Beja – Theme Documentation

Contact form

Contact form

Here is the Contact Form 7 template and source code for the Contact form.

To edit this form go to Contact> then edit your targeted form

Beja contact form:

<div class="row">
	<div class="col-lg-6 col-md-6">
		<div class="form-group">
			[text* your-name class:form-control placeholder "Your Name"]
		</div>
	</div>

	<div class="col-lg-6 col-md-6">
		<div class="form-group">
			[email* your-email class:form-control placeholder "Your email address"]
		</div>
	</div>

	<div class="col-lg-6 col-md-6">
		<div class="form-group">
			[number* your-number class:form-control placeholder "Enter your number"]
		</div>
	</div>

	<div class="col-lg-6 col-md-6">
		<div class="form-group">
			[text* your-subject class:form-control placeholder "Your subject"]
		</div>
	</div>

	<div class="col-lg-12">
		<div class="form-group">
			[textarea your-message class:form-control rows:5 placeholder "Write your message..."]
		</div>
	</div>

	<div class="col-12">
		<div class="form-group">
			[acceptance  gdpr class:gdpr-term ] Accept <a href="http://localhost/wordpress/adlin/terms-conditions/">terms</a> and <a href="http://localhost/wordpress/adlin/privacy-policy/">privacy policy</a>.[/acceptance]
		</div>
	</div>

	<div class="col-lg-12 col-md-12 text-center">
		<button type="submit" class="default-btn">
			Send Message
		</button>
	</div>
</div>

Beja apply for credit card

<div class="container">
    <div class="loan-form">
        <h2 class="section-title mb-30">Personal information</h2>
        <div class="row pb-75">
            <div class="col-md-4">
                <div class="form-group">
                    <label>First name</label>
                    [text* first-name]
                </div>
            </div>
            <div class="col-md-4">
                <div class="form-group">
                    <label>Middle name</label>
                    [text middle-ame]
                </div>
            </div>
            <div class="col-md-4">
                <div class="form-group">
                    <label>Last name</label>
                    [text last-name]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Date of birth(DD/MM/YY)</label>
                    [date* birth]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>SS or individual TAX ID</label>
                    [number* tax-id]
                </div>
            </div>
            <div class="col-12">
                <div class="form-group">
                    <label>Are you a USA Citizen name</label>
                    <div class="select-option-type">
                        [radio usa-citizen default:1 "Yes" "No"]
                    </div>
                </div>
            </div>
        </div>
        <h2 class="section-title mb-30">Contact information</h2>
        <div class="row pb-75">
            <div class="col-md-6">
                <div class="form-group">
                    <label>Residential Address 1</label>
                    [text* residential-address1]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Residential Address 2(optional)</label>
                    [text residential-address2]
                </div>
            </div>
            <div class="col-md-4">
                <div class="form-group">
                    <label>ZIP code</label>
                    [number* zip]
                </div>
            </div>
            <div class="col-md-4">
                <div class="form-group">
                    <label>City</label>
                    [select* city "Florida" "New york"]
                </div>
            </div>
            <div class="col-md-4">
                <div class="form-group">
                    <label>Province</label>
                    [select* city "Florida" "New york"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Email address</label>
                    [email* email]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Telephone number</label>
                    [tel* tel]
                </div>
            </div>
        </div>
        <h2 class="section-title mb-30">Financial information</h2>
        <div class="row pb-75">
            <div class="col-md-6">
                <div class="form-group">
                    <label>Employment Status</label>
                    [select* employment-status "Govt job" "Private job" "Business"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Total annual income</label>
                    [number* annual-income]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Monthly mortgage or rental payment</label>
                    [number* monthly-rental-payment]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Do you have any bank account?</label>
                    [select* bank "Yes" "No"]
                </div>
            </div>
        </div>
        <h2 class="section-title mb-30">Additional information</h2>
        <div class="select-check_box">
            <div class="checkbox">
                [checkbox* term use_label_element "By clicking this checkbox, I agree to the above Card Terms and Conditions"]
            </div>
            <div class="checkbox">
                [checkbox* term2 use_label_element "By clicking this checkbox, I certify that I have read and consent Maecenas volutpat etiam sit in tincidunt pretium tempus. Tristique pretium quisque egestas sit in vivamus sed ut pretium. Condimentum leo luctus adipiscing porta aliquam est tristique. Viverra porttitor fames libero pellentesque. Est rhoncus eget nullam sem ipsum. Sed lorem sed massa viverra. Purus amet eget semper ut scelerisque lectus ipsum placerat. Convallis urna quis dictum pulvinar fringilla aliquam ut."]
            </div>
        </div>
        <p><b>Note: </b>You must check all boxes before submitting the application.</p>
        <button class="btn-one" type="submit">Agree &amp; Submit<svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="feather feather-arrow-right"><line x1="5" y1="12" x2="19" y2="12"></line><polyline points="12 5 19 12 12 19"></polyline></svg></button>
    </div>
</div>

