PAL.C.T MINI SHELL
<div class='news_tittle'>
<h4> Application Advisor </h4>
</div>
<div class="col-md-12">
<br>
Silahkan kirim ....
<form role="form" method="POST" class="form-horizontal" action="aksi-appadvisor.html" enctype='multipart/form-data'>
<div class="form-group">
<label class="col-sm-3 control-label" ><span class='red'>*</span>Nama</label>
<div class="col-sm-8">
<input name="nama" type="text" placeholder="Nama Anda" class="form-control">
</div>
</div>
<div class="form-group">
<label class="col-sm-3 control-label" ><span class='red'>*</span>Email</label>
<div class="col-sm-8">
<input name="email" type="email" id="exampleInputEmail1" placeholder="Email" class="form-control">
</div>
</div>
<div class="form-group">
<label class="col-sm-3 control-label" ><span class='red'>*</span>Ponsel</label>
<div class="col-sm-8">
<input name="phone" type="text" placeholder="No.Ponsel" class="form-control">
</div>
</div>
<div class="form-group">
<label class="col-sm-3 control-label" ><span class='red'>*</span>Produk</label>
<div class="col-sm-8">
<input name="subjek" type="text" placeholder="Subjek" class="form-control">
</div>
</div>
<div class="form-group">
<label class="col-sm-3 control-label" >Pertanyaan</label>
<div class="col-sm-8">
<textarea class="form-control" name="pertanyaan" cols="40"></textarea>
</div>
</div>
<div class="form-group">
<div class="col-sm-offset-3 col-sm-9">
<button class="btn btn-primary" type="submit">Submit</button>
<br><br><i>Note : Form yang bertanda <span class='red'>*</span> harus di isi.</i>
</div>
</div>
</form>
</div>
<br><br>
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