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previewbusiness.blade.php 19KB

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  1. <!DOCTYPE html>
  2. <html>
  3. <head>
  4. <style id="stndz-style"></style>
  5. <meta charset="UTF-8">
  6. <meta name="viewport" content="width=device-width, initial-scale=1">
  7. <style type="text/css">
  8. .step {
  9. height: 15px;
  10. width: 15px;
  11. margin: 0 2px;
  12. background-color: #bbbbbb;
  13. border: none;
  14. border-radius: 50%;
  15. display: inline-block;
  16. opacity: 0.5;
  17. }
  18. </style>
  19. <link rel="profile" href="http://gmpg.org/xfn/11">
  20. <link rel="pingback" href="https://www.citybroadband.my/xmlrpc.php">
  21. <link href="https://fonts.googleapis.com/css?family=Open+Sans|Oswald:400,500|Signika:400,600" rel="stylesheet">
  22. <script type="text/javascript" async="" src="http://www.google-analytics.com/ga.js"></script><script type="text/javascript" src="http://ajax.googleapis.com/ajax/libs/jquery/1.10.2/jquery.min.js"></script>
  23. <script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/js/bootstrap.min.js" integrity="sha384-Tc5IQib027qvyjSMfHjOMaLkfuWVxZxUPnCJA7l2mCWNIpG9mGCD8wGNIcPD7Txa" crossorigin="anonymous"></script>
  24. <link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/bootstrap-datepicker/1.8.0/css/bootstrap-datepicker3.css">
  25. <title>Residential Application</title>
  26. <link rel="dns-prefetch" href="//fonts.googleapis.com">
  27. <link rel="dns-prefetch" href="//s.w.org">
  28. <link rel="alternate" type="application/rss+xml" title="Cyberjaya Broadband » Feed" href="https://www.citybroadband.my/feed/">
  29. <link rel="alternate" type="application/rss+xml" title="Cyberjaya Broadband » Comments Feed" href="https://www.citybroadband.my/feed/">
  30. <link rel="icon" href="https://citybroadband.my/wp-content/uploads/2018/09/favicon-2.png" type="image/gif">
  31. <link rel="icon" href="https://citybroadband.my/wp-content/uploads/2018/09/favicon-3.png" type="image/png">
  32. <link rel="apple-touch-icon" href="https://citybroadband.my/wp-content/uploads/2018/09/favicon-4.png">
  33. <link rel="stylesheet" href="{{url('css/bootstrap.min.css')}}" type="text/css">
  34. <link rel="stylesheet" href="{{url('css/style.css')}}" type="text/css">
  35. <!-- Custom Signature files -->
  36. <!--<link rel="stylesheet" href="../include/plugins/signature_pad/docs/css/signature-pad.css">-->
  37. <!-- Font Awesome -->
  38. <link rel="stylesheet" href="https://use.fontawesome.com/releases/v5.2.0/css/all.css">
  39. <script type="text/javascript">
  40. var _gaq = _gaq || [];
  41. _gaq.push(['_setAccount', 'UA-39365077-1']);
  42. _gaq.push(['_trackPageview']);
  43. (function() {
  44. var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true;
  45. ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js';
  46. var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s);
  47. })();
  48. </script>
  49. </head>
  50. <body>
  51. <div id="page" class="site">
  52. <a class="skip-link screen-reader-text" href="#"></a>
  53. <header id="masthead" class="site-header" role="banner">
  54. <div class="fixed-portal-login">
  55. <a href="#" target="_blank">User Portal Login</a>
  56. </div>
  57. </header>
  58. </div>
  59. <div class="nav-container">
  60. <nav id="site-navigation" class="main-navigation" role="navigation">
  61. <div class="container nav-bar">
  62. <div class="row">
  63. <div class="module left site-title-container">
  64. <a href="#">
  65. <img class="bigLogo" src="{{url('assets/logo/cbb_new_logo2.png')}}" width="106" height="auto">
  66. <img class="smallLogo" src="{{url('assets/logo/cbb_new_logo2.png')}}" width="106" height="auto">
  67. </a>
  68. </div>
  69. <div class="bigLogo module widget-handle search-widget-handle right hidden-xs">
  70. <div class="search">