Beja apply for mortgage

<div class="container ptb-100">
    <div class="row">
        <div class="col-xxl-6 offset-xl-3 col-xl-8 offset-xl-2">
            <div class="content-title text-center mb-40">
                <h2>Online mortgage application</h2>
                <p>When applying for a mortgage, the following information is commonly required. Here's a sample list of the information needed to complete a mortgage application form</p>
            </div>
        </div>
    </div>
    <h2 class="section-title mb-40">Request Type</h2>
    <div class="row pb-100 loan-form loan-form2">
        <div class="col-md-6 smb-20">
            <div class="checkbox">
                [checkbox test_2 "Mortgage application"]
            </div>
        </div>
        <div class="col-md-6">
            <h4 class="mb-25">I'm interested in</h4>
            <div class="select-request-type">
                [radio radio-group default:1 "Purchasing a new home"]
                [radio radio-group "Moving my mortgage to Bpox"]
                [radio radio-group "Refinancing my existing mortgage"]
                <div class="form-group">
                    <label class="mb-3">Down payment:(Minimum of 5%)</label>
                    [number down-payment-per]
                </div>
            </div>
        </div>
    </div>
    <h2 class="section-title mb-40">Personal information</h2>
    <div class="loan-form">
        <div class="row">
            <div class="col-md-4">
                <div class="form-group">
                    <label>Full name</label>
                    [text* full-name "Full name"]
                </div>
            </div>
            <div class="col-md-4">
                <div class="form-group">
                    <label>Date of Birth(MM/DD/YY)</label>
                    [date date-of-birth "Date of Birth(MM/DD/YY)"]
                </div>
            </div>
            <div class="col-md-4">
                <div class="form-group">
                    <label>Social Security Number</label>
                    [text* social-security-number "Social Security Number"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Marital status</label>
                    [select marital-status "Marital status" "Married" "Unmarried"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Home address</label>
                    [text home-address "Home address"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Unit (optional)</label>
                    [text unit "Unit (optional)"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>City</label>
                    [select city "City" "Florida" "New York"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Province</label>
                    [select province "Province" "Florida" "New York"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Postal code</label>
                    [number postal-code "Postal code"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Telephone number</label>
                    [number telephone-number "Telephone number"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Email address</label>
                    [email* email-address "Email address"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Gross annual household income</label>
                    [select gross-annual-household-income "Gross annual household income" "Select amount" "$2000" "$4000"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Down payment amount</label>
                    [select down-payment-amount "Down payment amount" "Select amount" "$2000" "$4000"]
                </div>
            </div>
            <div class="col-12">
                <div class="form-check checkbox">
                    [checkbox test_20 "I/we do hereby confirm that all information mentioned above is true."]
                </div>
            </div>
            <div class="col-12">
                <button class="btn-one" type="submit">Submit Now</button>
            </div>
        </div>
    </div>
</div>

Beja home banner form

<h4><i class="ri-refund-2-line"></i>Request fo a credit card</h4>
<div class="form-group">
    <label>Full Name</label>
    [text* your-name placeholder "Enter your name"]
</div>
<div class="form-group">
    <label>Email</label>
    [text* your-email placeholder "Enter your email"]
</div>
<div class="form-group">
    <label>Number</label>
    [number* your-number placeholder "Enter your number"]
</div>
<div class="form-group">
    <div class="d-flex flex-wrap justify-content-between">
        <p class="text-white">We will provide our regularly update to your mail</p>
    </div>
</div>
<button type="submit" class="btn-one d-block w-100">Apply Now</button>

