File: //proc/self/cwd/raquel/themes/web/agende.php
<?php $v->layout("_theme");
$v->insert("views/page-title", ["pageTitle" => $pageTitle, "breadcrumb" => $breadcrumb]);
?>
<section id="content">
<div class="content-wrap">
<div class="container">
<div class="row justify-content-between align-items-center col-mb-30 mw-md mt-4 px-3">
<div class="col-md-3 offset-md-2 ">
<h1 class="color-2 font-weight-bolder" style="font-size: 2.5em">Agende sua Mentoria</h1>
<p>Preencha seus dados para agendar sua mentoria de carreira</p>
</div>
<div class="col-md-7">
<div class="form-widget" data-alert-type="inline">
<div class="form-result"></div>
<form class="nobottommargin" id="recipe-contactform" action="<?= url("contact-mentoria")?>" method="post">
<?= csrf_input("csrf_leonardo_ct2"); ?>
<div class="form-process bg-transparent"></div>
<div class="col_half">
<label class="nott ls0 t400" for="recipe-contactform-name">Nome <small>*</small></label>
<input type="text" id="recipe-contactform-name" name="name" value="" class="form-control required" />
</div>
<div class="col_half col_last">
<label class="nott ls0 t400" for="recipe-contactform-email">Email <small>*</small></label>
<input type="email" id="recipe-contactform-email" name="email" value="" class="required email form-control" />
</div>
<div class="clear"></div>
<div class="col_half">
<label class="nott ls0 t400" for="recipe-contactform-phone">Telefone <small>*</small></label>
<input type="text" name="phone" value="" class="form-control mask-celular" />
</div>
<div class="col_half">
<label class="nott ls0 t400" for="recipe-contactform-phone">Nascimento <small>*</small></label>
<input type="text"name="birthdate" value="" class="form-control mask-date" />
</div>
<div class="col_half col_last">
<label class="nott ls0 t400" for="recipe-contactform-subject">Cidade <small>*</small></label>
<input type="text" name="city" value="" class="required form-control" />
</div>
<div class="col_half col_last">
<label class="nott ls0 t400" for="recipe-contactform-subject">Naturalidade <small>*</small></label>
<input type="text" name="natural" value="" class="required form-control" />
</div>
<div class="col_half col_last">
<label class="nott ls0 t400" for="recipe-contactform-subject">Estado Civil <small>*</small></label>
<input type="text" name="civil_state" value="" class="required form-control" />
</div>
<div class="col_half col_last">
<label class="nott ls0 t400" for="recipe-contactform-subject">Endereço Completo com Cep <small>*</small></label>
<input type="text" name="address" value="" class="required form-control" />
</div>
<div class="col_half col_last">
<label class="nott ls0 t400" for="recipe-contactform-subject">CPF <small>*</small></label>
<input type="text" name="document" value="" class="required form-control mask-cpf" />
</div>
<div class="col_half col_last">
<label class="nott ls0 t400" for="recipe-contactform-subject">Formação Acadêmica <small>*</small></label>
<textarea class="required form-control" id="message" name="academic" rows="3" cols="30"></textarea>
<small>Cursos Realizados</small>
</div>
<div class="col_half col_last">
<label class="nott ls0 t400" for="recipe-contactform-subject">Empresa Atual <small>*</small></label>
<input type="text" name="company" value="" class="required form-control" />
</div>
<div class="col_half col_last">
<label class="nott ls0 t400" for="recipe-contactform-subject">Cargo Atual <small>*</small></label>
<textarea class="required form-control" id="message" name="job" rows="3" cols="30"></textarea>
<small>Preenhca uma breve descrição das atribuições</small>
</div>
<div class="col_half col_last">
<label class="nott ls0 t400" for="recipe-contactform-subject">Objetivo com a mentoria <small>*</small></label>
<textarea class="required form-control" id="message" name="objective" rows="3" cols="30"></textarea>
</div>
<!-- <div class="col_half col_last">-->
<!-- <label class="nott ls0 t400" for="recipe-contactform-subject">Pagamento <small>*</small></label>-->
<!-- <select id="cars" name="payment" class="form-control">-->
<!-- <option value="À vista cartão">À vista cartão</option>-->
<!-- <option value="À vista Pix">À vista Pix</option>-->
<!-- <option value="2x s/ juros cartão">2x s/ juros cartão</option>-->
<!-- <option value="3x s/ juros cartão">3x s/ juros cartão</option>-->
<!-- <option value="4x s/ juros cartão">4x s/ juros cartão</option>-->
<!-- <option value="5x s/ juros cartão">5x s/ juros cartão</option>-->
<!-- <option value="6x s/ juros cartão">6x s/ juros cartão</option>-->
<!-- <option value="7x s/ juros cartão">7x s/ juros cartão</option>-->
<!-- <option value="8x s/ juros cartão">8x s/ juros cartão</option>-->
<!-- <option value="9x s/ juros cartão">9x s/ juros cartão</option>-->
<!-- <option value="10x s/ juros cartão">10x s/ juros cartão</option>-->
<!-- <option value="11x s/ juros cartão">11x s/ juros cartão</option>-->
<!-- <option value="12x s/ juros cartão">12x s/ juros cartão</option>-->
<!---->
<!-- </select>-->
<!---->
<!-- </div>-->
<input type="hidden" name="action" value="mentoria">
<input type="hidden" name="subject" value="mentoria">
<input type="hidden" name="message" value="mentoria">
<div class="col_full mt-5">
<button class="button button-rounded button-large nomargin button-circle" type="submit" id="recipe-contactform-submit" name="recipe-contactform-submit" value="submit">Enviar Formulário</button>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
<?php $v->insert("views/newsletter-widget-2"); ?>
</section><!-- #content end -->