  71. <form role="search" method="get" class="search-form" action="#">
  72. <input type="search" class="search-field" placeholder="Search ..." value name="s" title="Search for:">
  73. </form>
  74. </div>
  75. </div>
  76. <div class="module widget-handle mobile-toggle right visible-xs">
  77. <button type="button" class="navbar-toggle" data-toggle="collapse" data-target="#menu">
  78. <span class="sr-only">Toggle Navigation</span>
  79. <span class="icon-bar"></span>
  80. <span class="icon-bar"></span>
  81. <span class="icon-bar"></span>
  82. </button>
  83. </div>
  84. <div style="clear: both;" class="module-group right menuholder">
  85. <div class="collapse navbar-collapse navbar-ex1-collapse">
  86. <ul id="menu" class="menu nav-menu" aria-expanded="false">
  87. <li id="menu-item-16" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-16">
  88. <a title="Residential" href="#">Residential</a>
  89. </li>
  90. <li id="menu-item-15" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-15">
  91. <a title="Business" href="#">Business</a>
  92. </li>
  93. <li id="menu-item-14" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-14">
  94. <a title="Our Story" href="#">Our Story</a>
  95. </li>
  96. <li id="menu-item-13" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-13">
  97. <a title="Support" href="#">Support</a>
  98. </li>
  99. <li id="menu-item-12" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-12">
  100. <a href="#" title="Contact Us">Contact Us</a>
  101. </li>
  102. </ul>
  103. </div>
  104. </div>
  105. <div class="smallLogo module right">
  106. <form role="search" method="get" class="search-form" action="#">
  107. <input type="search" class="search-field" placeholder="Search ..." value name="s" title="Search for:">
  108. </form>
  109. </div>
  110. </div>
  111. </div>
  112. </nav>
  113. </div>
  114. <div id="content" class="main-container">
  115. <section class="content-area">
  116. <div id="main" role="main">
  117. <div class="bg-white splash-text" style="padding-bottom: 0">
  118. <div class="container">
  119. <h1 class="black text-center">Business Application</h1>
  120. <p class="text-center">
  121. "Please follow the steps below to complete your application. We will get back to you shortly."
  122. </p>
  123. </div>
  124. </div>
  125. <div class="container">
  126. <div class="row">
  127. <div class="col-md-13">
  128. <section class="form-box">
  129. <div class="row">
  130. <div class="container">
  131. @foreach($data as $a)
  132. <form action method="post" ectype="multipart/form-data" name="registerForm" novalidate="novalidate">
  133. <div class="tracking-process" >
  134. </div>
  135. <div class="moving-tab" style="width: 180px; transition: transform 0s ease 0s;">
  136. Preview
  137. </div>
  138. <div class="tab-content">
  139. <div class="tab-pane active" id="signaturess">
  140. <div class="inner-pane">
  141. <!-- Preview -->
  142. <div class="row">
  143. <div class="col-md-12">
  144. <div id="preview">
  145. <label><b>Subscription Details</b></label>
  146. <table class="table table-sm table-bordered">
  147. <tbody>
  148. <tr><th>Type Application</th>
  149. <td>{{$a['application']}}</td>
  150. </tr>
  151. <tr><th>Residential Package</th>
  152. <td>10Mbps</td>
  153. </tr>
  154. <tr><th>Contract Term</th>
  155. <td>{{$a['subscription']}} Months</td>
  156. </tr>
  157. <tr><th>Prefered Appointment Date</th>
  158. <td>{{$a['thedate']}}</td>
  159. </tr>
  160. </tbody>
  161. </table>
  162. <hr><label><b>Add-On(s)</b></label>
  163. <table class="table table-sm table-bordered">
  164. <tbody>
  165. <tr><th>Subscribe for Voice</th>
  166. <td>{{$a['voice']}}</td>
  167. </tr>
  168. </tbody>
  169. </table>
  170. <hr><label><b>Company Details</b></label>
  171. <table class="table table-sm table-bordered">
  172. <tbody>
  173. <tr><th>Company Name</th>
