<?php $__env->startSection('title'); ?> <?php echo e(lang('Booking on request','Booking on request')); ?> 
<?php $__env->stopSection(); ?>
<?php $__env->startSection('content'); ?> 
<script src="https://ajax.aspnetcdn.com/ajax/jquery.validate/1.9/jquery.validate.min.js" type="text/javascript"></script>
<section id="main">
  <div class="contact-form rooms-detail">
    <header data-animatedtop="" data-animatedbottom="" data-animatedx="" class="partial-banner " data-timeweather=""> <img src='<?php echo e(@$bannerRow->link); ?>'> </header>
    <div style="margin-left: 103.5px; margin-right: 0px; width: 1479.5px;" class="fixed-left-sidebar-layout site-width">
      <nav class="partial-left_navigation sidebar">
        <?php echo $__env->make('frontend.include.left', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
      </nav>
      <article style="min-height: 793px;" class="content booking-reservation">
        <header>
			<div id="">
			          <div class="partial-share"> <span class="share-title">Share</span>
            <ul class="item-set">
              <li class="item email"> <a href="mailto:info@hanoilasiestahotel.com" title="Email"></a> </li>
              <li class="item facebook"> <a href="javascript:window.open('https://www.facebook.com/sharer/sharer.php?u=http://hanoilasiestahotel.com/booking-on-request.htm','','width=626,height=436,resizable=yes,scrollbars=yes');void(0);" title="Facebook"></a> </li>
              <li class="item twitter"> <a href="javascript:window.open('http://twitter.com/intent/tweet?text=text&amp;url=http://hanoilasiestahotel.com/booking-on-request.htm','','width=767,height=438,resizable=yes,scrollbars=yes');void(0);" title="Twitter"></a> </li>
              <li class="item pinterest"> <a href="javascript:window.open('http://pinterest.com/pin/create/button/?url=http://hanoilasiestahotel.com/booking-on-request.htm&amp;media=&amp;description=','','width=767,height=334,resizable=yes,scrollbars=yes');void(0);" title="Pinterest"></a> </li>
            </ul>
          </div>
          <h1 class="content-title multiline"> <span class="subhead">Hanoi La Siesta Hotel</span> Booking on request </h1>
			
			</div>

        </header>
		  <div id="">
		  <form method="post" id="validateForm" style="margin-bottom: 40px;">
			  <?php echo e(Helper::form('booking')); ?>

		   <section class="guest-information">
			  
          <div class="off-color login-cta">
            <div class="richtext">
              <p>Mandatory fields are marked as "*", but by providing more information it will allow us to better address your needs.</p>
            </div>
          </div>
          <div class="columns columns-7" style="padding-bottom:20px;">
            <fieldset class="column top-label columns-half first-row first-column room room-info">
              <ul class="dates">
                <li>
                  <label>Check in:*<span id="mscheckIn" style="color:red"></span></label>
                  <input id="checkIn" value="17/04/2019" placeholder="DD/MM/YYYY" class="check-in mdp-input undefined-hasValue mdp-hasValue" name="checkIn" type="text">
                </li>
                <li>
                  <label>Check out:*<span id="mscheckOut" style="color:red"></span></label>
                  <input id="checkOut" value="18/04/2019" placeholder="DD/MM/YYYY" class="check-in mdp-input undefined-hasValue mdp-hasValue" name="checkOut" type="text">
                </li>
              </ul>
            </fieldset>
            <fieldset class="column columns-half top-label first-row">
              <ul>
                <li>
                  <label>Adults:*<span id="msadults" style="color:red"></span></label>
                  <input id="adults" autocomplete="off" class="ember-view ember-text-field englishOnly" maxlength="50" name="adults" type="text" value="1">
                </li>
                <li>
                  <label>Children:*<span id="mschildren" style="color:red"></span></label>
                  <input id="children" autocomplete="off" class="ember-view ember-text-field mobileNumber" maxlength="50" name="children" type="text" value="0">
                </li>
              </ul>
            </fieldset>
          </div>
          <div class="columns mobile-tabel" style="padding-bottom:20px;">
            <table id='roomlistrate' style='width: 100%; border-collapse: collapse;' border='1' cellspacing='0' cellpadding='10' class='roomlist'>
              <thead>
                <tr>
                  <th class='title' rowspan='2' style='text-align: left; vertical-align:middle; width:25%; font-weight:bold;'>Room type</th>
                  <th class='title' colspan='5' style='text-align: center; vertical-align:central; font-weight:bold;'>Number of Room</th>
                </tr>
                <tr>
                  <th style='text-align: center; width: 15%;font-weight:bold;'>1 person</th>
                  <th style='text-align: center; width: 15%;font-weight:bold;'>2 people</th>
                  <th style='text-align: center; width: 15%;font-weight:bold;'>3 people</th>
                  <th style='text-align: center; width: 15%;font-weight:bold;'>4 people</th>
                  <th style='text-align: center; width: 15%;font-weight:bold;'>5 people</th>
