43 lines
2.3 KiB
PHP
43 lines
2.3 KiB
PHP
<?php
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require_once __DIR__ . '/includes/lang.php';
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require_once __DIR__ . '/includes/header.php';
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?>
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<main class="container py-5">
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<div class="row justify-content-center">
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<div class="col-lg-8">
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<h1 class="mb-4 fw-bold text-center"><?php echo __('submit_request'); ?></h1>
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<div class="card bg-dark border-secondary p-4">
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<form action="#" method="POST">
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<div class="mb-3">
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<label class="form-label text-muted small"><?= __('email_address') ?></label>
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<input type="email" class="form-control bg-dark text-white border-secondary" placeholder="email@example.com" required>
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</div>
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<div class="mb-3">
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<label class="form-label text-muted small"><?= __('issue_type') ?></label>
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<select class="form-select bg-dark text-white border-secondary">
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<option><?= __('account_access') ?></option>
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<option><?= __('dep_with_issue') ?></option>
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<option><?= __('trading_issue') ?></option>
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<option><?= __('bug_report') ?></option>
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<option><?= __('other') ?></option>
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</select>
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</div>
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<div class="mb-3">
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<label class="form-label text-muted small"><?= __('subject') ?></label>
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<input type="text" class="form-control bg-dark text-white border-secondary" placeholder="<?= __('subject') ?>" required>
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</div>
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<div class="mb-4">
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<label class="form-label text-muted small"><?= __('description') ?></label>
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<textarea class="form-control bg-dark text-white border-secondary" rows="5" placeholder="<?= __('description') ?>" required></textarea>
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</div>
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<button type="submit" class="btn btn-primary w-100 py-3 fw-bold"><?= __('submit_ticket') ?></button>
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</form>
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<div class="mt-4 text-center small text-muted">
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<?= __('support_response_time') ?>
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</div>
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</div>
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</div>
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</div>
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</main>
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<?php require_once __DIR__ . '/includes/footer.php'; ?>
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