Sites Pertecentes a (o) MG

298

<![CDATA[<fieldset> <div class="custom-control custom-checkbox"> <input type="checkbox" class="custom-control-input" name="anonimo" id="anonimo" value="1"> <label class="custom-control-label" for="anonimo"> Anônimo </label> </div> <div class="row"> <div class="col-xl-6 col-lg-6 col-md-6 col-sm-6 col-12"> <div class="form-group"> <label for="categoria">Categoria</label> <select class="form-control" id="categoria" aria-describedby="info" name="categoria"><option selected="selected" value="">Selecione</option><option value="1">Reclamação</option><option value="2">Denuncia</option><option value="3">Sugestão</option><option value="4">Elogio</option><option value="5">Outros</option></select> </div> </div> <div class="col-xl-6 col-lg-6 col-md-6 col-sm-6 col-12"> <div class="form-group"> <label for="setor">Setor</label> <select class="form-control" id="setor" aria-describedby="info" name="setor"><option selected="selected" value="">Selecione</option><option value="1">Administração</option><option value="2">Contabilidade</option><option value="3">CRAS/CREAS</option><option value="4">Cultura</option><option value="5">Educação</option><option value="6">Obras</option><option value="7">Recursos Humanos</option><option value="8">Saúde</option><option value="9">Tesouraria</option><option value="10">Transportes</option><option value="11">Tributos</option></select> </div> </div> </div> <div class="row" id="dados"> <div class="col-xl-8 col-lg-8 col-md-8 col-sm-6 col-12"> <div class="form-group"> <label for="nome">Nome</label> <input type="text" name="nome" class="form-control" id="nome"> </div> </div> <div class="col-xl-4 col-lg-4 col-md-4 col-sm-6 col-12"> <div class="form-group"> <label for="email">Email</label> <input type="email" name="email" class="form-control" id="email"> </div> </div> <div class="col-xl-3 col-lg-3 col-md-3 col-sm-6 col-12"> <div class="form-group"> <label for="sexo">Sexo</label> <select class="form-control" id="sexo" name="sexo"><option selected="selected" value="">Selecione</option><option value="1">Feminino</option><option value="2">Masculino</option><option value="3">Prefiro não informar</option></select> </div> </div> <div class="col-xl-4 col-lg-4 col-md-4 col-sm-4 col-12"> <div class="form-group"> <label for="escolaridade">Escolaridade</label> <select class="form-control" id="escolaridade" aria-describedby="info" name="escolaridade"><option selected="selected" value="">Selecione</option><option value="1">Analfabeto</option><option value="2">Ensino Fundamental incompleto</option><option value="3">Ensino Fundamental completo</option><option value="4">Ensino Médio completo</option><option value="5">Ensino Médio incompleto</option><option value="6">Superior completo (ou graduação)</option><option value="7">Pós-graduação</option><option value="8">Mestrado</option><option value="9">Doutorado</option><option value="10">Pós-Doutorado</option></select> </div> </div> <div class="col-xl-5 col-lg-5 col-md-5 col-sm-5 col-12"> <div class="form-group"> <label for="ocupacao">Ocupação </label> <input type="text" class="form-control" name="ocupacao" id="ocupacao" value=""> </div> </div> <div class="col-xl-6 col-lg-6 col-md-6 col-sm-6 col-12"> <div class="form-group"> <label for="telefone">Telefone</label> <input type="text" class="form-control" name="telefone" id="telefone"> </div> </div> <div class="col-xl-6 col-lg-6 col-md-6 col-sm-6 col-12"> <div class="form-group"> <label for="celular">Celular</label> <input type="text" class="form-control" id="celular" name="celular"> </div> </div> <div class="col-xl-4 col-lg-4 col-md-4 col-sm-4 col-12"> <div class="form-group"> <label for="cep">CEP </label> <input type="text" class="form-control" data-mask="00000-000" name="cep" id="cep" value=""> </div> </div> <div class="col-xl-8 col-lg-8 col-md-8 col-sm-8 col-12"> <div class="form-group"> <label for="rua">Rua </label> <input type="text" class="form-control" name="rua" id="rua" value=""> </div> </div> <div class="col-xl-3 col-lg-3 col-md-3 col-sm-4 col-12"> <div class="form-group"> <label for="numero">Número </label> <input type="text" class="form-control" name="numero" id="numero" value=""> </div> </div> <div class="col-xl-9 col-lg-9 col-md-9 col-sm-8 col-12"> <div class="form-group"> <label for="complemento">Complemento </label> <input type="text" class="form-control" name="complemento" id="complemento" value=""> </div> </div> <div class="col-xl-5 col-lg-5 col-md-5 col-sm-6 col-12"> <div class="form-group"> <label for="bairro">Bairro </label> <input type="text" class="form-control" name="bairro" id="bairro" value=""> </div> </div> <div class="col-xl-5 col-lg-5 col-md-5 col-sm-6 col-12"> <div class="form-group"> <label for="cidade">Cidade </label> <input type="text" class="form-control" name="cidade" id="cidade" value=""> </div> </div> <div class="col-xl-2 col-lg-2 col-md-2 col-sm-6 col-12"> <div class="form-group"> <label for="uf">Estado </label> <input type="text" class="form-control" name="estado" id="uf" maxlength="2" minlength="2" value=""> </div> </div> </div> <div class="row"> <div class="col-xl-12 col-lg-12 col-md-12 col-sm-12 col-12"> <div class="form-group"> <label for="mensagem">Mensagem</label> <textarea class="form-control" id="mensagem" name="solicitacao" required></textarea> </div> </div> <div data-sitekey="6Ld-Y6YUAAAAAOkvIXTjMiBZV5VmUR4mZf7laSRr" class="g-recaptcha"></div> <div class="col-xl-12 col-lg-12 col-md-12 col-sm-12 col-12"> <div class="form-group text-right"> <button type="submit" class="btn btn_solid">Enviar</button> </div> </div> </div> </fieldset>]]>