                </tr>
              </thead>
              <tbody>
                <tr class='listroom'>
                  <td><a class='roomName' href='#' title='Superior Double or Twin' style='font-weight:bold;'>Superior room</a></td>
                  <td style='vertical-align: middle;text-align: center;'><select id='single1' name='single1' class='selectedSingleCabin' style='width:auto; margin:0;'>
                      <option value='0'>No.Room</option>
                      <option value='1'>1</option>
                      <option value='2'>2</option>
                      <option value='3'>3</option>
                      <option value='4'>4</option>
                      <option value='5'>5</option>
                    </select></td>
                  <td style='vertical-align: middle;text-align: center;'><select id='double1' name='double1' class='selectedDoubleCabin' style='width:auto; margin:0;'>
                      <option value='0'>No.Room</option>
                      <option value='1'>1</option>
                      <option value='2'>2</option>
                      <option value='3'>3</option>
                      <option value='4'>4</option>
                      <option value='5'>5</option>
                    </select></td>
                  <td style='vertical-align: middle;text-align: center;'> N/A</td>
                  <td style='vertical-align: middle;text-align: center;'> N/A</td>
                  <td style='vertical-align: middle;text-align: center;'> N/A</td>
                </tr>
                <tr class='listroom'>
                  <td><a class='roomName' href='#' title='Deluxe Double or Twin' style='font-weight:bold;'>Deluxe room</a></td>
                  <td style='vertical-align: middle;text-align: center;'><select id='single2' name='single2' class='selectedSingleCabin' style='width:auto; margin:0;'>
                      <option value='0'>No.Room</option>
                      <option value='1'>1</option>
                      <option value='2'>2</option>
                      <option value='3'>3</option>
                      <option value='4'>4</option>
                      <option value='5'>5</option>
                    </select></td>
                  <td style='vertical-align: middle;text-align: center;'><select id='double2' name='double2' class='selectedDoubleCabin' style='width:auto; margin:0;'>
                      <option value='0'>No.Room</option>
                      <option value='1'>1</option>
                      <option value='2'>2</option>
                      <option value='3'>3</option>
                      <option value='4'>4</option>
                      <option value='5'>5</option>
                    </select></td>
                  <td style='vertical-align: middle;text-align: center;'> N/A</td>
                  <td style='vertical-align: middle;text-align: center;'> N/A</td>
                  <td style='vertical-align: middle;text-align: center;'> N/A</td>
                </tr>
                <tr class='listroom'>
                  <td><a class='roomName' href='#' title='Deluxe Triple' style='font-weight:bold;'>Executive room</a></td>
                  <td style='vertical-align: middle;text-align: center;'><select id='single3' name='single3' class='selectedSingleCabin' style='width:auto; margin:0;'>
                      <option value='0'>No.Room</option>
                      <option value='1'>1</option>
                      <option value='2'>2</option>
                      <option value='3'>3</option>
                      <option value='4'>4</option>
                      <option value='5'>5</option>
                    </select></td>
                  <td style='vertical-align: middle;text-align: center;'><select id='double3' name='double3' class='selectedDoubleCabin' style='width:auto; margin:0;'>
                      <option value='0'>No.Room</option>
                      <option value='1'>1</option>
                      <option value='2'>2</option>
                      <option value='3'>3</option>
                      <option value='4'>4</option>
                      <option value='5'>5</option>
                    </select></td>
                  <td style='vertical-align: middle;text-align: center;'><select id='twin3' name='twin3' class='selectedTwinCabin' style='width:auto; margin:0;'>
                      <option value='0'>No.Room</option>
                      <option value='1'>1</option>
                      <option value='2'>2</option>
                      <option value='3'>3</option>
                      <option value='4'>4</option>
                      <option value='5'>5</option>
                    </select></td>
                  <td style='vertical-align: middle;text-align: center;'> N/A</td>
                  <td style='vertical-align: middle;text-align: center;'> N/A</td>
                </tr>
                
              </tbody>
            </table>
          </div>
          <div class="columns columns-7" style="margin-bottom:20px; border-bottom:1px solid #e5e2db; padding-bottom:20px;">
            <fieldset class="column columns-half top-label first-row first-column">
              <legend>Your Information:</legend>
              <ul>
