<form method="post" action="<?php echo e(route('portfolio.request-quote')); ?>" id="request-quote-form" class="mb-4">
    <?php echo csrf_field(); ?>
    <div class="row align-items-center">
        <div class="col-lg-12">
            <div class="form-grp">
                <input type="text" name="name" class="form-control" placeholder="<?php echo e(__('Your name')); ?>">
            </div>
        </div>

        <div class="col-lg-12">
            <div class="form-grp">
                <input type="email" name="email" class="form-control" placeholder="<?php echo e(__('Your email address')); ?>">
            </div>
        </div>

        <?php $__currentLoopData = $customFields; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $customField): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
            <?php if($customField->type == Botble\Portfolio\Enums\CustomFieldType::TEXT): ?>
                <div class="col-md-12">
                    <div class="form-grp">
                        <input type="text" class="form-control" name="custom_fields[<?php echo e($customField->getKey()); ?>]" placeholder="<?php echo e($customField->name); ?>">
                    </div>
                </div>
            <?php elseif($customField->type == Botble\Portfolio\Enums\CustomFieldType::NUMBER): ?>
                <div class="col-md-12">
                    <div class="form-grp">
                        <input type="number" class="form-control" name="custom_fields[<?php echo e($customField->getKey()); ?>]" placeholder="<?php echo e($customField->name); ?>">
                    </div>
                </div>
            <?php elseif($customField->type == Botble\Portfolio\Enums\CustomFieldType::TEXTAREA): ?>
                <div class="col-md-12">
                    <div class="form-grp">
                        <textarea class="form-control" name="custom_fields[<?php echo e($customField->getKey()); ?>]" rows="5" placeholder="<?php echo e($customField->name); ?>"></textarea>
                    </div>
                </div>
            <?php elseif($customField->type == Botble\Portfolio\Enums\CustomFieldType::DROPDOWN): ?>
                <?php if(! $customField->options->filter(fn ($option) => ! empty($option->label))) continue; ?>
                <div class="col-md-12">
                    <div class="form-grp">
                        <select class="form-select" name="custom_fields[<?php echo e($customField->getKey()); ?>]">
                            <option value=""><?php echo e($customField->name); ?></option>
                            <?php $__currentLoopData = $customField->options; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $option): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                                <option value="<?php echo e($option->getKey()); ?>"><?php echo e($option->label); ?></option>
                            <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                        </select>
                    </div>
                </div>
            <?php elseif($customField->type == Botble\Portfolio\Enums\CustomFieldType::CHECKBOX): ?>
                <?php if(! $customField->options->filter(fn ($option) => ! empty($option->label))) continue; ?>
                <div class="col-md-12 mb-10">
                    <div class="mb-3">
                        <strong class="font-sm-bold color-grey-900"><?php echo e($customField->name); ?></strong>
                        <div class="row mt-10 box-cb-form">
                            <?php $__currentLoopData = $customField->options; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $option): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                                <div class="col-lg-6 col-md-6">
                                    <div class="form-check">
                                        <?php ($id = Str::kebab("{$customField->name}-{$loop->index}")); ?>
                                        <input
                                            class="form-check-input"
                                            type="checkbox"
                                            name="custom_fields[<?php echo e($customField->getKey()); ?>][]"
                                            value="<?php echo e($option->value); ?>"
                                            id="cb-<?php echo e($id); ?>"
                                        />
                                        <label for="cb-<?php echo e($id); ?>">
                                            <?php echo e($option->label); ?>

                                        </label>
                                    </div>
                                </div>
                            <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                        </div>
                    </div>
                </div>
            <?php endif; ?>
        <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>

        <div class="col-lg-12">
            <div class="form-grp">
                <textarea class="form-control" name="message" rows="4" placeholder="<?php echo e(__('Message / Note')); ?>"></textarea>
            </div>
        </div>

        <?php if(is_plugin_active('captcha') && Captcha::isEnabled()): ?>
            <div class="col-lg-12">
                <div class="mb-3">
                    <?php echo Captcha::display(); ?>

                </div>
            </div>
        <?php endif; ?>

        <div class="col-lg-12">
            <button type="submit" class="btn btn-brand-1-big mr-25">
                <svg fill="none" stroke="currentColor" stroke-width="1.5" viewbox="0 0 24 24" xmlns="http://www.w3.org/2000/svg" aria-hidden="true">
                    <path stroke-linecap="round" stroke-linejoin="round" d="M15.75 15.75V18m-7.5-6.75h.008v.008H8.25v-.008zm0 2.25h.008v.008H8.25V13.5zm0 2.25h.008v.008H8.25v-.008zm0 2.25h.008v.008H8.25V18zm2.498-6.75h.007v.008h-.007v-.008zm0 2.25h.007v.008h-.007V13.5zm0 2.25h.007v.008h-.007v-.008zm0 2.25h.007v.008h-.007V18zm2.504-6.75h.008v.008h-.008v-.008zm0 2.25h.008v.008h-.008V13.5zm0 2.25h.008v.008h-.008v-.008zm0 2.25h.008v.008h-.008V18zm2.498-6.75h.008v.008h-.008v-.008zm0 2.25h.008v.008h-.008V13.5zM8.25 6h7.5v2.25h-7.5V6zM12 2.25c-1.892 0-3.758.11-5.593.322C5.307 2.7 4.5 3.65 4.5 4.757V19.5a2.25 2.25 0 002.25 2.25h10.5a2.25 2.25 0 002.25-2.25V4.757c0-1.108-.806-2.057-1.907-2.185A48.507 48.507 0 0012 2.25z"></path>
                </svg>
                <?php echo e(__('Get a quote')); ?>

            </button>
            <?php if(($buttonLabel = $shortcode->button_label) && ($buttonUrl = $shortcode->button_url)): ?>
                <a class="btn btn-link-medium" href="<?php echo e($buttonUrl); ?>">
                    <?php echo e($buttonLabel); ?>

                    <svg class="w-6 h-6 icon-16 ml-5" fill="none" stroke="currentColor" viewbox="0 0 24 24" xmlns="http://www.w3.org/2000/svg">
                        <path stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M14 5l7 7m0 0l-7 7m7-7H3"></path>
                    </svg>
                </a>
            <?php endif; ?>
        </div>
    </div>
</form>
<?php /**PATH /home/mideatek/taxandaccounts.ae/platform/themes/gerow/partials/request-quote-form.blade.php ENDPATH**/ ?>