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Samform.html
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<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<title>Contact | Your Representative</title>
<meta property="og:title" content="Connect with Sam the Representative of the People">
<meta property="og:description" content="Join hands with me as we build Enugu North and South Federal Constituency.">
<meta property="og:image" content="img/Chimaobi_Atu.jpg">
<meta property="og:url" content="https://cyberbill1.github.io/ifeanyi-barth/sam-atu">
<meta name="description" content="">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="robots" content="all,follow">
<!-- Bootstrap CSS-->
<link rel="stylesheet" href="vendor/bootstrap/css/bootstrap.min.css">
<!-- Font Awesome CSS-->
<link rel="stylesheet" href="vendor/font-awesome/css/font-awesome.min.css">
<!-- Google fonts - Roboto + Roboto Slab-->
<link rel="stylesheet" href="https://fonts.googleapis.com/css?family=Roboto+Slab:400,700%7CRoboto:400,700,300">
<!-- Google Web Fonts -->
<link rel="preconnect" href="https://fonts.googleapis.com">
<link rel="preconnect" href="https://fonts.gstatic.com" crossorigin>
<link href="https://fonts.googleapis.com/css2?family=Montserrat:wght@400;500&family=Roboto:wght@500;700&display=swap" rel="stylesheet">
<!-- Icon Font Stylesheet -->
<link href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/5.10.0/css/all.min.css" rel="stylesheet">
<link href="https://cdn.jsdelivr.net/npm/bootstrap-icons@1.4.1/font/bootstrap-icons.css" rel="stylesheet"> -->
<!-- owl carousel-->
<link rel="stylesheet" href="vendor/owl.carousel/assets/owl.carousel.css">
<link rel="stylesheet" href="vendor/owl.carousel/assets/owl.theme.default.css">
<!-- animate.css-->
<link rel="stylesheet" href="vendor/animate.css/animate.css">
<!-- theme stylesheet-->
<link rel="stylesheet" href="css/style.default.css" id="theme-stylesheet">
<!-- Custom stylesheet - for your changes-->
<link rel="stylesheet" href="css/custom.css">
<!-- Leaflet CSS - For the map-->
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/leaflet/1.4.0/leaflet.css">
<!-- Favicon-->
<link rel="shortcut icon" href="img/Chimaobi_Atu.jpg">
<!-- Tweaks for older IEs--><!--[if lt IE 9]>
<script src="https://oss.maxcdn.com/html5shiv/3.7.3/html5shiv.min.js"></script>
<script src="https://oss.maxcdn.com/respond/1.4.2/respond.min.js"></script><![endif]-->
<style>
/* Styling for the main content area */
main {
margin-top: 20px;
display: flex;
justify-content: center;
align-items: center;
}
#submit{
border: none;
background-color: red;
color: white;
width: 200px;
margin-top: 20px;
border-radius: 20px;
align-items: center;
}
#submit:hover{
background-color: #26d48c;
}
</style>
</head>
<!-- Facebook Comment-->
<div id="fb-root"></div>
<script async defer crossorigin="anonymous" src="https://connect.facebook.net/en_US/sdk.js#xfbml=1&version=v18.0" nonce="FTfp0K0d"></script>
<header class="header">
<nav class="navbar navbar-expand-lg fixed-top">
<div class="container"><a href="#contact" class="navbar-brand scrollTo"> <h4>Contact Sam</h4></a>
<button type="button" data-toggle="collapse" data-target="#navbarcollapse" aria-controls="navbarSupportedContent" aria-expanded="false" aria-label="Toggle navigation" class="navbar-toggler navbar-toggler-right"><span class="fa fa-bars"></span></button>
<div id="navbarcollapse" class="collapse navbar-collapse">
<ul class="navbar-nav ml-auto">
<li class="nav-item"><a href="index.html" class="nav-link link-scroll">Home</a></li>
</ul>
</div>
</div>
</nav>
</header>
<!-- <section id="intro" style="background: url(img/Chimaobi_Atu.jpg) center center no-repeat; background-size: cover; opacity: 0.5;" class="intro-section pb-2"> -->
<!-- Contact-->
<section id="intro" style="background: url(img/Chimaobi_Atu.jpg) center center no-repeat; background-size: cover; opacity: 0.8;" class="intro-section pb-2">
<div class="container text-center">
<!--<div data-animate="fadeInRight" class="logo"><img src="img/NA.jpg" alt="logo" width="300"></div>-->
<p></p>
<h1 data-animate="fadeInDown" class="text-shadow mb-2">Maka Ọ di nma Ndi Be Anyị</h1>
<p></p>
<p data-animate="slideInDown" class="h3 text-shadow text-500">Register and contact me in order to effectively represent you</p>
</div>
</section>
<section id="contact" data-animate="bounceIn" class="contact-section contact">
<div class="container">
<header class="text-center">
<h2 class="title" style="color: #26d48c;">Contact me</h2>
</header>
<p>I am committed to being accessible to my constituents and indeed the entire Nigeria Populace.