                <li>
                  <label>Title:*<span id="msTitle" style="color:red"></span></label>
                  <select id="title" name="title" class="ember-view ember-select">
                    <option selected="selected" class="ember-view" value="Mr">Mr</option>
                    <option class="ember-view" value="Ms">Ms</option>
                    <option class="ember-view" value="Mrs">Mrs</option>
                    <option class="ember-view" value="Dr">Dr</option>
                  </select>
                </li>
                <li>
                  <label>First Name:*<span id="msFirstName" style="color:red"></span></label>
                  <input id="firstName" autocomplete="off" class="ember-view ember-text-field englishOnly" maxlength="40" name="firstName" type="text">
                </li>
                <li>
                  <label>Last Name:*<span id="msLastName" style="color:red"></span></label>
                  <input id="lastName" autocomplete="off" class="ember-view ember-text-field englishOnly" maxlength="40" name="lastName" type="text">
                </li>
                <li>
                  <label>Email:*<span id="msEmail" style="color:red"></span></label>
                  <input id="email" autocomplete="off" class="ember-view ember-text-field englishOnly" maxlength="50" name="email" type="text">
                </li>
                <li>
                  <label>Phone:*<span id="msPhone" style="color:red"></span></label>
                  <input id="phone" autocomplete="off" class="ember-view ember-text-field mobileNumber" maxlength="50" name="phone" type="text">
                </li>
                <li>
                  <label>Country of Residence:*<span id="msCountry" style="color:red"></span></label>
                  <select id="country" name="country" class="ember-view ember-select countryRequired">
                    <option selected="selected" value="">Please Select</option>
                    <option class="ember-view" value="Afghanistan">Afghanistan</option>
                    <option class="ember-view" value="Aland Islands">Aland Islands</option>
                    <option class="ember-view" value="Albania">Albania</option>
                    <option class="ember-view" value="Algeria">Algeria</option>
                    <option class="ember-view" value="American Samoa">American Samoa</option>
                    <option class="ember-view" value="Andorra">Andorra</option>
                    <option class="ember-view" value="Angola">Angola</option>
                    <option class="ember-view" value="Anguilla/St Kitts">Anguilla/St Kitts</option>
                    <option class="ember-view" value="Antarctica">Antarctica</option>
                    <option class="ember-view" value="Antigua and Barbuda">Antigua and Barbuda</option>
                    <option class="ember-view" value="Argentina">Argentina</option>
                    <option class="ember-view" value="Armenia">Armenia</option>
                    <option class="ember-view" value="Aruba">Aruba</option>
                    <option class="ember-view" value="Australia">Australia</option>
                    <option class="ember-view" value="Austria">Austria</option>
                    <option class="ember-view" value="Azerbaijan">Azerbaijan</option>
                    <option class="ember-view" value="Bahamas">Bahamas</option>
                    <option class="ember-view" value="Bahrain">Bahrain</option>
                    <option class="ember-view" value="Bangladesh">Bangladesh</option>
                    <option class="ember-view" value="Barbados">Barbados</option>
                    <option class="ember-view" value="Belarus">Belarus</option>
                    <option class="ember-view" value="Belgium">Belgium</option>
                    <option class="ember-view" value="Belize">Belize</option>
                    <option class="ember-view" value="Benin">Benin</option>
                    <option class="ember-view" value="Bermuda">Bermuda</option>
                    <option class="ember-view" value="Bhutan">Bhutan</option>
                    <option class="ember-view" value="Bolivia">Bolivia</option>
                    <option class="ember-view" value="Bonaire,Saba,St Eustatius">Bonaire,Saba,St Eustatius</option>
                    <option class="ember-view" value="Bosnia And Herzegovina">Bosnia And Herzegovina</option>
                    <option class="ember-view" value="Botswana">Botswana</option>
                    <option class="ember-view" value="Bouvet Island">Bouvet Island</option>
                    <option class="ember-view" value="Brazil">Brazil</option>
                    <option class="ember-view" value="British Indian Ocean Territory">British Indian Ocean Territory</option>
                    <option class="ember-view" value="Brunei Darussalam">Brunei Darussalam</option>
                    <option class="ember-view" value="Bulgaria">Bulgaria</option>
                    <option class="ember-view" value="Burkina Fasa">Burkina Fasa</option>
                    <option class="ember-view" value="Burundi">Burundi</option>
                    <option class="ember-view" value="Cambodia">Cambodia</option>
