Viewing File: /home/ubuntu/ridge-crop-landing-ui/common-form.html
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<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Document</title>
<script src="https://code.iconify.design/3/3.1.0/iconify.min.js"></script>
</head>
<body>
<div class="corp-form-wrapped">
<form class="corp-contact-form form-inline has-validation-callback"
action="https://clientzone.ridgecorp.io/en/RegisterLead" method="post" id="real_form">
<div class="mb-3" bis_skin_checked="1">
<label class="form-label">Name</label>
<div class="form-group input-icon username-icon2" id="fname-div" bis_skin_checked="1">
<input type="text" value="" class="form-control" name="lead_name" id="first_name"
placeholder="Full Name" data-validation="required"
data-validation-error-msg="First Name required">
</div>
</div>
<div class="mb-3" bis_skin_checked="1">
<label class="form-label">Email Address</label>
<div class="form-group input-icon email-icon has-success" id="form-group-email"
bis_skin_checked="1">
<input type="email" value="" class="form-control valid" name="email" id="email"
placeholder="Enter Email" data-validation="custom"
data-validation-regexp="^([a-z0-9_.+-])+\@(([a-z0-9-])+\.)+([a-z0-9]{2,4})+$"
data-validation-error-msg="Email Required">
</div>
</div>
<div class="row" bis_skin_checked="1">
<div class="col-md-12 col-lg-6 col-xl-6">
<label class="form-label">Select Country</label>
<div class="form-group select-new input-icon country-icon" bis_skin_checked="1">
<select class="form-control select-country" name="country" id="real-country" onchange="changecode(this.value)">
<option selected="" value="US">🇺🇸 United States </option>
<option value="AF">🇦🇫 Afghanistan </option>
<option value="AX">🇦🇽 Aland Islands </option>
<option value="AL">🇦🇱 Albania </option>
<option value="DZ">🇩🇿 Algeria </option>
<option value="AS">🇦🇸 American Samoa </option>
<option value="AD">🇦🇩 Andorra </option>
<option value="AO">🇦🇴 Angola </option>
<option value="AI">🇦🇮 Anguilla </option>
<option value="AQ">🇦🇶 Antarctica </option>
<option value="AG">🇦🇬 Antigua and Barbuda </option>
<option value="AR">🇦🇷 Argentina </option>
<option value="AM">🇦🇲 Armenia </option>
<option value="AW">🇦🇼 Aruba </option>
<option value="AU">🇦🇺 Australia </option>
<option value="AT">🇦🇹 Austria </option>
<option value="AZ">🇦🇿 Azerbaijan </option>
<option value="BS">🇧🇸 Bahamas </option>
<option value="BH">🇧🇠Bahrain </option>
<option value="BD">🇧🇩 Bangladesh </option>
<option value="BB">🇧🇧 Barbados </option>
<option value="BY">🇧🇾 Belarus </option>
<option value="BE">🇧🇪 Belgium </option>
<option value="BZ">🇧🇿 Belize </option>
<option value="BJ">🇧🇯 Benin </option>
<option value="BM">🇧🇲 Bermuda </option>
<option value="BT">🇧🇹 Bhutan </option>
<option value="BO">🇧🇴 Bolivia </option>
<option value="BA">🇧🇦 Bosnia and Herzegovina </option>
<option value="BW">🇧🇼 Botswana </option>
<option value="BV">🇧🇻 Bouvet Island </option>
<option value="BR">🇧🇷 Brazil </option>
<option value="IO">🇮🇴 British Indian Ocean Territory </option>
<option value="BN">🇧🇳 Brunei </option>
<option value="BG">🇧🇬 Bulgaria </option>
<option value="BF">🇧🇫 Burkina Faso </option>
<option value="BI">🇧🇮 Burundi </option>
<option value="KH">🇰🇠Cambodia </option>
<option value="CM">🇨🇲 Cameroon </option>
<option value="CA">🇨🇦 Canada </option>
<option value="CV">🇨🇻 Cape Verde </option>
