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<!DOCTYPE html> |
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<html lang="en"> |
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<head> |
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<meta charset="UTF-8"> |
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<meta name="viewport" content="width=device-width, initial-scale=1.0"> |
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<title>Submit Support Ticket</title> |
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<link href="https://cdn.jsdelivr.net/npm/bootstrap@5.3.0/dist/css/bootstrap.min.css" rel="stylesheet"> |
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<link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/bootstrap-icons@1.10.0/font/bootstrap-icons.css"> |
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<style> |
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.ticket-form { |
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background-color: |
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border-radius: 10px; |
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padding: 30px; |
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box-shadow: 0 5px 15px rgba(0,0,0,0.1); |
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} |
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.form-header { |
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border-bottom: 2px solid |
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padding-bottom: 15px; |
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margin-bottom: 30px; |
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} |
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</style> |
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</head> |
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<body> |
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<!-- Navigation --> |
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<nav class="navbar navbar-expand-lg navbar-dark bg-dark"> |
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<div class="container"> |
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<a class="navbar-brand" href="index.html">SupportHub</a> |
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<button class="navbar-toggler" type="button" data-bs-toggle="collapse" data-bs-target="#navbarNav"> |
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<span class="navbar-toggler-icon"></span> |
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</button> |
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<div class="collapse navbar-collapse" id="navbarNav"> |
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<ul class="navbar-nav ms-auto"> |
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<li class="nav-item"> |
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<a class="nav-link" href="index.html">Home</a> |
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</li> |
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<li class="nav-item"> |
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<a class="nav-link active" href="submit-ticket.php">Submit Ticket</a> |
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</li> |
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<li class="nav-item"> |
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<a class="nav-link" href="track-ticket.php">Track Ticket</a> |
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</li> |
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<li class="nav-item"> |
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<a class="nav-link" href="login.php">Login</a> |
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</li> |
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</ul> |
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</div> |
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</div> |
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</nav> |
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<!-- Main Content --> |
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<div class="container my-5"> |
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<div class="row justify-content-center"> |
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<div class="col-lg-8"> |
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<div class="ticket-form"> |
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<div class="form-header text-center"> |
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<h2><i class="bi bi-ticket-detailed"></i> Submit Support Ticket</h2> |
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<p class="text-muted">Fill out the form below and our team will get back to you shortly</p> |
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</div> |
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<?php if ($success_message): ?> |
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<div class="alert alert-success alert-dismissible fade show" role="alert"> |
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<?php echo $success_message; ?> |
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<button type="button" class="btn-close" data-bs-dismiss="alert" aria-label="Close"></button> |
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</div> |
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<?php endif; ?> |
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<?php if ($error_message): ?> |
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<div class="alert alert-danger alert-dismissible fade show" role="alert"> |
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<?php echo $error_message; ?> |
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<button type="button" class="btn-close" data-bs-dismiss="alert" aria-label="Close"></button> |
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</div> |
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<?php endif; ?> |
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<form method="POST" action="<?php echo htmlspecialchars($_SERVER['PHP_SELF']); ?>"> |
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<div class="row mb-3"> |
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<div class="col-md-6 mb-3"> |
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<label for="name" class="form-label">Full Name</label> |
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<input type="text" class="form-control" id="name" name="name" value="<?php echo htmlspecialchars($name); ?>" required> |
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</div> |
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<div class="col-md-6 mb-3"> |
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<label for="email" class="form-label">Email Address</label> |
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<input type="email" class="form-control" id="email" name="email" value="<?php echo htmlspecialchars($email); ?>" required> |
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</div> |
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</div> |
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<div class="mb-3"> |
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<label for="subject" class="form-label">Subject</label> |
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<input type="text" class="form-control" id="subject" name="subject" value="<?php echo htmlspecialchars($subject); ?>" required> |
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</div> |
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<div class="mb-3"> |
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<label for="description" class="form-label">Description</label> |
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<textarea class="form-control" id="description" name="description" rows="5" required><?php echo htmlspecialchars($description); ?></textarea> |
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</div> |
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<div class="mb-4"> |
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<label for="priority" class="form-label">Priority</label> |
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<select class="form-select" id="priority" name="priority" required> |
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<option value="" disabled selected>Select priority level</option> |
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<option value="Low" <?php echo ($priority == 'Low') ? 'selected' : ''; ?>>Low</option> |
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<option value="Medium" <?php echo ($priority == 'Medium') ? 'selected' : ''; ?>>Medium</option> |
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<option value="High" <?php echo ($priority == 'High') ? 'selected' : ''; ?>>High</option> |
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<option value="Critical" <?php echo ($priority == 'Critical') ? 'selected' : ''; ?>>Critical</option> |
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</select> |
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</div> |
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<div class="d-grid"> |
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<button type="submit" class="btn btn-primary btn-lg"> |
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<i class="bi bi-send-fill"></i> Submit Ticket |
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</button> |
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</div> |
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</form> |
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</div> |
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</div> |
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</div> |
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</div> |
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<!-- Footer --> |
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<footer class="bg-dark text-white py-4"> |
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<div class="container"> |
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<div class="text-center"> |
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<p class="mb-0">© 2023 SupportHub. All rights reserved.</p> |
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</div> |
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</div> |
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</footer> |
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<script src="https://cdn.jsdelivr.net/npm/bootstrap@5.3.0/dist/js/bootstrap.bundle.min.js"></script> |
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</body> |
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</html> |
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