<form action="" class="floating-labels animate-floating-labels" name="contact_form" method="post"> <div class="fieldset"> <div class="field"> <div class="field__input-wrapper"> <label class="field__label" for="email">Email *</label> <input autocomplete="off" class="field__input" id="email" name="" pattern="[a-zA-Z0-9.-_]{1,}@[a-zA-Z.-]{2,}[.]{1}[a-zA-Z]{2,}" required="" type="text" value=""> </div> </div> <div class="field"> <div class="field__input-wrapper"> <label class="field__label" for="billingName">Họ và tên *</label> <input autocomplete="off" class="field__input" id="billingName" minlength="2" name="" required="" type="text" value=""> </div> </div> <div class="field"> <div class="field__input-wrapper"> <label class="field__label" for="billingPhone">Số điện thoại (tùy chọn)</label> <input autocomplete="off" class="field__input" id="billingPhone" name="" type="text" value=""> </div> </div> <div class="field"> <div class="field__input-wrapper"> <label class="field__label" for="billingAddress">Địa chỉ *</label> <input autocomplete="off" class="field__input" id="billingAddress" minlength="10" name="" required="" type="text" value=""> </div> </div> <div class="field field--show-floating-label"> <div class="field__input-wrapper field__input-wrapper--select2"> <label class="field__label" for="billingProvince">Tỉnh thành *</label> <select aria-hidden="true" class="field__input field__input--select" data-address-type="province" data-address-zone="billing" id="billingProvince" name="billingProvince" required="" type="text"> <option hidden="" value="">---</option> </select> <input id="address_1" name="" type="hidden" value=""> </div> </div> <div class="field field--show-floating-label"> <div class="field__input-wrapper field__input-wrapper--select2"> <label class="field__label" for="billingDistrict">Quận huyện *</label> <select aria-hidden="true" class="field__input field__input--select " data-address-type="district" data-address-zone="billing" id="billingDistrict" name="billingDistrict" required="" type="text"> <option hidden="" value="">---</option> </select> <input id="address_2" name="" type="hidden" value=""> </div> </div> <div class="field field--show-floating-label"> <div class="field__input-wrapper field__input-wrapper--select2"> <label class="field__label" for="billingWard">Phường xã *</label> <select aria-hidden="true" class="field__input field__input--select" data-address-type="ward" data-address-zone="billing" id="billingWard" name="billingWard" required="" type="text"> <option hidden="" value="">---</option> </select> <input id="address_3" name="" type="hidden" value=""> </div> </div> <div class="field"> <div class="field__input-wrapper"> <label class="field__label" for="billingCompany">Tên công ty (tùy chọn)</label> <input autocomplete="off" class="field__input" id="billingCompany" name="" type="text" value=""> </div> </div> <div class="field"> <div class="field__input-wrapper"> <label class="field__label" for="billingTax">Mã số thuế (tùy chọn)</label> <input autocomplete="off" class="field__input" id="billingTax" name="" type="text" value=""> </div> </div> <div class="field"> <div class="field__input-wrapper"> <label class="field__label" for="note">Nội dung *</label> <textarea autocomplete="off" class="field__input" id="note" minlength="15" name="" required="" type="text"></textarea> </div> </div> <div class="field"><button class="btn has-hover" type="submit">GỬI</button></div> </div> <div class="background-overlay hidden"></div></form><iframe class="hidden" name="hidden_iframe" width="0" height="0"></iframe>