Beja open account

<div class="container ptb-100">
    <h2 class="section-title text-center mb-40">Open a Beja acccount</h2>
    <div class="loan-form">
        <div class="row">
            <div class="col-md-4">
                <div class="form-group">
                    <label>First name</label>
                    [text* first-name]
                </div>
            </div>
            <div class="col-md-4">
                <div class="form-group">
                    <label>Middle name</label>
                    [text middle-name]
                </div>
            </div>
            <div class="col-md-4">
                <div class="form-group">
                    <label>Last name</label>
                    [text* last-name]
                </div>
            </div>
            <div class="col-12">
                <div class="form-group">
                    <label>Taxpayer ID</label>
                    <div class="select-taxpayer">
                        <div class="checkbox">
                            [radio radio-group default:1 "Social security number"]
                            [radio radio-group "Individual tax identification number"]
                        </div>
                    </div>
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>ID type</label>
                    [select id-type "Business" "Student"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>ID number</label>
                    [number id-number]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>State issue</label>
                    [select state-issue "Florida" "Los Angeles"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Expiration date</label>
                    [date expiration-date]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Date of birth</label>
                    [date date-of-birth]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Citizenship</label>
                    [select citizenship "Florida" "New York"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Email Address</label>
                    [email* email-address]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Phone Number</label>
                    [tel* phone-number]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Home address 01</label>
                    [text home-address-01]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Home address 02(optional)</label>
                    [text home-address-02]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>City</label>
                    [select city "Florida" "New York"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>State</label>
                    [select state "Florida" "New York"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Zip code</label>
                    [number zip-code]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Profession</label>
                    [text profession]
                </div>
            </div>
            <div class="col-12">
                <div class="form-check checkbox">
                    [checkbox* agree-terms "By clicking this checkbox, I agree to the all terms and conditions"]
                </div>
            </div>
            <div class="col-12">
                <button class="btn-one" type="submit">Open account</button>
            </div>
        </div>
    </div>
</div>

Beja personal loan apply:

<div class="container ptb-100">
    <h2 class="section-title text-center mb-40">Personal loan application form</h2>
    <div class="loan-form">
        <div class="row">
            <div class="col-md-6">
                <div class="form-group">
                    <label>First name</label>
                    [text* your-name]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Date of Birth(MM/DD/YY)</label>
                    [text* birthDate id:bddatepicker autocomplete:off]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Telephone number</label>
                    [number* your-number]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Email address</label>
                    [email* your-email]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Marital status</label>
                    [select* marital-status id:marital-status first_as_label "-- Select --" "Married" "Single"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Home address</label>
                    [text* your-homeadd]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>City</label>
                    [select* city id:city first_as_label "-- Select --" "Florida" "New york"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Postal code</label>
                    [number* your-postalcode]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Profession</label>
                    [text* your-profession]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Name of the organization</label>
                    [text* your-organization]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Monthly income</label>
                    [select* mincome id:mincome first_as_label "-- Select --" "$2000" "$4000"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Select your desired amount</label>
                    [select* amnt id:amnt first_as_label "-- Select --" "$3000" "$4000"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Loan tuner(Month)</label>
                    [select* loan id:loan first_as_label "-- Select --" "60 month" "60 month"]
                </div>
            </div>
            <div class="col-md-6">
                <div class="form-group">
                    <label>Total monthly installments of all existing loans</label>
                    [select* tomonth id:tomonth first_as_label "-- Select --" "60 month" "40 month" "30 month"]
                </div>
            </div>
            <div class="col-12">
                <div class="form-check checkbox">
                    <input class="form-check-input" type="checkbox" id="test_2">
                    <label class="form-check-label" for="test_2">
                        I/we do hereby confirm that all information mentioned above is true.
                    </label>
                </div>
            </div>

            <div class="col-12">
                <button class="btn-one" type="submit">Submit Now</button>
            </div>
        </div>
    </div>
</div>