<option value="KY">🇰🇾 Cayman Islands </option>
<option value="CF">🇨🇫 Central African Republic </option>
<option value="TD">🇹🇩 Chad </option>
<option value="CL">🇨🇱 Chile </option>
<option value="CN">🇨🇳 China </option>
<option value="CX">🇨🇽 Christmas Island </option>
<option value="CC">🇨🇨 Cocos (Keeling) Islands </option>
<option value="CO">🇨🇴 Colombia </option>
<option value="KM">🇰🇲 Comoros </option>
<option value="CG">🇨🇬 Congo (Brazzaville) </option>
<option value="CD">🇨🇩 Congo The Democratic Republic Of The </option>
<option value="CK">🇨🇰 Cook Islands </option>
<option value="CR">🇨🇷 Costa Rica </option>
<option value="CI">🇨🇮 Cote D'Ivoire </option>
<option value="HR">ðŸ‡ðŸ‡· Croatia </option>
<option value="CU">🇨🇺 Cuba </option>
<option value="CY">🇨🇾 Cyprus </option>
<option value="CZ">🇨🇿 Czech Republic </option>
<option value="DK">🇩🇰 Denmark </option>
<option value="DJ">🇩🇯 Djibouti </option>
<option value="DM">🇩🇲 Dominica </option>
<option value="DO">🇩🇴 Dominican Republic </option>
<option value="EC">🇪🇨 Ecuador </option>
<option value="EG">🇪🇬 Egypt </option>
<option value="SV">🇸🇻 El Salvador </option>
<option value="GQ">🇬🇶 Equatorial Guinea </option>
<option value="ER">🇪🇷 Eritrea </option>
<option value="EE">🇪🇪 Estonia </option>
<option value="ET">🇪🇹 Ethiopia </option>
<option value="FK">🇫🇰 Falkland Islands </option>
<option value="FO">🇫🇴 Faroe Islands </option>
<option value="FJ">🇫🇯 Fiji </option>
<option value="FI">🇫🇮 Finland </option>
<option value="FR">🇫🇷 France </option>
<option value="GF">🇬🇫 French Guiana </option>
<option value="PF">🇵🇫 French Polynesia </option>
<option value="TF">🇹🇫 French Southern Territories </option>
<option value="GA">🇬🇦 Gabon </option>
<option value="GM">🇬🇲 Gambia </option>
<option value="GE">🇬🇪 Georgia </option>
<option value="DE">🇩🇪 Germany </option>
<option value="GH">🇬🇠Ghana </option>
<option value="GI">🇬🇮 Gibraltar </option>
<option value="GR">🇬🇷 Greece </option>
<option value="GL">🇬🇱 Greenland </option>
<option value="GD">🇬🇩 Grenada </option>
<option value="GP">🇬🇵 Guadeloupe </option>
<option value="GU">🇬🇺 Guam </option>
<option value="GT">🇬🇹 Guatemala </option>
<option value="GG">🇬🇬 Guernsey </option>
<option value="GN">🇬🇳 Guinea </option>
<option value="GW">🇬🇼 Guinea-Bissau </option>
<option value="GY">🇬🇾 Guyana </option>
<option value="HT">ðŸ‡ðŸ‡¹ Haiti </option>
<option value="HM">ðŸ‡ðŸ‡² Heard Island and McDonald Islands </option>
<option value="VA">🇻🇦 Vatican </option>
<option value="HN">ðŸ‡ðŸ‡³ Honduras </option>
<option value="HK">ðŸ‡ðŸ‡° Hong Kong </option>
<option value="HU">ðŸ‡ðŸ‡º Hungary </option>
<option value="IS">🇮🇸 Iceland </option>
<option value="IN">🇮🇳 India </option>
<option value="ID">🇮🇩 Indonesia </option>
<option value="IR">🇮🇷 Iran Islamic Republic Of </option>
<option value="IQ">🇮🇶 Iraq </option>
<option value="IE">🇮🇪 Ireland </option>
<option value="IM">🇮🇲 Isle of Man </option>
<option value="IL">🇮🇱 Israel </option>
<option value="IT">🇮🇹 Italy </option>
<option value="JM">🇯🇲 Jamaica </option>
<option value="JP">🇯🇵 Japan </option>
<option value="JE">🇯🇪 Jersey </option>
<option value="JO">🇯🇴 Jordan </option>
<option value="KZ">🇰🇿 Kazakhstan </option>
<option value="KE">🇰🇪 Kenya </option>
<option value="KI">🇰🇮 Kiribati </option>
<option value="KP">🇰🇵 Korea Democratic People'S Republic Of </option>
<option value="KR">🇰🇷 Korea Republic Of </option>
<option value="KW">🇰🇼 Kuwait </option>
