33 lines
1.3 KiB
HTML
33 lines
1.3 KiB
HTML
<extend name="Public:common" />
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<block name="main">
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<div class="gallery">
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<div class="col-md-offset-2">
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<h2><strong>联系方式</strong></h2>
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<hr style="width:80%" class="col-md-offset-0"/>
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<h5><strong>请您准确填写您的联系方式，以便我们能够准确为您邮寄兑换的礼品。</strong></h5><br/>
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<form method="post" action="{:U('info/add')}">
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<div class="form-group">
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<label>姓名：</label>
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<input type="text" name="realname" class="form-control" style="width:50%" placeholder="请输入姓名">
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</div>
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<div class="form-group">
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<label>邮编：</label>
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<input type="text" name="zipcode" class="form-control" style="width:50%" placeholder="请输入邮编">
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</div>
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<div class="form-group">
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<label>住址：</label>
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<input type="text" name="location" class="form-control" style="width:50%" placeholder="请输入住址">
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</div>
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<div class="form-group">
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<label>电话：</label>
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<input type="text" name="tel" class="form-control" style="width:50%" placeholder="请输入电话">
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</div>
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<!--<div class="form-group">
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<input type="hidden" name="user_id" value="">
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</div>-->
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<button type="submit" class="btn btn-default">提交</button>
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</form>
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</div>
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</block> |