Form
Form #1
Retailer Inquiries
This form is for retailer inquiries only. For all other customer or shopper support requests, please visit the links below this form.
<div class="row my-10">
<!-- col -->
<div class="offset-lg-1 col-lg-10 col-12">
<div class="mb-8">
<!-- heading -->
<h1 class="h3">Retailer Inquiries</h1>
<p class="lead mb-0">This form is for retailer inquiries only. For all other customer or shopper
support requests, please visit the links below this form.
</p>
</div>
<!-- form -->
<form class="row">
<!-- input -->
<div class="col-md-6 mb-3">
<label class="form-label" for="fname"> First Name<span class="text-danger">*</span></label>
<input type="text" id="fname" class="form-control" name="fname" placeholder="Enter Your First Name" required>
</div>
<div class="col-md-6 mb-3">
<!-- input -->
<label class="form-label" for="lname"> Last Name<span class="text-danger">*</span></label>
<input type="text" id="lname" class="form-control" name="lname" placeholder="Enter Your Last name" required>
</div>
<div class="col-md-12 mb-3">
<!-- input -->
<label class="form-label" for="company"> Company<span class="text-danger">*</span></label>
<input type="text" id="company" name="company" class="form-control" placeholder="Your Company" required>
</div>
<div class="col-md-12 mb-3">
<!-- input -->
<label class="form-label" for="title"> Title</label>
<input type="text" id="title" name="title" class="form-control" placeholder="Your Title" required>
</div>
<div class="col-md-6 mb-3">
<label class="form-label" for="emailContact">Email<span class="text-danger">*</span></label>
<input type="email" id="emailContact" name="emailContact" class="form-control" placeholder="Enter Your First Name" required >
</div>
<div class="col-md-6 mb-3">
<!-- input -->
<label class="form-label" for="phone"> Phone</label>
<input type="text" id="phone" name="phone" class="form-control" placeholder="Your Phone Number" required>
</div>
<div class="col-md-12 mb-3">
<!-- input -->
<label class="form-label" for="comments"> Comments</label>
<textarea rows="3" id="comments" class="form-control" placeholder="Additional Comments"></textarea>
</div>
<div class="col-md-12">
<!-- btn -->
<button type="submit" class="btn btn-primary">Submit</button>
</div>
</form>
</div>
</div>
Form #2
Account Setting
Account details
Password
<div class="py-6 p-md-6 p-lg-10">
<div class="mb-6">
<!-- heading -->
<h2 class="mb-0">Account Setting</h2>
</div>
<div>
<!-- heading -->
<h5 class="mb-4">Account details</h5>
<div class="row">
<div class="col-lg-5">
<!-- form -->
<form>
<!-- input -->
<div class="mb-3">
<label class="form-label">Name</label>
<input type="text" class="form-control" placeholder="jitu chauhan">
</div>
<!-- input -->
<div class="mb-3">
<label class="form-label">Email</label>
<input type="email" class="form-control" placeholder="example@gmail.com">
</div>
<!-- input -->
<div class="mb-5">
<label class="form-label">Phone</label>
<input type="text" class="form-control" placeholder="Phone number">
</div>
<!-- button -->
<div class="mb-3">
<button class="btn btn-primary">Save Details</button>
</div>
</form>
</div>
</div>
</div>
<hr class="my-10">
<div class="pe-lg-14">
<!-- heading -->
<h5 class="mb-4">Password</h5>
<form class=" row row-cols-1 row-cols-lg-2">
<!-- input -->
<div class="mb-3 col">
<label class="form-label">New Password</label>
<input type="password" class="form-control" placeholder="**********">
</div>
<!-- input -->
<div class="mb-3 col">
<label class="form-label">Current Password</label>
<input type="password" class="form-control" placeholder="**********">
</div>
<!-- input -->
<div class="col-12">
<p class="mb-4">Can’t remember your current password?<a href="#"> Reset your password.</a></p>
<a href="#" class="btn btn-primary">Save Password</a>
</div>
</form>
</div>
</div>
Form #3
Enter your phone number to Signup or Register
<div class="container">
<div class="row justify-content-center">
<div class="col-lg-8 col-12">
<div class="py-6">
<h4 class="fs-6 mb-4">Enter your phone number to Signup or Register</h4>
<form>
<div class="input-phone mb-2">
<input type="tel" maxlength="10" class="form-control" pattern="[0-9]{3}-[0-9]{2}-[0-9]{3}" required >
</div>
<div class="d-grid">
<button type="button" class="btn btn-primary">Next</button>
</div>
<div class="mt-4">
<small>
<a href="#">Terms of Service</a>
<a href="#" class="ms-3">Privacy Policy</a>
</small>
</div>
</div>
</div>
</div>
</div>