<link href="//netdna.bootstrapcdn.com/bootstrap/3.1.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//netdna.bootstrapcdn.com/bootstrap/3.1.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <div> <div class="jumbotron jumbotron-sm"> <div class="container"> <div class="row"> <div class="col-sm-12 col-lg-12"> <h1 class="h1"> W czym możemy Ci pomóc?<small><br>Formularz kontaktowy</small></h1> </div> </div> </div> </div> <div class="container"> <div class="row"> <div class="col-md-8"> <div class="well well-sm"> <form> <div class="row"> <div class="col-md-6"> <div class="form-group"> <label for="name"> Imię i nazwisko *</label> <input type="text" class="form-control" id="name" placeholder="" required="required" /> </div> <div class="form-group"> <label for="email"> E-mail *</label> <div class="input-group"> <span class="input-group-addon"><span class="glyphicon glyphicon-envelope"></span> </span> <input type="email" class="form-control" id="email" placeholder="" required="required" /></div> </div> <div class="form-group"> <label for="subject"> Kategoria *</label> <select id="subject" name="subject" class="form-control" required="required"> <optgroup label="Wybierz kategorię wiadomości:"> <option value="customer">Obsługa klienta</option> <option value="support">Problemy techniczne</option> <option value="invoice">Faktury i płatności</option> <option value="complaint">Reklamacje</option> <option value="other">Inne</option> </optgroup> </select> </div> </div> <div class="col-md-6"> <div class="form-group"> <label for="name"> Wiadomość *</label> <textarea name="message" id="message" class="form-control" rows="9" cols="25" required="required" placeholder=""></textarea> </div> </div> <div class="col-md-12"> <button type="submit" class="btn btn-primary pull-right" id="btnContactUs"> Wyślij wiadomość</button> </div> </div> </form> </div> </div> <div class="col-md-4"> <form> <legend><span class="glyphicon glyphicon-globe"></span> Dane teleadresowe:</legend> <address> <strong>PromoLabs</strong> Sławomir Siudek<br> Graniczna 12/30<br> 27-200 Starachowice<br> NIP: 664-19-95-787<br><br> <abbr title="Telefon"> T:</abbr> +48) 793 967 770<br> <abbr title="E-mail"> E:</abbr> <a href="mailto:#">biuro@promolabs.pl</a> </address> </form> <img src="http://punktyswl.promolabs.pl/img/promolabs-logo-small.png"> </div> </div> </div> </div>

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