Your feedback is important to me. Please contact me to share your thoughts and ideas on how we can make our community a better place.</p>
<ul>
<li>In the second section we have provided a form for you to register. This will give us data to plan for our developmental Interventions and will ensure you are carried along</li>
</ul>
</header>
<section>
<header class="text-center">
<h6 data-animate="fadeInDown" class="title" style="color: #26d48c; font-size: 18px;">General Contact Form</a></h6>
</header>
<div class="row">
<div class="col-lg-8 mx-auto">
<form name="contact-form" id="sheetdb-form" method="post" action="https://sheetdb.io/api/v1/vgbvme3cgb2jt">
<div class="controls">
<div class="row">
<div class="col-md-6">
<input type="text" name="full-name" placeholder="Enter Full name *" required="required" class="form-control">
</div>
<div class="col-md-6">
<input type="text" name="phone-number" placeholder="Enter Phone Number *" required="required" class="form-control">
</div>
<div class="col-md-6">
<input type="text" name="email" placeholder="Enter Email Address *" required="required" class="form-control">
</div>
<div class="col-md-12">
<textarea name="message" placeholder="Message for Me *" rows="4" required="required" class="form-control"></textarea>
</div>
<div class="col-md-12 text-center">
<button type="submit" class="btn btn-outline-primary" id="submit">Send message</button>
</div>
</section>
<section>
<header class="text-center">
<h6 data-animate="fadeInDown" class="title" style="color: #26d48c; font-size: 18px;">Register for Our Interventions</a></h6>
</header>
<div class="row">
<div class="col-lg-8 mx-auto">
<form name="contact-form" id="sheetdb-form" method="post" action="https://sheetdb.io/api/v1/vgbvme3cgb2jt">
<div class="controls">
<div class="row">
<div class="col-md-6">
<input type="text" name="first-name" placeholder="Enter Firstname *" required="required" class="form-control">
</div>
<div class="col-md-6">
<input type="text" name="surname" placeholder="Enter Lastname *" required="required" class="form-control">
</div>
<div class="col-md-6">
<input type="text" name="phone-number" placeholder="Enter Phone Number *" required="required" class="form-control">
</div>
<div class="col-md-6">
<input type="text" name="email" placeholder="Enter Email Address *" required="required" class="form-control">
</div>
<div class="col-md-6">
<input type="text" name="address" placeholder="Where do you Live *" required="required" class="form-control">
</div>
<div class="col-md-6">
<select name="gender" required="required" class="form-control">
<option value="">Gender *</option>
<option value="male">Male</option>
<option value="female">Female</option>
</select>
</div>
<div class="col-md-6">
<select name="age-bracket" required="required" class="form-control">
<option value="">Select Age Range *</option>
<option value="15-19">15-19</option>
<option value="20-24">20-24</option>
<option value="25-29">25-29</option>
<option value="30-34">30-34</option>
<option value="35-39">35-39</option>
<option value="40-64">40-64</option>
<option value="65 and above">65 and Above</option>
</select>
</div>
<div class="col-md-6">
<select name="education" required="required" class="form-control">
<option value="">Select Highest Education Attained *</option>
<option value="Uneducated">Uneducated</option>
<option value="Primary School">Primary School</option>
<option value="Secondary School">Secondary School</option>
<option value="Undergraduate">Undergraduate</option>
<option value="NCE/OND">NCE/OND</option>
<option value="BSc/HND">BSc/HND</option>
