1+ <!DOCTYPE html>
2+ < html lang ="en ">
3+ < head >
4+ < meta charset ="UTF-8 ">
5+ < meta name ="viewport " content ="width=device-width, initial-scale=1.0 ">
6+ < title > Complaint Request</ title >
7+ < link rel ="stylesheet " href ="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/4.7.0/css/font-awesome.min.css ">
8+ < link rel ="stylesheet " href ="style.css ">
9+ < style >
10+
11+ form {
12+ max-width : 600px ;
13+ margin : 0 auto;
14+ background : linear-gradient (90deg , # FEC45D, # FC6E7B, # 995FBB );
15+ padding : 20px ;
16+ border-radius : 5px ;
17+ box-shadow : 0 2px 10px rgba (0 , 0 , 0 , 0.1 );
18+ }
19+
20+ label {
21+ display : block;
22+ margin-bottom : 8px ;
23+ }
24+
25+ input [type = "text" ],
26+ input [type = "email" ],
27+ select ,
28+ textarea {
29+ width : 100% ;
30+ padding : 10px ;
31+ margin-bottom : 15px ;
32+ border-radius : 5px ;
33+ border : 1px solid # ccc ;
34+ color : # 000000 ;
35+ }
36+
37+ /* button[type="submit"] {
38+ background-color : linear-gradient(90deg, #FEC45D, #FC6E7B, #995FBB);
39+ color: rgb(0, 0, 0);
40+ padding: 10px 15px;
41+ border: none;
42+ border-radius: 5px;
43+ cursor: pointer;
44+ }
45+
46+ button[type="submit"]:hover {
47+ background-color : linear-gradient(90deg, #FEC45D, #FC6E7B, #995FBB);
48+ } */
49+ # request-title {
50+ text-align : center;
51+ margin-top : 20px ;
52+ font-size : 24px ;
53+ color : # f4ab00 ;
54+ font-weight : bold;
55+ text-shadow : 2px 2px 4px rgba (0 , 0 , 0 , 0.2 );
56+ font-family : 'Arial' , sans-serif;
57+ /* background: linear-gradient(90deg, #FEC45D, #FC6E7B, #995FBB); */
58+ padding : 10px ;
59+ }
60+ /* #topic {
61+ height: auto;
62+ } */
63+
64+
65+
66+
67+ </ style >
68+ </ head >
69+ < body >
70+ < div id ="header-bar ">
71+ < button id ="logo-btn " onclick ="location.href='index.html' ">
72+ < div id ="logo " href ="index.html ">
73+ < h1 > FAQ HubB</ h1 >
74+ < p > Developed By Sujit Tomar</ p >
75+ </ div >
76+ </ button >
77+
78+ < div id ="language ">
79+ <!-- <h1>Langaguge : </h1> -->
80+ <!-- <select name="lang" id="lang">
81+ <option value="english">English</option>
82+ <option value="hindi">Hindi</option>
83+ <option value="chiinese">Chinese</option>
84+ </select> -->
85+ < button name ="request-btn " id ="request-btn " onclick ="location.href='request.html' ">
86+ < i class ="fa fa-question-circle "> </ i >
87+ Submit Request
88+ </ button >
89+ </ div >
90+ </ div >
91+ < div >
92+ < h1 id ="request-title "> Submit Your Request</ h1 >
93+ < form id ="request-form ">
94+ < label for ="name "> Name:</ label >
95+ < input type ="text " id ="name " name ="name " required >
96+
97+ < label for ="email "> Email:</ label >
98+ < input type ="email " id ="email " name ="email " required >
99+
100+ < label for ="topic " id ="topic "> Topic:</ label >
101+ < select id ="topic " name ="topic " required >
102+ < option value ="General "> General</ option >
103+ < option value ="Technical "> Technical</ option >
104+ < option value ="Billing "> Billing</ option >
105+ </ select >
106+
107+ < label for ="message "> Message:</ label >
108+ < textarea id ="message " name ="message " rows ="4 " required > </ textarea >
109+
110+ < button type ="submit " id ="request-btn "> Submit Request</ button >
111+ </ form >
112+ </ div >
113+ </ body >
114+ < script src ="scripts.js "> </ script >
115+ < script >
116+
117+ document . getElementById ( 'request-form' ) . addEventListener ( 'submit' , function ( event ) {
118+ event . preventDefault ( ) ; // Prevent the form from submitting normally
119+
120+ // Get form data
121+ const name = document . getElementById ( 'name' ) . value ;
122+ const email = document . getElementById ( 'email' ) . value ;
123+ const topic = document . getElementById ( 'topic' ) . value ;
124+ const message = document . getElementById ( 'message' ) . value ;
125+
126+ // Here you can send the data to your server or handle it as needed
127+ // console.log('Request submitted:', { name, email, topic, message });
128+
129+ // Optionally, show a success message or redirect the user
130+ alert ( 'Your request has been submitted successfully!' ) ;
131+ // Reset the form
132+ document . getElementById ( 'request-form' ) . reset ( ) ;
133+ // store the data in a variable
134+ const requestData = {
135+ name : name ,
136+ email : email ,
137+ topic : topic ,
138+ message : message
139+ } ;
140+ console . log ( 'Request Data:' , requestData ) ;
141+ } ) ;
142+
143+ </ script >
144+ </ html >
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