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type="text" id="form_job_date" name="form[job_date]" required="required" class="form-control datepicker" placeholder="dd/mm/yy" value="20/04/2024" /> </div> <div class="col-sm-12"> <label for="inputEmail3" class="control-label">Job Category *</label> <div class="row"> <div class="col-sm-6"> <label class="checkbox-inline"> <input type="checkbox" id="form_job_categories_0" name="form[job_categories][]" value="Tiled Roofs" /> Tiled Roofs </label> <br> <label class="checkbox-inline"> <input type="checkbox" id="form_job_categories_2" name="form[job_categories][]" value="Slate Roofs" /> Slate Roofs </label> <br> <label class="checkbox-inline"> <input type="checkbox" id="form_job_categories_4" name="form[job_categories][]" value="Fascias, Soffits & Guttering" /> Fascias, Soffits & Guttering </label> <br> </div> <div class="col-sm-6"> <label class="checkbox-inline"> <input type="checkbox" id="form_job_categories_1" name="form[job_categories][]" value="Flat Roofs" /> Flat Roofs </label> <br> <label class="checkbox-inline"> <input type="checkbox" id="form_job_categories_3" name="form[job_categories][]" value="Guttering Repairs or Replacement" /> Guttering Repairs or Replacement </label> <br> <label class="checkbox-inline"> <input type="checkbox" id="form_job_categories_5" name="form[job_categories][]" value="Roofing Services" /> Roofing Services </label> <br> </div> </div> </div> </div> <div class="form-group"> <div class="col-sm-12"> <textarea id="form_job_description" name="form[job_description]" required="required" class="form-control" rows="3" placeholder="Please enter the job description" minlength="20"></textarea> </div> </div> <div class="center-block"> <div class="g-recaptcha" data-sitekey="6LfVOBUTAAAAANuA1WqMKBYBbS7dC8DwbgINIWnn" data-stoken="NfcxFmvpu_egcJ_z5mr1rhlDuXK6mlNPlAjVfaH7YbJXwojD_PaFU2-u1XMGX6U0Fny-HYC0A9P8QmJo4tijOA"></div> <button type="submit" id="form_submit" name="form[submit]" class="btn btn-default btn-submit">Submit</button> </div> <div class="row_contact_job_related"> <div class="form-group col-sm-12"> <input type="text" id="form_job_related" name="form[job_related]" class="form-control" placeholder="Job Related" autocomplete="off" /> </div> </div> </div> </div> </div> </form> </div> </div> </div> </section> <section class="contact_innaerpage_bottom"> <div class="container"> <div class="row"> <div class="col-sm-4"> <div class="cbbbox"> <div class="addr_icon"> <i class="fa fa-map-marker fa-3x color-white"></i> </div> <div class="addrs_info"> <p>Unit 13, Industry Rd,</p> <p>Carlton Industrial Estate, Barnsley, S71 3PQ</p> </div> </div> </div> <div class="col-sm-5"> <div class="cbbbox "> <div class="addr_icon"> <i class="fa fa-envelope fa-3x color-white"></i> </div> <div class="addrs_info"> <p> <a href="mailto:info@bprroofing.co.uk">info@bprroofing.co.uk</a> </p> </div> </div> </div> <div class="col-sm-3"> <div class="cbbbox "> <div class="addr_icon"> <i class="fa fa-phone fa-3x color-white"></i> </div> <div 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