<option value="Post Graduate">Post Graduate</option>
</select>
</div>
<div class="col-md-6">
<select name="occupation" required="required" class="form-control">
<option value="">Select Occupation *</option>
<option value="Artisan (Ọrụ Aka)">Artisan (Ọrụ Aka)</option>
<option value="Business">Business</option>
<option value="Civil Servant (salary earner)">Civil Servant (salary earner)</option>
<option value="Farmer">Farmer</option>
<option value="Student">Student</option>
<option value="Unemployed">Unemployed</option>
</select>
</div>
<div class="col-md-6">
<select name="intervention-area" class="form-control">
<option value="">Select Intervention area you desire</option>
<option value="Agriculture">Agriculture</option>
<option value="Computer/Tech Skills">Computer/Tech Skills</option>
<option value="Skill Acquisition (imu ọrụ aka)">Skill Acquisition (imu ọrụ aka)</option>
<option value="Business Support">Business Support</option>
<option value="Sports">Sports</option>
<option value="Education: Scholarship, Loan/Grant">Education: Scholarship, Loan/Grant</option>
</select>
</div>
<!-- HTML -->
<div class="col-md-6">
<select name="LGA" id="lga" class="form-control" required>
<option value="">Select your Local Government Area *</option>
<option value="Enugu North">Enugu North</option>
<option value="Enugu South">Enugu South</option>
<!-- Add more LGAs as needed -->
</select>
</div>
<div class="col-md-6">
<select name="Political-ward" id="ward" class="form-control" required>
<option value="">Select your Ward *</option>
<!-- Wards will be populated dynamically using JavaScript -->
</select>
</div>
<!-- JavaScript -->
<script>
// Create a mapping of LGAs to wards
const lgaWardMapping = {
"Enugu North": [
"Ward 1 ASATA TOWNSHIP",
"Ward 2 UMUNEVO",
"Ward 3 IHEWUZI",
"Ward 4 ONU-ASATA",
"Ward 5 OGBETTE EAST",
"Ward 6 OGBETTE WEST",
"Ward 7 G.R.A",
"Ward 8 OGUI NEW LAYOUT",
"Ward 9 CHINA TOWN",
"Ward 10 NEW HAVEN",
"Ward 11 INDEPENDENCE LAYOUT",
"Ward 12 UDI SIDING/IVA VALLEY",
"Ward 13 OGUI TOWNSHIP"
],
"Enugu South": [
"Ward 1 AMECHI I",
"Ward 2 AMECHI II",
"Ward 3 OBEAGU",
"Ward 4 UWANI EAST",
"Ward 5 UWANI WEST",
"Ward 6 ACHARA LAYOUT EAST",
"Ward 7 ACHARA LAYOUT WEST",
"Ward 8 AWKUNANAW EAST",
"Ward 9 AWKUNANAW WEST",
"Ward 10 UGWUAJI",
"Ward 11 OBEAGU II",
"Ward 12 AKWUKE",
"Ward 13 MARYLAND"
]
};
const lgaSelect = document.getElementById("lga");
const wardSelect = document.getElementById("ward");
lgaSelect.addEventListener("change", function () {
const selectedLGA = lgaSelect.value;
// Clear current ward options
wardSelect.innerHTML = "<option value=''>Select your Ward *</option>";
// Populate the ward dropdown based on the selected LGA
if (selectedLGA in lgaWardMapping) {
const wards = lgaWardMapping[selectedLGA];
wards.forEach((ward) => {
const option = document.createElement("option");
option.value = ward;
option.textContent = ward;
wardSelect.appendChild(option);
});
}
});
</script>
<div class="col-md-12">
<textarea name="Pooling-unit" placeholder="What is your Pooling Unit, Describe where you vote during elections*" rows="4" required="required" class="form-control"></textarea>
</div>
<div class="col-md-12">
<textarea name="Bill-Motion" placeholder="Suggest a Bill/Motion" rows="4" class="form-control"></textarea>
</div>
<div class="col-md-12">
<textarea name="message" placeholder="Any Message for Me?" rows="4" required="required" class="form-control"></textarea>
</div>
<!-- picture upload -->
<div class="col-md-6">
<input type="file" name="Passport" accept=".jpg, .jpeg, .png, .gif" class="form-control" required>
