="Saat seç" name="randevu_zamans" id="form-time" data-error="Subject field is required" required/="">
                            </div>
                            <div class="col-md-6 col-12 form-group">
                                <input type="text" placeholder="İl" class="form-control" name="randevu_il" data-error="Name field is required" required="">
                                <div class="help-block with-errors"></div>
                            </div>
                            <div class="col-md-6 col-12 form-group">
                                <input type="text" placeholder="İlçe" class="form-control" name="randevu_ilce" data-error="Phone field is required" required="">
                                <div class="help-block with-errors"></div>
                            </div>
                            <div class="col-12 form-group ">
                                <textarea placeholder="Address" class="textarea form-control" name="randevu_adres" id="form-message" rows="2" cols="20" data-error="Message field is required" required=""></textarea>
                                <div class="help-block with-errors"></div>
                            </div>
                            <div class="col-12 form-group">
                                <button type="submit" class="fw-btn-fill bg-accent text-primarytext" name="randevu">RANDEVU AL<i class="fas fa-angle-right"></i></button>
                            </div>
                        </div>
                        <div class="form-response"></div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</section>
<?php include("footer.php");?>