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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta http-equiv="X-UA-Compatible" content="ie=edge">
<title>Форма обратной связи</title>
<link rel="stylesheet" href="./css/form.css">
</head>
<body>
<h1>Форма обратной связи</h1>
<form class="contentform" novalidate>
<fieldset>
<label class="form-group">
<p>Фамилия <span>*</span></p>
<span class="icon-case"><i class="fa fa-male"></i></span>
<input type="text" name="lastname">
</label>
<label class="form-group">
<p>Имя <span>*</span></p>
<span class="icon-case"><i class="fa fa-user"></i></span>
<input type="text" name="name">
</label>
<label class="form-group">
<p>Электронная почта <span>*</span></p>
<span class="icon-case"><i class="fa fa-envelope-o"></i></span>
<input type="email" name="email">
</label>
<label class="form-group">
<p>Компания <span>*</span></p>
<span class="icon-case"><i class="fa fa-home"></i></span>
<input type="text" name="company">
</label>
<label class="form-group">
<p>Адрес офиса <span>*</span></p>
<span class="icon-case"><i class="fa fa-location-arrow"></i></span>
<input type="text" name="address">
</label>
<label class="form-group">
<p>Почтовый индекс <span>*</span></p>
<span class="icon-case"><i class="fa fa-map-marker"></i></span>
<input type="text" name="zip">
</label>
</fieldset>
<fieldset>
<label class="form-group">
<p>Город <span>*</span></p>
<span class="icon-case"><i class="fa fa-building-o"></i></span>
<input type="text" name="city">
</label>
<label class="form-group">
<p>Номер телефона <span>*</span></p>
<span class="icon-case"><i class="fa fa-phone"></i></span>
<input type="tel" name="phone">
</label>
<label class="form-group">
<p>Специализация <span>*</span></p>
<span class="icon-case"><i class="fa fa-info"></i></span>
<input type="text" name="role">
</label>
<label class="form-group">
<p>Тема сообщения <span>*</span></p>
<span class="icon-case"><i class="fa fa-comment-o"></i></span>
<input type="text" name="subject">
</label>
<label class="form-group">
<p>Сообщение <span>*</span></p>
<span class="icon-case"><i class="fa fa-comments-o"></i></span>
<textarea name="message" rows="14"></textarea>
</label>
</fieldset>
<button type="submit" class="button-contact" disabled>Отправить сообщение</button>
</form>
<main class="hidden" id="output">
<h2>Ваше сообщение</h2>
<p>Привет, меня зовут <output id="name"></output> <output id="lastname"></output>. Я представляю компанию <output id="company"></output>. Специализация нашей компании — <output id="role"></output>.</p>
<p>Наш адрес:</p>
<address><output id="zip"></output>, город <output id="city"></output>, <output id="address"></output></address>
<h3><output id="subject"></output></h3>
<p><output id="message"></output></p>
<button class="button-contact">Изменить сообщение</button>
</main>
<script src="https://use.fontawesome.com/70378a66b8.js"></script>
</body>
</html>