<small class="form-text text-muted">Upload picture showing your face clearly (JPG, JPEG, PNG, GIF) *</small>
</div>
<div class="col-md-12 text-center">
<button type="submit" class="btn btn-outline-primary" id="submit">Send message</button>
</div>
</div>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</section>
<section>
<!-- Comment List Start -->
<div class="fb-comments" data-href="https://cyberbillafrica.github.io/honatunews" data-width="" data-numposts="3"></div>
</div>
</div>
</section>
<footer class="main-footer">
<div class="container">
<div class="col-lg-3 col-md-6">
<h3 style="color: red;">Constituency Office</h3>
<div class="text-white mt-4 d-flex flex-column contact-link">
<a hre="#" class="pb-3 text-light border-bottom border-primary"><i class="fas fa-map-marker-alt text-secondary me-2"></i> 75 Presidential Road, Enugu Nigeria</a>
<a hre="#" class="py-3 text-light border-bottom border-primary"><i class="fas fa-phone-alt text-secondary me-2"></i> +234 456 7890</a>
<a hre="#" class="py-3 text-light border-bottom border-primary"><i class="fas fa-envelope text-secondary me-2"></i> info@honatu.com</a>
</div>
</div>
</div>
<hr>
<div class="row">
<div class="col-md-6 text-center text-lg-left data-animate="fadeInUp">
<a href="https://www.facebook.com/profile.php?id=100090941446137&mibextid=ZbWKwL" class="btn-light nav-fill btn btn-square rounded-circle me-2"><i class="fab fa-facebook-f text-primary"></i></a>
<a href="https://x.com/chimaobisamAtu?t=OkaAETsEq7bt3oIMQ4hGMw&s=09" class="btn-light nav-fill btn btn-square rounded-circle me-2"><i class="fab fa-twitter text-primary"></i></a>
<a hre="" class="btn-light nav-fill btn btn-square rounded-circle me-2"><i class="fab fa-instagram text-primary"></i></a>
<a hre="" class="btn-light nav-fill btn btn-square rounded-circle me-0"><i class="fab fa-linkedin-in text-primary"></i></a>
</div>
</div>
<!--<hr>
<div class="row">
<div class="col-md-6 text-center text-lg-left">
<p class="social"><a href="https://www.facebook.com/" class="external facebook wow fadeInUp"><i class="fa fa-facebook"></i></a><a href="www.twitter.com" data-wow-delay="0.2s" class="external linkedin wow fadeInUp"><i class="fa fa-linkedin"></i></a><a href="https://www.linkedin.com/in/" data-wow-delay="0.4s" class="external gplus wow fadeInUp"><i class="fa fa-google-plus"></i></a><a href="https://mail.google.com/mail/u/?authuser=" data-wow-delay="0.6s" class="email wow fadeInUp"><i class="fa fa-envelope"></i></a></p>
</div>
</div>
<!-- Footer End -->
<div class="col-md-6 text-center text-lg-right mt-4 mt-lg-0">
<p>© 2023 Sam Atu. All rights reserved.</p>
</div>
<div class="col-md-6 text-center text-lg-right mt-4 mt-lg-0">
<span class="text-light">Designed By <a href="https://cyberbillafrica.github.io/portal/">CyberBill Africa 🌍</a></span>
</div>
</div>
</footer>
<!-- Back to Top -->
<a href="#top" class="btn btn-lg btn-lg-square rounded-circle back-to-top" style=" color: white; background-color: #3DCF60;"><i class="bi bi-arrow-up"></i></a>
<!-- JavaScript files-->
<script src="vendor/jquery/jquery.min.js"></script>
<script src="vendor/bootstrap/js/bootstrap.bundle.min.js"></script>
<script src="vendor/jquery.cookie/jquery.cookie.js"> </script>
<script src="vendor/owl.carousel/owl.carousel.min.js"></script>
<script src="vendor/waypoints/lib/jquery.waypoints.min.js"></script>
<script src="vendor/jquery.counterup/jquery.counterup.js"></script>
<script src="https://cdnjs.cloudflare.com/ajax/libs/leaflet/1.4.0/leaflet.js"> </script>
<script src="script.js"></script>
<script src="js/front.js"></script>
</body>
</html>