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testpagestudent.php
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testpagestudent.php
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<?php include("studentCover.html"); ?>
<!DOCTYPE html>
<html lang="en">
<head>
<title>Request form</title>
</head>
<body>
<div class="content container">
<div class="row">
<h1 class="h1-title">Welcome to AirNART's Student Page</h1>
</div>
<div class="row">
<div class="col-xs-12 col-sm-3 col-md-3 ">
<form class="form-signin">
<h2 class="form-signin-heading">Logged in as Student</h2>
<h4 class="form-signin-heading"><a href="index.html">Log Out</a></h4>
<input align="right" type="checkbox" value="remember-me" id="rememberMe" name="rememberMe"> Remember me
<br/>
</label>
<hr>
</form>
</div>
<span class="col-xs-12 col-sm-8 col-md-8">
<h2>Please enter your request details</h2><br>
<form>
<div class="h3-title">
<h3>Flight Information</h3>
</div>
<br><br>
<label>
Do you require aiport pickup?
</label>
<input type="radio" name="needAP" value="Yes"> Yes
<input type="radio" name="needAP" value="No"> No<br><br>
<h4>Departure Flight</h4>
<label>
Home Country Airline Name
</label>
<br>
<input type="text" name="departurename"><br><br>
<label>
Departure Flight Number
</label>
<br>
<input type="text" name="departurenumber"><br><br>
<label>
Departure Date
</label>
<input type="date" name="departuredate">
<label>
Departure Time
</label>
<input type="time" name="departuretime"><br><br>
<h4>Arrival Flight</h4>
<label>
Arrival Airline Name
</label>
<br>
<input type="text" name="arrivalname"><br><br>
<label>
Arrival Flight Number
</label>
<br>
<input type="text" name="arrivalnumber"><br><br>
<label>
Arrival Date
</label>
<input type="date" name="arrivaldate">
<label>
Arrival Time
</label>
<input type="time" name="arrivaltime"><br><br>
<br><br>
<div class="h3-title">
<h3>Housing Information</h3>
</div>
<br><br>
<label>
Do you require housing?
</label>
<input type="radio" name="needHousing" value="Yes"> Yes
<input type="radio" name="needHousing" value="No"> No<br><br>
<h4>When?</h4>
<label>Date</label>
<input type="date" name="housingdate">
<label>Number of days</label>
<input type="text" name="numofdays">
<br><br>
<label>Next Destination(address)</label>
<br>
<input type="address" name="nextdestination"><br><br>
<label>Comments</label>
<textarea rows="4" cols="100" name="comments" form="requestform">Please tell us any special needs or concerns you might have....</textarea><br><br>
<h4>Where would you like to be sent?</h4><br>
<label>Resident name</label>
<br>
<input type="text" name="nonaffiliatedname">
<br>
<label>Resident phone</label>
<br>
<input type="text" name="nonaffiliatedphone"><br><br>
<label>Resident Address</label>
<br>
<input type="address" name="nonaffiliatedaddress"><br><br>
<button class="btn btn-lg btn btn-warning">Submit Request</button>
</form>
</span>
</div>
</div><!-- content container -->
<footer class="container-fluid col-md-12">
<p>Copyright 2016 AirNart Inc. </p>
</footer>
<script src="js/jquery-2.1.4.min.js"></script>
<script src="js/bootstrap.min.js"></script>
<script src="js/script.js"></script>
</body>
</html>