Ygor
3/23/2010 - 3:23 PM

gistfile1.txt


 
    <form action="/inquiries" class="new_inquiry form" id="new_inquiry" method="post"><div style="margin:0;padding:0;display:inline"><input name="authenticity_token" type="hidden" value="TLOxUEiWoPIA8elVWpOFkGvUa2f9AJUlJmeRQcYS9gc=" /></div> 
      <ol> 
        <li> 
          <ol> 
            <li class='field'> 
              <label class="required" for="inquiry_name">Naam *</label> 
              <input id="inquiry_name" name="inquiry[name]" size="30" type="text" /> 
            </li> 
            <li class='field'> 
              <label class="required" for="inquiry_title">Titel *</label> 
              <select id="inquiry_title" name="inquiry[title]"><option value="Dhr.">Dhr.</option> 
<option value="Mevr.">Mevr.</option></select> 
            </li> 
          </ol> 
        </li> 
        <li> 
          <ol> 
            <li class='field'> 
              <label class="required" for="inquiry_postalcode">Postcode *</label> 
              <input id="inquiry_postalcode" name="inquiry[postalcode]" size="30" type="text" /> 
            </li> 
            <li class='field'> 
              <label class="required" for="inquiry_city">Plaats *</label> 
              <input id="inquiry_city" name="inquiry[city]" size="30" type="text" /> 
            </li> 
          </ol> 
        </li> 
        <li class='field'> 
          <label class="required" for="inquiry_street">Straat en huisnummer *</label> 
          <input id="inquiry_street" name="inquiry[street]" size="30" type="text" /> 
        </li> 
        <li> 
          <ol> 
            <li class='field'> 
              <label class="required" for="inquiry_phone">Telefoon *</label> 
              <input id="inquiry_phone" name="inquiry[phone]" size="30" type="text" /> 
            </li> 
            <li class='field'> 
              <label for="inquiry_email">Email</label> 
              <input id="inquiry_email" name="inquiry[email]" size="30" type="text" /> 
            </li> 
          </ol> 
        </li> 
        <li class='field message_field'> 
          <label for="inquiry_message">Opmerkingen</label> 
          <textarea cols="40" id="inquiry_message" name="inquiry[message]" rows="8">Ik zou graag door DieetPlaneet worden teruggebeld om een afspraak te maken.</textarea> 
        </li> 
      </ol> 
      <div class='actions'> 
        <input id="inquiry_submit" name="commit" type="submit" value="Versturen" /> 
        
      </div> 
    </form>