File: D:/HostingSpaces/SBogers60/agrimac.nl/app/storage/views/54390f73853745171448d2870184c7fc
<div class="small-offer-form">
<?php if(!$page->send): ?>
<h3><?php echo KommaLang::get('smallOfferForm.title'); ?></h3>
<p><?php echo KommaLang::get('smallOfferForm.text'); ?></p>
<?php echo Form::open(['url' => URL::to(route('smallOffer.process'), [], true), 'id' => 'smallOfferForm', 'class' => 'form']); ?>
<input name="truckType" type="hidden" value="<?php echo $page->project->translation->name_short; ?>">
<div class="name form-element ">
<?php echo Form::label('name',trans('translations.name')); ?>
<span class="error-message <?php echo ($errors->has('name')? 'active' :''); ?>"><?php echo $errors->first('name'); ?></span>
<?php echo Form::text('name', Input::old('name'), ['id' => 'name']); ?>
</div>
<div class="company form-element">
<?php echo Form::label('company',trans('translations.company')); ?>
<span class="error-message <?php echo ($errors->has('company')? 'active' :''); ?>"><?php echo $errors->first('company'); ?></span>
<?php echo Form::text('company', Input::old('company'), ['id' => 'company']); ?>
</div>
<div class="city form-element">
<?php echo Form::label('city',trans('translations.city')); ?>
<span class="error-message <?php echo ($errors->has('city')? 'active' :''); ?>"><?php echo $errors->first('city'); ?></span>
<?php echo Form::text('city', Input::old('city'), ['id' => 'city']); ?>
</div>
<div class="phone form-element">
<?php echo Form::label('phone',trans('translations.phone')); ?>
<span class="error-message <?php echo ($errors->has('phone')? 'active' :''); ?>"><?php echo $errors->first('phone'); ?></span>
<?php echo Form::text('phone', Input::old('phone'), ['id' => 'phone']); ?>
</div>
<div class="time-slot form-element select">
<p class="label"><?php echo \Illuminate\Support\Facades\Lang::get('translations.bestContactMoment'); ?></p>
<div class="select-wrapper">
<span class="icon"></span>
<select name="timeSlot" id="timeSlot">
<?php foreach(trans('translations.timeSlots') as $key => $value): ?>
<option <?php if(Input::old('timeSlot', null) == $value): ?> selected="selected"
<?php endif; ?> value="<?php echo $value; ?>"><?php echo $value; ?></option>
<?php endforeach; ?>
</select>
</div>
</div>
<div class="submit">
<p class="button">
<?php echo \Illuminate\Support\Facades\Lang::get('translations.send2'); ?>
</p>
<?php echo Form::submit(trans('translations.send2')); ?>
</div>
<?php echo Form::close(); ?>
<?php endif; ?>
</div>