  174. <td>{{$a['company_name']}}</td>
  175. </tr>
  176. <tr><th>Business Reg.No</th>
  177. <td>{{$a['company_register']}}</td>
  178. </tr>
  179. <tr><th>Company Contact No.</th>
  180. <td>{{$a['company_number']}}</td>
  181. </tr>
  182. <tr><th>Company Fax No.</th>
  183. <td>{{$a['company_fax']}}</td>
  184. </tr>
  185. </tbody>
  186. </table>
  187. <hr><label><b>Technical Contact Person</b></label>
  188. <table class="table table-sm table-bordered">
  189. <tbody>
  190. <tr><th>Full Name</th>
  191. <td>{{$a['full_name']}}</td>
  192. </tr>
  193. <tr><th>MyKad/Passport</th>
  194. <td>{{$a['nric_passport']}}</td>
  195. </tr>
  196. <tr><th>Designation</th>
  197. <td>{{$a['designation']}}</td>
  198. </tr>
  199. <tr><th>Primary Phone Number</th>
  200. <td>{{$a['contact_primary']}}</td>
  201. </tr>
  202. <tr><th>Secondary Phone Number</th>
  203. <td>{{$a['contact_secondary']}}</td>
  204. </tr>
  205. <tr><th>Email Address</th>
  206. <td>{{$a['email']}}</td>
  207. </tr>
  208. </tbody>
  209. </table>
  210. <hr><label><b>Service Installation Address</b></label>
  211. <table class="table table-sm table-bordered">
  212. <tbody>
  213. <tr><th>Address</th>
  214. <td>{{$a['caddress']}}</td>
  215. </tr>
  216. <tr><th>Postcode</th>
  217. <td>{{$a['postcode']}}</td>
  218. </tr>
  219. <tr><th>City</th>
  220. <td>{{$a['ccity']}}</td>
  221. </tr>
  222. <tr><th>State</th>
  223. <td>{{$a['cstate']}}</td>
  224. </tr>
  225. </tbody>
  226. </table>
  227. <hr><label><b>Montly Recurring Fee</b></label>
  228. <table class="table table-sm table-bordered">
  229. <tbody>
  230. <tr><th>Description</th><th>Price excl. ST</th><th>With ST (6%)</th>
  231. </tr>
  232. <tr><th>Broadband Fee</th>
  233. <td>149</td>
  234. <td>157.94</td>
  235. </tr>
  236. <tr><th colspan="2">Deposit</th>
  237. <td>149</td>
  238. </tr>
  239. <tr><th colspan="2">OTC</th>
  240. <td>0.0</td>
  241. </tr>
  242. <tr><th colspan="2">Total Charges</th>
  243. <td>306.94</td>
  244. </tr>
  245. </tbody>
  246. </table>
  247. </div>
  248. </div>
  249. </div>
  250. </div>
  251. <!-- Document -->
  252. <h3>Declaration and Signature</h3>
  253. <div class="inner-pane">
  254. <div class="row">
  255. <div class="col-md-12" id="document">
  256. <label><b>Document &amp; Declaration </b><small style="color: red">*</small></label>
  257. <div class="form-group">
  258. <div class="checkbox">
  259. <label>
  260. <input type="checkbox" name="photocopy" id="photocopy" value="24" required="" aria-required="true"> <p>Photocopy of MyKad (front and back) or passport for Non-Malaysian (minimum 12 months validity)</p>
  261. </label>
  262. </div>
  263. <div class="checkbox">
  264. <label>
  265. <input type="checkbox" name="formss" id="formss" value="24" required="" aria-required="true"> <p>Photocopy of Form 9, 24, 44 &amp; 49 </p>
  266. </label>
  267. </div>
  268. <div class="checkbox">
  269. <label>
  270. <input type="checkbox" name="consent" id="consent" value="24" required="" aria-required="true"> <p>I hereby consent to the collection, use,
  271. disclosure of my personal information in accordance with the <b> Privacy Policy </b> available one www.citybroadband.my.</p>
  272. </label>
  273. </div>
  274. <div class="checkbox">
  275. <label>
  276. <input type="checkbox" name="declare" id="declare" value="24" required="" aria-required="true"> <p>I hereby declare that the above information, documents, and
  277. any appendices attached are true and valid. I have read and understood the contents of this form and agreed to be bound by <b> Terms &amp; Condition </b>
  278. as stated on the next page of this form which accompany the subscription of product(s) and/ or service(s). Allo Haruman Technology Sdn Bhd reserve the rights
  279. to refuse any application at any given time should any of the information is incorrect.
