<!DOCTYPE HTML>
<html>
    <head>
        <meta charset="utf-8">
        <meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
        <meta name="description" content="">
        <meta name="author" content="ModerWebStudios">
        <title>WordPress Website with Monthly Hosting</title>
        <link rel="stylesheet" href="https://stackpath.bootstrapcdn.com/bootstrap/4.3.1/css/bootstrap.min.css">
        <script src="https://code.jquery.com/jquery-3.5.1.min.js"></script>
        <script src="https://cdn.jsdelivr.net/npm/popper.js@1.16.1/dist/umd/popper.min.js"></script>
        <script src="https://stackpath.bootstrapcdn.com/bootstrap/4.5.2/js/bootstrap.min.js"></script>
        
        <style>
            body {background-color: #37414A; background-image: url(https://modernwebstudios.com/wp-content/uploads/Zoho-Background.jpg); background-size: cover; background-repeat: no-repeat; background-position: center top;}
            h2 {font-size: 22px; text-transform: uppercase; margin-left: -13px;}
            .container {max-width: 580px;}
            .jumbotron {padding: 1rem 2rem;}
            label {display: none;}
            .header-logo {text-align: center; margin-top: 10px;}
            .proceed-btn {margin-left: auto; margin-right: auto !important; margin-top: 27px; width: 65%; display: block; padding-bottom: 9px;}
            .btn-primary {background-color: #37414A; border-color: #37414A;}
            .btn-primary:hover {background-color: #516271; border-color: #516271;}
        </style>

    </head>

    <body>

        <div class="container">
            <div class="header-logo"><img src="https://modernwebstudios.com/wp-content/uploads/Zoho-Header.png"></div>


            <div style="margin-top:0px" class="jumbotron">
                <?php
                if (substr_count($plan_id, 'woo')) {
                echo '<h1 style="font-size:30px; text-align: center; margin-bottom: 37px;" class="center">eCommerce WordPress Website<br/>with Monthly Hosting '.$_GET['id'].'</h1>';     
                } else {
                echo '<h1 style="font-size:30px; text-align: center; margin-bottom: 37px;" class="center">WordPress Website<br/>with Monthly Hosting '.$_GET['id'].'</h1>';   
                }

                ?>
                <h2>Company Information:</h2>
                <div class="row">

                    <form action="https://signup.modernwebstudios.com/subscriptions/process.php" method="POST">
                        <input type="hidden" name="token" value="<?php echo $token->access_token; ?>">
                        <input type="hidden" name="plan_id" value="<?php echo $plan_id; ?>">


                        <div class="form-group mb-2 mr-2">
                            <label for="f_name">First Name</label>
                            <input type="text" class="form-control" name="f_name" id="f_name" placeholder="First Name" required>

                        </div>
                        <div class="form-group mb-2 mr-2">
                            <label for="l_name">Last Name</label>
                            <input type="text" class="form-control" name="l_name" id="l_name" placeholder="Last Name" required>

                        </div>


                        <!-- Input type text -->
                        <div class="form-group mb-2 mr-2">
                            <label class="mr-2" for="input_id_0">Company</label>
                            <input type="text" class="form-control" name="company" id="input_id_0" placeholder="Company" required>
                        </div>

                        <!-- Input type text -->
                        <div class="form-group mb-2 mr-2">
                            <label class="mr-2" for="u_email">Email</label>
                            <input type="text" class="form-control" name="u_email" id="u_email" placeholder="Email" required>
                        </div>
                        <!-- Input type text -->
                        <div class="form-group mb-2 mr-2">
                            <label class="mr-2" for="u_email">Phone/Mobile</label>
                            <input type="text" class="form-control" name="u_phone" id="u_phone" placeholder="Phone" required>
                        </div>
                        <!-- Input type text -->
                        <div class="form-group mb-2 mr-2">
                            <label class="mr-2" for="address">Address</label>
                            <input type="text" class="form-control" name="address" id="address" placeholder="Street Address">
                        </div>



                        <!-- columns -->
                        <div class="form-group mb-2 mr-2">
                            <div class="form-row align-items-center">
                                <div class="col-md-6 mb-3">
                                    <!-- Input type text -->
                                    <label for="input_id_20">City</label>
                                    <input type="text" class="form-control" name="city" id="input_id_20" placeholder="City">
                                </div>

