  <?php include "include/header.php" ;?>
 <style>
	.newsletter-form {
		background: #eee;
	    padding: 20px;
	}
</style> 
<div class="parallax inverse-text page-title-wrapper" data-parallax-img="<?php echo base_url();?>assets/images/pattern.jpg" data-parallax-img-width="1920" data-parallax-img-height="455">
    <div class="container inner text-center pt-40 pb-40 ">
      <h1 class="section-title">Supplier Registration Form</h1>
      <div class="space10"></div>
      <div class="meta breadcrumbs text-center mb-0"><span><a href="<?php echo base_url();?>">Home</a></span><span><a href="#">Supplier</a></span></div>
    </div>
    <!-- /.container --> 
  </div>
  <!-- /.parallax -->
  <!-- /.parallax -->
  <div class="wrapper light-wrapper">
    <div class="container inner pt-40 pb-40">
      <div class="row">
      
        <div class="col-md-12">
        <p>If you feel that you can partner with us by way of supplying raw material for our material handling equipments, please download the format and send it with all the require documents. In Shakti, we believe in long lasting and fruitful business relationships.</p>
        </div>
        <!-- /column -->       
        <div class="col-md-12">
        <a href="<?php echo base_url();?>assets/registration-form.jpg" class="btn btn-rounded" download="registration-form.jpg">CLICK HERE TO DOWNLOAD SUPPLIER FORM</a>
        </div>
        <!-- /column --> 
      </div>
    
      
    <div class="row">
    <div class="col-sm-8 col-md-offset-2 mb-20">
        <div class="form-container">
            <form action="<?php echo base_url();?>enquiry/register_now" method="post" enctype="multipart/form-data" class="vanilla vanilla-form newsletter-form" id="form">
			  <h1 class="text-center mb-20">Vendor Registration Form</h1>
              <div class="row">
				<div class="col-sm-6 pr-10">
                  <div class="form-group" >
					<label>Code</label>
                    <input type="text" class="form-control" name="code" id="code" placeholder="Enter code" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->
				  <div class="col-sm-6 pr-10">
                  <div class="form-group" >
					<label>Category</label>
                    <input type="text" class="form-control" name="category" id="category" placeholder="Enter category" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->
                <div class="col-sm-6 pr-10">
                  <div class="form-group" >
					<label>Supplier Name *</label>
                    <input type="text" class="form-control" name="name" id="name" placeholder="Enter Your name" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->
				
                <div class="col-sm-6 pr-10">
                  <div class="form-group">
					<label>E-mail Address *</label>
                    <input type="email" class="form-control" name="email" id="email" placeholder="Enter Your E-mail" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->
               <div class="col-sm-6 pr-10">
                  <div class="form-group">
					<label>Mobile Number *</label>
                    <input type="text" class="form-control" name="mobile" id="mobile" placeholder="Enter Mobile Number" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->
				<div class="col-sm-6 pr-10">
                  <div class="form-group">
					<label>Telephone Number</label>
                    <input type="text" class="form-control" name="phone" id="phone" placeholder="Enter telephone Number" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->
				<div class="col-sm-6 pr-10">
                  <div class="form-group">
					<label>Fax Number</label>
                    <input type="text" class="form-control" name="fax" id="fax" placeholder="Enter Fax Number" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->
				
				<div class="col-sm-6 pr-10">
					<label>Owner Person</label>
                  <div class="form-group">
                    <input type="text" class="form-control" name="owner" id="owner" placeholder="Owner" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->
				<div class="col-sm-6 pr-10">
					<label>Address</label>
                  <div class="form-group">
                    <input type="text" class="form-control" name="address" id="address" placeholder="Enter Your Address" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->
				<div class="col-sm-6 pr-10">
                  <div class="form-group">
					<label>City *</label>
                    <input type="text" class="form-control" name="city" id="city" placeholder="Enter City" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->    
               <div class="col-sm-6 pr-10">
                  <div class="form-group">
					<label>State *</label>
                    <input type="text" class="form-control" name="state" id="state" placeholder="Enter State" required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->
                <div class="col-sm-6 pr-10">
                  <div class="form-group">
					<label>Pincode *</label>
                    <input type="text" class="form-control" name="pincode" id="pincode" placeholder="Enter Pincode"  required>
                  </div>
                  <!--/.form-group -->
                </div>
                <!--/column -->  
				<div class="col-sm-12 mt-20 text-center">
				    <div class="form-group">
                    <button type="submit" name="submit1" class="btn btn-rounded enquiry-btn" style="width:50%">Submit</button>
					</div>
				</div>
              </div>
              <!--/.row -->
            </form>
            <!--/.vanilla-form -->
          </div>

        </div>

    <!-- /.row -->
    </div>
  </div>
  <?php include "include/footer.php" ;?>
  <script src="<?php echo base_url(); ?>assets/plugins/jquery-validation/js/jquery.validate.min.js"></script>
    <script>
    $().ready(function() {
   // validate signup form on keyup and submit
    $("#form").validate({
        rules: {
            name:{
              required: true
            },
            email:{
                email:true,
                required:true,
            },
            mobile:{
              required: true,
              minlength:10,
              maxlength:10,
            },
           
        },
        messages: {
            mobile: "Please enter 10 digits number",
            name: "Your name is required",
            email: "Please enter valid Email address"
        },
        submitHandler: function(form) {
          form.submit();
        }
    });

});
</script>