  280. </p>
  281. </label>
  282. </div>
  283. <input type="text" name="dealer_id" value="" id="dealer_id" style="display:none">
  284. <input type="text" name="dealer_company" value="" id="dealer_company" style="display:none">
  285. <input type="text" name="package" value="10" id="package" style="display:none">
  286. </div>
  287. </div>
  288. </div>
  289. </div>
  290. </div>
  291. </div>
  292. </div>
  293. <div class="col-md-12">
  294. <div class="footer">
  295. <div class="footer-inner">
  296. <div class="pull-right">
  297. <a href="">
  298. <input type="button" class="btn btn-next" name="next" value="Submit" style="background-color: orangered; display: inline-block;">
  299. <input type="button" id="save-data" class="btn btn-finish" data-loading-text="Please Wait..." name="finish" value="Submit" style="display: none;">
  300. </a>
  301. </div>
  302. <div class="pull-left">
  303. <a href="{{url('Residential/form3')}}">
  304. <input type="button" class="btn btn-previous" id="save-data" name="previous" value="Previous" style="background-color: grey;">
  305. </a>
  306. </div>
  307. <div class="clearfix"></div>
  308. </div>
  309. </div>
  310. </div>
  311. </form>
  312. @endforeach
  313. </div>
  314. </div>
  315. </section>
  316. </div>
  317. </div>
  318. </div>
  319. <div class="nonstick-footer padding bg-blue" align="center">
  320. <span class="medium-title text-centeryellow" style="color: yellow;">Got A Question?</span>
  321. <div align="center">
  322. <a class="nomargin btn btn-default" href="#" style="width: 230px;">
  323. Read FAQ
  324. </a>
  325. <a style="width:230px" href="#" class="nomargin btn btn-default">
  326. Write to us
  327. </a>
  328. </div>
  329. </div>
  330. </div>
  331. </section>
  332. </div>
  333. <div class="footer-callout">
  334. </div>
  335. <footer id="colophon" class="site-footer footer" role="contentinfo">
  336. <div class="container footer-inner">
  337. <div class="row">
  338. <div class="footer-widget-area">
  339. <div class="col-md-6 col-md-3 footer-widget" role="complementary">
  340. <div class="widget widget_nav_menu" id="nav_menu-3">
  341. <h2 class="widget-title">Overview</h2>
  342. <div class="menu-main-container">
  343. <ul id="menu-main" class="menu">
  344. <li class="menu-item menu-item-type-post_type menu-item-object-page menu-item-16">
  345. <a href="#">Residential</a>
  346. </li>
  347. <li class="menu-item menu-item-type-post_type menu-item-object-page menu-item-15">
  348. <a href="#">Business</a>
  349. </li>
  350. <li class="menu-item menu-item-type-post_type menu-item-object-page menu-item-14">
  351. <a href="#/">Our Story</a>
  352. </li>
  353. <li class="menu-item menu-item-type-post_type menu-item-object-page menu-item-13">
  354. <a href="#">Support</a>
  355. </li>
  356. <li class="menu-item menu-item-type-post_type menu-item-object-page menu-item-12">
  357. <a href="#">Contact Us</a>
  358. </li>
  359. </ul>
  360. </div>
  361. </div>
  362. </div>
  363. <div class="col-md-3 col-sm-6 footer-widget" role="complementary">
  364. <div id="nav_menu-2" class="widget widget_nav_menu">
  365. <h2 class="widget-title">Legal</h2>
  366. <div class="menu-footer-2-container">
