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<div id="est-phone-number"></div>
<style>
.estimate-form-inner-wrapper {
display: flex;
flex-direction: column;
gap: 16px;
margin-bottom: 0px !important;
}
.estimate-form-input-grid {
display: grid;
align-items: initial;
grid-template-columns: 1fr 1fr;
grid-gap: 16px;
}
.estimate-form-input-wrapper {
display: flex;
flex-direction: column;
justify-content: flex-end;
}
.estimate-form-input-wrapper p {
font-family: Inter;
font-size: 14px;
font-weight: 500;
line-height: 21px;
color: black;
margin-bottom: 4px;
}
.estimate-form-input-wrapper span {
color: red;
}
.estimate-form-input-wrapper input {
padding: 8px 16px;
border-radius: 4px;
border: 0.5px solid rgba(163, 163, 163, 0.5);
color: black;
font-family: Inter;
font-size: 16px;
font-weight: 500;
line-height: 24px;
}
.estimate-form-input-wrapper input::placeholder {
color: #a3a3a3;
font-family: Inter;
font-size: 16px;
font-weight: 500;
line-height: 24px;
}
.estimate-submit-btn {
padding: 12px 28px !important;
border-radius: 999px !important;
background-color: #043968 !important;
background-color: var(--bricks-color-fvnfur)!important;
font-size: 16px !important;
font-weight: 700 !important;
line-height: 24px !important;
color: #ffffff !important;
text-transform: uppercase !important;
align-self: flex-start !important;
transition: all 0.3s ease !important;
cursor: pointer !important;
}
.estimate-submit-btn:hover {
background-color: var(--bricks-color-ykxnnf) !important;
color: white !important;
}
.wpcf7-form input[type="submit"].custom-estimate-submit-btn {
padding: 12px 16px !important;
border-radius: 8px !important;
background-color: #043968 !important;
font-family: "Filson pro" !important;
font-size: 16px !important;
font-weight: 700 !important;
line-height: 24px !important;
color: #95c93d !important;
text-transform: uppercase !important;
align-self: flex-start !important;
transition: all 0.3s ease !important;
cursor: pointer !important;
}
.wpcf7-form input[type="submit"].custom-estimate-submit-btn:hover {
background-color: #7eb4a3 !important;
color: white !important;
}
@media only screen and (max-width: 990px) {
.estimate-form-wrapper {
grid-template-columns: 1fr;
grid-gap: 64px;
}
}
@media only screen and (max-width: 477px) {
.estimate-form-input-grid {
grid-template-columns: 1fr;
}
}
</style>
<form method="post" class="estimate-form-inner-wrapper" id="seviceminder-form">
<div class="estimate-form-input-grid">
<div class="estimate-form-input-wrapper">
<p>Name <span>*</span></p>
<input
type="text"
id="name"
name="Name"
required
placeholder="First Name"
/>
</div>
<div class="estimate-form-input-wrapper">
<input type="text" name="lName" id="lName" placeholder="Last Name" />
</div>
</div>
<div class="estimate-form-input-grid">
<div class="estimate-form-input-wrapper">
<p>Email <span>*</span></p>
<input
type="email"
id="email"
name="Email"
required
placeholder="Enter Email"
/>
</div>
<div class="estimate-form-input-wrapper">
<p>Phone Number <span>*</span></p>
<input type="tel" id="phone" name="Phone1" maxLength=14 placeholder="Enter phone number" required/>
</div>
</div>
<div class="estimate-form-input-grid">
<div class="estimate-form-input-wrapper">
<p>Address line 1</p>
<input type="text" id="address1"
name="Address1" />
</div>
<div class="estimate-form-input-wrapper">
<p>Address line 2</p>
<input type="text" id="address2"
name="Address2" />
</div>
</div>
<div class="estimate-form-input-grid">
<div class="estimate-form-input-wrapper">
<p>City</p>
<input type="text" aria-required="true"
aria-invalid="false"
id="city"
name="City" />
</div>
<div class="estimate-form-input-wrapper">
<p>State</p>
<input type="text" aria-required="true"
aria-invalid="false"
id="state"
name="State" />
</div>
</div>
<div class="estimate-form-input-grid">
<div class="estimate-form-input-wrapper">
<p>Zip Code <span>*</span></p>
<input type="text" id="postalcode"
name="PostalCode" required />
</div>
<div class="estimate-form-input-wrapper">
<input type="hidden" name="key" id="serviceminder-key" />
</div>
</div>
<input
type="hidden"
id="RedirectUrlPopup"
name="RedirectUrl"
/>
<button type="submit" class="estimate-submit-btn" id="serviceminder-submit">
Submit
</button>
</form>