<?php

/**
 * Created by PhpStorm.
 * User: xiaofeng
 * Date: 2018/3/6
 * Time: 下午5:49
 */
use backend\assets\AppAsset;
AppAsset::addScript($this,Yii::$app->request->baseUrl.'/js/other/mail.js')
?>
<style>
    .layui_w_t {margin:25px auto 0;width:70%;}
</style>

<form class="layui-form layui-form-pane" id="signupForm">
    <div class="layui_w_t">
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label"><span style="color:red">*</span>邮箱：</label>
                <div class="layui-input-block" style="width:270px;">
                    <!--                    id="EventDate"-->
                    <input type="text" name="email"  lay-verify="required"  placeholder="请输入邮箱" autocomplete="off" class="layui-input">
                </div>
            </div>
        </div>

        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label"><span style="color:red">*</span>区域：</label>
                <div class="layui-input-block imputSelect" style="width:270px;">
                    <select name="city" lay-search>
                        <option value="">请选择</option>
                        <?php foreach($city as $val){?>
                            <option value="<?php echo $val['id'] ?>"><?php echo $val['city_name']?></option>
                        <?php }?>
                    </select>
                </div>
            </div>
        </div>


        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label"><span style="color:red">*</span>邮箱所属人姓名：</label>
                <div class="layui-input-block" style="width:270px;">
                    <!--                    id="EventDate"-->
                    <input type="text" name="name"  lay-verify="required"  placeholder="请输入姓名" autocomplete="off" class="layui-input">
                </div>
            </div>
        </div>



        <div class="layui-form-item">
            <div class="layui-input-block xm_xcxqTc_tj" style="margin:20px 0 0 0;text-align:center;">
                <button class="layui-btn"  lay-submit="" lay-filter="email_tijiao">提交</button>
            </div>
        </div>
    </div>
</form>