<option value="KG">🇰🇬 Kyrgyzstan </option>
<option value="LA">🇱🇦 Lao People'S Democratic Republic
</option>
<option value="LV">🇱🇻 Latvia </option>
<option value="LB">🇱🇧 Lebanon </option>
<option value="LS">🇱🇸 Lesotho </option>
<option value="LR">🇱🇷 Liberia </option>
<option value="LY">🇱🇾 Libyan Arab Jamahiriya </option>
<option value="LI">🇱🇮 Liechtenstein </option>
<option value="LT">🇱🇹 Lithuania </option>
<option value="LU">🇱🇺 Luxembourg </option>
<option value="MO">🇲🇴 Macao </option>
<option value="MK">🇲🇰 Macedonia The Former Yugoslav Republic Of </option>
<option value="MG">🇲🇬 Madagascar </option>
<option value="MW">🇲🇼 Malawi </option>
<option value="MY">🇲🇾 Malaysia </option>
<option value="MV">🇲🇻 Maldives </option>
<option value="ML">🇲🇱 Mali </option>
<option value="MT">🇲🇹 Malta </option>
<option value="MH">🇲🇠Marshall Islands </option>
<option value="MQ">🇲🇶 Martinique </option>
<option value="MR">🇲🇷 Mauritania </option>
<option value="MU">🇲🇺 Mauritius </option>
<option value="YT">🇾🇹 Mayotte </option>
<option value="MX">🇲🇽 Mexico </option>
<option value="FM">🇫🇲 Micronesia Federated States Of </option>
<option value="MD">🇲🇩 Moldova Republic Of </option>
<option value="MC">🇲🇨 Monaco </option>
<option value="MN">🇲🇳 Mongolia </option>
<option value="MS">🇲🇸 Montserrat </option>
<option value="MA">🇲🇦 Morocco </option>
<option value="MZ">🇲🇿 Mozambique </option>
<option value="MM">🇲🇲 Myanmar </option>
<option value="NA">🇳🇦 Namibia </option>
<option value="NR">🇳🇷 Nauru </option>
<option value="NP">🇳🇵 Nepal </option>
<option value="NL">🇳🇱 Netherlands </option>
<option value="AN">🇫🇴 Netherlands Antilles </option>
<option value="NC">🇳🇨 New Caledonia </option>
<option value="NZ">🇳🇿 New Zealand </option>
<option value="NI">🇳🇮 Nicaragua </option>
<option value="NE">🇳🇪 Niger </option>
<option value="NG">🇳🇬 Nigeria </option>
<option value="NU">🇳🇺 Niue </option>
<option value="NF">🇳🇫 Norfolk Island </option>
<option value="MP">🇲🇵 Northern Mariana Islands </option>
<option value="NO">🇳🇴 Norway </option>
<option value="OM">🇴🇲 Oman </option>
<option value="PK">🇵🇰 Pakistan </option>
<option value="PW">🇵🇼 Palau </option>
<option value="PS">🇵🇸 Palestinian Territory Occupied </option>
<option value="PA">🇵🇦 Panama </option>
<option value="PG">🇵🇬 Papua New Guinea </option>
<option value="PY">🇵🇾 Paraguay </option>
<option value="PE">🇵🇪 Peru </option>
<option value="PH">🇵🇠Philippines </option>
<option value="PN">🇵🇳 Pitcairn </option>
<option value="PL">🇵🇱 Poland </option>
<option value="PT">🇵🇹 Portugal </option>
<option value="PR">🇵🇷 Puerto Rico </option>
<option value="QA">🇶🇦 Qatar </option>
<option value="RE">🇷🇪 Reunion </option>
<option value="RO">🇷🇴 Romania </option>
<option value="RU">🇷🇺 Russian Federation
</option>
<option value="RW">🇷🇼 Rwanda </option>
<option value="SH">🇸🇠Saint Helena </option>
<option value="KN">🇰🇳 Saint Kitts and Nevis </option>
<option value="LC">🇱🇨 Saint Lucia </option>
<option value="PM">🇵🇲 Saint Pierre and Miquelon </option>
<option value="VC">🇻🇨 Saint Vincent and the Grenadines </option>
<option value="WS">🇼🇸 Samoa </option>
<option value="SM">🇸🇲 San Marino </option>
<option value="ST">🇸🇹 Sao Tome and Principe </option>
<option value="SA">🇸🇦 Saudi Arabia </option>
<option value="SN">🇸🇳 Senegal </option>
<option value="RS">🇷🇸 Serbia And Montenegro </option>
<option value="SC">🇸🇨 Seychelles </option>
