<?php
session_start();
if (!isset($_SESSION['email'])) {
header('Location: index.php');
}
$fecha = date("Y-m-d H:i:s");
?>
<!DOCTYPE HTML>
<html>
<head>
<title>ENCUESLAB</title>
<meta name="viewport" content="width=device-width, initial-scale=1">
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta name="keywords" content="Notable Feedback Form template Responsive, Login form web template,Flat Pricing tables,Flat Drop downs Sign up Web Templates,
Flat Web Templates, Login sign up Responsive web template, SmartPhone Compatible web template, free web designs for Nokia, Samsung, LG, SonyEricsson, Motorola web design">
<script type="application/x-javascript">
addEventListener("load", function () {
setTimeout(hideURLbar, 0);
}, false);
function hideURLbar() {
window.scrollTo(0, 1);
}
</script>
<link href="css/font-awesome.css" rel="stylesheet">
<link href="css/style-form.css" rel='stylesheet' type='text/css' />
<link rel="stylesheet" href="css/jquery-ui.css"/>
<link rel="stylesheet" href="css/font-awesome-form.css">
<link href="//fonts.googleapis.com/css?family=PT+Sans+Caption" rel="stylesheet">
<link href="//fonts.googleapis.com/css?family=Old+Standard+TT" rel="stylesheet">
<link href="https://fonts.googleapis.com/css?family=Amiri:400,400i,700,700i" rel="stylesheet">
<link href="//fonts.googleapis.com/css?family=Roboto:300,400,500,700" rel="stylesheet">
<link href="//fonts.googleapis.com/css?family=Montserrat:400,700" rel="stylesheet">
</head>
<body>
<div class="w3l-head">
<h1>Bienvenido</h1>
</div>
<div class="w3ls-form">
<form method="post" action="envia.php">
<div class="w3l-last-grid1">
<div class="w3l-grid1">
<label class="text">Nombre Completo</label>
<div class="w3l-div">
<i class="fa fa-user" aria-hidden="true"></i>
<input type="text" id="nombre" name="nombre" placeholder="Nombre Completo" required pattern="[a-zA-ZàáâäãåąčćęèéêëėįìíîïłńòóôöõøùúûüųūÿýżźñçčšžÀÁÂÄÃÅĄĆČĖĘÈÉÊËÌÍÎÏĮŁŃÒÓÔÖÕØÙÚÛÜŲŪŸÝŻŹÑßÇŒÆČŠŽ∂ð ,.'-]{2,48}">
</div>
</div>
<div class="w3l-grid2">
<label class="text">Fecha y Hora</label>
<div class="w3l-div">
<i class="fa fa-calendar" aria-hidden="true"></i>
<input type="text" name="fecha" placeholder="Fecha" required value="<?= $fecha; ?>" id="fecha
" readonly=”readonly”>
</div>
</div>
<div class="clear"></div>
</div>
<div class="w3l-last-grid1">
<div class="w3l-grid2">
<label class="text">Fecha de Cumpleaños</label>
<div class="w3l-div">
<i class="fa fa-calendar" aria-hidden="true"></i>
<input type="text" class="date" id="date" name="cumple" placeholder="0000-00-00" required maxlength="30" size="10">
</div>
</div>
<div class="w3l-grid1">
<label class="text">Email</label>
<div class="w3l-div">
<i class="fa fa-envelope-o"></i>
<input type="email" id="email" name="email" placeholder="e-mail" required pattern="^[a-zA-Z0-9.!#$%&’*+/=?^_'{|}~-]+@[a-zA-Z0-9-]+(?:\.[a-zA-Z0-9-]+)*$" title="Debe ingresar un correo por ejemplo [email protected]">
</div>
</div>
<div class="clear"></div>
</div>
<div class="w3l-last-grid1">
<div class="clear"></div>
</div>
<div class="w3l-right-grid1">
<div class="w3l-grid1">
<label class="text">Mesa</label>
<div class="w3l-div">
<i class="fa fa-book" aria-hidden="true"></i>
<input type="text" id="mesa" name="mesa" placeholder="Mesa" required pattern="[1-9]"/>
</div>
</div>
<label class="text">Nos recomendaria</label>
<div class="w3l-grid2">
<div class="w3l-div">
<i class="fa fa-book" aria-hidden="true"></i>
<select class="form-contro2" name="respuesta" id="respuesta" required>
<option>Selecciona opcion</option>
<option>SI</option>
<option>NO</option>
</select>
</div>
</div>
</div>
<div class="clear"></div>
<div class="w3ls-submit">
<input type="submit" value="Enviar" id="envia">
</div>
</form>
</div>
<footer>© 2018 ENCUESLAB. Todos los derechos reservados | Design by <a href="https://twitter.com/Jesus_A_Cruz21?lang=es"> Jesus Alejandro</a></footer>
<script type="text/javascript" src="js/jquery-2.1.4.min.js"></script>
<!-- Calendar -->
<script src="js/jquery-ui.js"></script>
</body>
</html>