  367. <ul id="menu-footer-2" class="menu">
  368. <li id="menu-item-22" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-22">
  369. <a href="#">Terms &amp; Conditions</a>
  370. </li>
  371. <li id="menu-item-373" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-373">
  372. <a href="#">Privacy Policy</a>
  373. </li>
  374. </ul>
  375. </div>
  376. </div>
  377. </div>
  378. <div class="col-md-3 col-sm-6 footer-widget" role="complementary">
  379. <div id="text-2" class="widget widget_text">
  380. <h2 class="widget-title">Hotline</h2>
  381. <div class="textwidget"><span class="number-big yellow">1300-38-8000</span></div>
  382. </div>
  383. </div>
  384. <div class="col-md-3 col-sm-6 footer-widget" role="complementary">
  385. <div id="text-4" class="widget widget_text">
  386. <h2 class="widget-title">We Accept</h2>
  387. <div class="textwidget"><img src=""></div>
  388. </div>
  389. </div>
  390. </div>
  391. </div>
  392. </div>
  393. <div class="container">
  394. <div class="lowerfooter">
  395. <img width="50px" src="{{url('assets/logo/footerlogo.png')}}" align="left">
  396. <span class="lower-disclaimer">Copyright © 2017 Allo Technology Sdn Bhd. All rights reserved.</span>
  397. </div>
  398. <a class="btn btn-sm fade-half back-to-top inner-link" href="#top"><i class="fa fa-angle-up"></i></a>
  399. </div>
  400. </footer>
  401. <script type="text/javascript" src="{{url('js/navigation.js')}}"></script>
  402. <script type="text/javascript" src="{{url('js/skip-link-focus.js')}}"></script>
  403. <!-- Boostrap Wizard -->
  404. <script src="{{url('js/jquery.bootstrap.wizard.js')}}" type="text/javascript"></script>
  405. <!-- Plugin for the Wizard -->
  406. <script src="{{url('js/gsdk.bootstrap.wizard.js')}}" type="text/javascript"></script>
  407. <script src="{{url('js/jquery.validate.min.js')}}" type="text/javascript"></script>
  408. <!-- DatePicker -->
  409. <script src="https://cdnjs.cloudflare.com/ajax/libs/bootstrap-datepicker/1.8.0/js/bootstrap-datepicker.min.js" type="text/javascript"></script>
  410. <!-- Signature -->
  411. <script src="{{url('js/signature_pad.ums.js')}}" type="text/javascript"></script>
  412. </body>
  413. </html>
  414. <script type="text/javascript">
  415. $(window).scroll(function() {
  416. var scroll = $(window).scrollTop();
  417. if (scroll >= 150) {
  418. $(".site-header").addClass("smallHeader");
  419. }
  420. else {
  421. $(".site-header").removeClass("smallHeader");
  422. }
  423. });
  424. $(".header-blue100,.header-blue500,.header-pink, .header-blue-10, .header-blue-30, .header-blue-50, .header-blue-100, .header-blue-500").hover(function () {
  425. $(this).toggleClass("expanded-column");
  426. });
  427. $(window).on("scroll touchmove",function() {
  428. if($('body').height() <= ($(window).height() + $(window).scrollTop())) {
  429. $('footer').addClass('reached-bottom');
  430. } else {
  431. $('footer').removeClass('reached-bottom');
  432. }
  433. });
  434. </script>
  435. <style>
  436. select {
  437. height: 40px !important;
  438. }
  439. #nf-field-21-wrap .nf-field-label {
  440. padding-left: 5px;
  441. }
  442. .nf-field-element p {margin:0;}
  443. div#nf-field-22-container {
  444. margin: 0;
  445. }
  446. </style>