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

Can’t remember your current password? Reset your password.

Save 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>