@extends('frontend.layouts.amp') @section('title', 'Enter to Win - ' . app_name()) @push('head-area') @endpush @section('content')
ENTER TO WIN
@include('includes.partials.messages') {!! Form::open(array('method' => 'POST', 'id' => 'frm_enter_to_win')) !!}
{!! Form::label('email', 'Email Address:') !!} * {!! Form::text('email', null, ['type' => 'email', 'required' => 'required', 'class' => 'form-control w-97', 'placeholder' => 'Enter email address ...', 'id' => 'sp_email']) !!}
{!! Form::label('first_name', 'First Name:') !!} * {!! Form::text('first_name', null,['class'=>'form-control w-97', 'required' => 'required', 'placeholder'=>'Enter first name ...']) !!}
{!! Form::label('last_name', 'Last Name:') !!} * {!! Form::text('last_name', null,['class'=>'form-control w-97', 'required' => 'required', 'placeholder'=>'Enter last name ...']) !!}
{!! Form::label('company', 'Company:') !!} {!! Form::text('company', null,['class'=>'form-control w-97', 'placeholder'=>'Enter company name ...']) !!}
{!! Form::label('phone', 'Phone:') !!} * {!! Form::text('phone', null,['class'=>'form-control w-97', 'required' => 'required', 'placeholder'=>'Enter phone ...']) !!}
{!! Form::label('city', 'City:') !!} {!! Form::text('city', null,['class'=>'form-control w-97', 'placeholder'=>'Enter city ...']) !!}
{!! Form::label('state', 'State:') !!} {!! Form::select('state', $data['states'] ,null ,['class'=>'form-control w-97', 'required' => 'required', 'placeholder'=>'Please Select ...']) !!}
{!! Form::label('zip', 'Zip / Post Code:') !!} {!! Form::text('zip', null,['class'=>'form-control w-97', 'placeholder'=>'Enter zip / post code ...']) !!}
{!! Form::label('role', 'Your Role:') !!} * {!! Form::select('role', ['Veterinarian' => 'Veterinarian', 'Dentist' => 'Dentist', 'Technician' => 'Technician', 'Office Manager' => 'Office Manager', 'Clinic Owner' => 'Clinic Owner', 'Associated with Hospital' => 'Associated with Hospital', 'Other' => 'Other'] ,null ,['class'=>'form-control w-97', 'required' => 'required', 'placeholder'=>'Please Select ...']) !!}
{!! Form::label('comments', 'Additional Comments:') !!} {!! Form::textarea('comments', null,['class'=>'form-control w-97', 'placeholder'=>'Additional Comments ...', 'rows' => '3']) !!}
{!! Form::close() !!}
VETERINARY TECHNICIAN WEEK GIVEAWAY OFFER
On this Veterinary Technician Week, GerVetUSA honors the hard work, commitment and passion of our veterinary technicians to play an important role in preserving the health of our little fellas. To acknowledge their efforts, we are giving away our special offer consisting of High Level Bandage Scissors, Stitch Scissors, and Kelly Hemostatic Forceps. Not only this, we are also adding a pouch to keep the instruments safe and take them wherever you want too. Enter to win, now!
Also, make sure to do the following to grab more chances of winning!
1. Like us on Facebook:
2. Follow us on Instagram and Twitter
3. Why not LinkedIn?
4. Don’t just stop! Invite your Veterinarian buddies and reach the highest score.
Don’t just stop! Invite your Veterinarian buddies and reach the highest score.
Hurry up! Waiting for a lot of fun, maximum entries, great scores and the Lucky winner.
@endsection