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<!doctype html>
<html lang="en">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<title>Contact form</title>
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<link href="https://cdn.jsdelivr.net/npm/bootstrap@5.2.2/dist/css/bootstrap.min.css" rel="stylesheet" integrity="sha384-Zenh87qX5JnK2Jl0vWa8Ck2rdkQ2Bzep5IDxbcnCeuOxjzrPF/et3URy9Bv1WTRi" crossorigin="anonymous">
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</head>
<body>
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<p>
Alternativ können Sie im unteren Formular Ihre E-Mail-Adresse (und optional Telefon-Nummer) mit einer Nachricht mit Ihrem Anliegen hinterlassen. Wir versuchen dann, Sie so früh wie möglich zu kontaktieren.
</p>
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<h2>Kontakt-Formular</h2>
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<form action="/contact-form/submit" method="post">
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<input type="hidden" name="id" value="{{ id }}" required>
<div class="mb-3">
<label for="name" class="form-label">Name</label>
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<input type="text" name="name" value="{{ name }}" class="form-control" id="exampleInputEmail1" required>
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</div>
<div class="mb-3">
<label for="email" class="form-label">E-Mail</label>
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<input type="email" name="email" value="{{ email }}" class="form-control" id="email" required>
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</div>
<div class="mb-3">
<label for="telefon" class="form-label">Telefon</label>
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<input type="text" name="telefon" value="{{ telefon }}" class="form-control" id="telefon">
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</div>
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<div class="mb-5">
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<label for="message" class="form-label">Nachricht</label>
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<textarea name="message" rows="5" class="form-control" id="message" style="resize: none;" required>{{ message }}</textarea>
</div>
<div class="mb-3">
<img src="data:image/png;base64,{{ captcha }}">
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</div>
<div class="mb-3">
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<label for="captcha_answer" class="form-label">Code vom oberen Bild eingeben</label>
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<input type="text" name="captcha_answer" class="form-control" id="captcha_answer" required>
</div>
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<div class="d-grid">
<button type="submit" class="btn btn-primary">Abschicken</button>
</div>
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</form>
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<script src="https://cdn.jsdelivr.net/npm/bootstrap@5.2.2/dist/js/bootstrap.bundle.min.js" integrity="sha384-OERcA2EqjJCMA+/3y+gxIOqMEjwtxJY7qPCqsdltbNJuaOe923+mo//f6V8Qbsw3" crossorigin="anonymous"></script>
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</body>
</html>