                                <div class="col-md-3 mb-3">
                                    <!-- select -->
                                    <label for="state">State</label>
                                    <select class="custom-select" name="state" id="state">
                                        <option value="1">choose</option>
                                        <option value="Alabama">Alabama</option>
                                        <option value="Alaska">Alaska</option>
                                        <option value="Arizona">Arizona</option>
                                        <option value="Arkansas">Arkansas</option>
                                        <option value="California">California</option>
                                        <option value="Colorado">Colorado</option>
                                        <option value="Connecticut">Connecticut</option>
                                        <option value="Delaware">Delaware</option>
                                        <option value="District Of Columbia">District Of Columbia</option>
                                        <option value="Florida">Florida</option>
                                        <option value="Georgia">Georgia</option>
                                        <option value="Hawaii">Hawaii</option>
                                        <option value="Idaho">Idaho</option>
                                        <option value="Illinois">Illinois</option>
                                        <option value="Indiana">Indiana</option>
                                        <option value="Iowa">Iowa</option>
                                        <option value="Kansas">Kansas</option>
                                        <option value="Kentucky">Kentucky</option>
                                        <option value="Louisiana">Louisiana</option>
                                        <option value="Maine">Maine</option>
                                        <option value="Maryland">Maryland</option>
                                        <option value="Massachusetts">Massachusetts</option>
                                        <option value="Michigan">Michigan</option>
                                        <option value="Minnesota">Minnesota</option>
                                        <option value="Mississippi">Mississippi</option>
                                        <option value="Missouri">Missouri</option>
                                        <option value="Montana">Montana</option>
                                        <option value="Nebraska">Nebraska</option>
                                        <option value="Nevada">Nevada</option>
                                        <option value="New Hampshire">New Hampshire</option>
                                        <option value="New Jersey">New Jersey</option>
                                        <option value="New Mexico">New Mexico</option>
                                        <option value="New York">New York</option>
                                        <option value="North Carolina">North Carolina</option>
                                        <option value="North Dakota">North Dakota</option>
                                        <option value="Ohio">Ohio</option>
                                        <option value="Oklahoma">Oklahoma</option>
                                        <option value="Oregon">Oregon</option>
                                        <option value="Pennsylvania">Pennsylvania</option>
                                        <option value="Rhode Island">Rhode Island</option>
                                        <option value="South Carolina">South Carolina</option>
                                        <option value="South Dakota">South Dakota</option>
                                        <option value="Tennessee">Tennessee</option>
                                        <option value="Texas">Texas</option>
                                        <option value="Utah">Utah</option>
                                        <option value="Vermont">Vermont</option>
                                        <option value="Virginia">Virginia</option>
                                        <option value="Washington">Washington</option>
                                        <option value="West Virginia">West Virginia</option>
                                        <option value="Wisconsin">Wisconsin</option>
                                        <option value="Wyoming">Wyoming</option>
                                    </select>
                                </div>

                                <div class="col-md-3 mb-3">
                                    <!-- Input type text -->
                                    <label for="zip">Zip</label>
                                    <input type="text" class="form-control" name="zip" id="zip" placeholder="Zip">
                                </div>
                                <div class="col-md-7 mb-7">
                                    <!-- Input type text -->
                                    <label for="zip">Domain</label>
                                    <input type="text" class="form-control" name="domain" id="domain" placeholder="Domain Name (Website)">
                                </div>

                            </div>

                        </div>

                        <!-- Input type checkbox -->
                        <div class="form-group mb-2 mr-2">
                            <div style="display:none" class="form-check">
                                <input class="form-check-input" type="checkbox" name="agree" id="agree" value="remember">
                                <label class="form-check-label mr-2" for="agree">Agree to terms and conditions</label>
                            </div>
                        </div>

                        <button type="submit" class="btn btn-primary mr-2 mb-2 proceed-btn" name="button_id_16" id="button_id_16">Proceed to Payment Page</button>
                    </form>


                </div>
            </div>
        </div>

    </body>

</html>