<option value="SL">🇸🇱 Sierra Leone </option>
<option value="SG">🇸🇬 Singapore </option>
<option value="SK">🇸🇰 Slovakia </option>
<option value="SI">🇸🇮 Slovenia </option>
<option value="SB">🇸🇧 Solomon Islands </option>
<option value="SO">🇸🇴 Somalia </option>
<option value="ZA">🇿🇦 South Africa </option>
<option value="GS">🇬🇸 South Georgia and the South Sandwich Islands </option>
<option value="ES">🇪🇸 Spain </option>
<option value="LK">🇱🇰 Sri Lanka </option>
<option value="SD">🇸🇩 Sudan </option>
<option value="SR">🇸🇷 Suriname </option>
<option value="SJ">🇸🇯 Svalbard and Jan Mayen </option>
<option value="SZ">🇸🇿 Swaziland </option>
<option value="SE">🇸🇪 Sweden </option>
<option value="CH">🇨🇠Switzerland </option>
<option value="SY">🇸🇾 Syrian Arab Republic
</option>
<option value="TW">🇹🇼 Taiwan Province Of China </option>
<option value="TJ">🇹🇯 Tajikistan </option>
<option value="TZ">🇹🇿 Tanzania United Republic Of </option>
<option value="TH">🇹🇠Thailand </option>
<option value="TL">🇹🇱 Timor-Leste </option>
<option value="TG">🇹🇬 Togo </option>
<option value="TK">🇹🇰 Tokelau </option>
<option value="TO">🇹🇴 Tonga </option>
<option value="TT">🇹🇹 Trinidad and Tobago </option>
<option value="TN">🇹🇳 Tunisia </option>
<option value="TR">🇹🇷 Turkey </option>
<option value="TM">🇹🇲 Turkmenistan </option>
<option value="TC">🇹🇨 Turks and Caicos Islands </option>
<option value="TV">🇹🇻 Tuvalu </option>
<option value="UG">🇺🇬 Uganda </option>
<option value="UA">🇺🇦 Ukraine </option>
<option value="AE">🇦🇪 United Arab Emirates </option>
<option value="GB">🇬🇧 United Kingdom </option>
<option value="US">🇺🇸 United States </option>
<option value="UM">🇺🇲 United States Minor Outlying Islands </option>
<option value="UY">🇺🇾 Uruguay </option>
<option value="UZ">🇺🇿 Uzbekistan </option>
<option value="VU">🇻🇺 Vanuatu </option>
<option value="VE">🇻🇪 Venezuela </option>
<option value="VN">🇻🇳 Viet Nam </option>
<option value="VG">🇻🇬 Virgin Islands British </option>
<option value="VI">🇻🇮 Virgin Islands U.S. </option>
<option value="WF">🇼🇫 Wallis and Futuna </option>
<option value="EH">🇪🇠Western Sahara </option>
<option value="YE">🇾🇪 Yemen </option>
<option value="ZM">🇿🇲 Zambia </option>
<option value="ZW">🇿🇼 Zimbabwe </option>
</select>
</div>
</div>
<div class="col-md-12 col-lg-6 col-xl-6" bis_skin_checked="1">
<label class="form-label">Phone Number</label>
<input type="text" value="" class="form-control ph-number error" id="phone" name="phone"
data-validation="length,number" data-validation-length="5-12" placeholder="Enter Phone Number">
</div>
</div>
<div class="mb-3">
<label class="form-label">Messages</label>
<div class="form-group input-icon username-icon2" id="fname-div" bis_skin_checked="1">
<input class="form-control" name="messages"
placeholder="Message" data-validation="required"
data-validation-error-msg="First Name required">
</div>
</div>
<button type="submit" value="SIGN UP" name="submit" id="real_submit"
class="common-btn corp-secondary-btn w-100 mt-4">Submit</button>
</form>
</div>
<!-- <script src="assets/js/country-code.js"></script> -->
<script>
function changecode(str) {
jQuery.noConflict();
jQuery.ajax({
url: "https://clientzone.ridgecorp.io/real/countrychange",
type: "get",
data: "q=" + str,
success: function (a) {
jQuery("#real-countrycode").val(a);
}
});
};
</script>
</body>
</html>
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