                    <option class="ember-view" value="Cameroon">Cameroon</option>
                    <option class="ember-view" value="Canada">Canada</option>
                    <option class="ember-view" value="Cape Verde">Cape Verde</option>
                    <option class="ember-view" value="Cayman Islands">Cayman Islands</option>
                    <option class="ember-view" value="Central African Republic">Central African Republic</option>
                    <option class="ember-view" value="Chad">Chad</option>
                    <option class="ember-view" value="Chile">Chile</option>
                    <option class="ember-view" value="China">China</option>
                    <option class="ember-view" value="Christmas Island">Christmas Island</option>
                    <option class="ember-view" value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
                    <option class="ember-view" value="Colombia">Colombia</option>
                    <option class="ember-view" value="Comoros">Comoros</option>
                    <option class="ember-view" value="Congo">Congo</option>
                    <option class="ember-view" value="Congo, The Democratic Republic of the">Congo, The Democratic Republic of the</option>
                    <option class="ember-view" value="Cook Island">Cook Island</option>
                    <option class="ember-view" value="Costa Rica">Costa Rica</option>
                    <option class="ember-view" value="Cote D'Ivoire">Cote D'Ivoire</option>
                    <option class="ember-view" value="Croatia">Croatia</option>
                    <option class="ember-view" value="Cuba">Cuba</option>
                    <option class="ember-view" value="Curacao">Curacao</option>
                    <option class="ember-view" value="Cyprus">Cyprus</option>
                    <option class="ember-view" value="Czech Republic">Czech Republic</option>
                    <option class="ember-view" value="Denmark">Denmark</option>
                    <option class="ember-view" value="Djibouti">Djibouti</option>
                    <option class="ember-view" value="Dominica">Dominica</option>
                    <option class="ember-view" value="Dominican Republic">Dominican Republic</option>
                    <option class="ember-view" value="Ecuador">Ecuador</option>
                    <option class="ember-view" value="Egypt">Egypt</option>
                    <option class="ember-view" value="El Salvador">El Salvador</option>
                    <option class="ember-view" value="Equatorial Guinea">Equatorial Guinea</option>
                    <option class="ember-view" value="Eritrea">Eritrea</option>
                    <option class="ember-view" value="Estonia">Estonia</option>
                    <option class="ember-view" value="Ethiopia">Ethiopia</option>
                    <option class="ember-view" value="Falkland Islands">Falkland Islands</option>
                    <option class="ember-view" value="Faroe Islands">Faroe Islands</option>
                    <option class="ember-view" value="Fiji">Fiji</option>
                    <option class="ember-view" value="Finland">Finland</option>
                    <option class="ember-view" value="France">France</option>
                    <option class="ember-view" value="French Guiana">French Guiana</option>
                    <option class="ember-view" value="French Polynesia">French Polynesia</option>
                    <option class="ember-view" value="French Souther Territories">French Souther Territories</option>
                    <option class="ember-view" value="Gabon">Gabon</option>
                    <option class="ember-view" value="Gambia">Gambia</option>
                    <option class="ember-view" value="Georgia">Georgia</option>
                    <option class="ember-view" value="Germany">Germany</option>
                    <option class="ember-view" value="Ghana">Ghana</option>
                    <option class="ember-view" value="Gibraltar">Gibraltar</option>
                    <option class="ember-view" value="Greece">Greece</option>
                    <option class="ember-view" value="Greenland">Greenland</option>
                    <option class="ember-view" value="Grenada">Grenada</option>
                    <option class="ember-view" value="Guadeloupe">Guadeloupe</option>
                    <option class="ember-view" value="Guam">Guam</option>
                    <option class="ember-view" value="Guatemala">Guatemala</option>
                    <option class="ember-view" value="Guernsey">Guernsey</option>
                    <option class="ember-view" value="Guinea">Guinea</option>
                    <option class="ember-view" value="Guinea Bissau">Guinea Bissau</option>
                    <option class="ember-view" value="Guyana">Guyana</option>
                    <option class="ember-view" value="Haiti">Haiti</option>
                    <option class="ember-view" value="Heard Island and McDonald Islands">Heard Island and McDonald Islands</option>
                    <option class="ember-view" value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
                    <option class="ember-view" value="Honduras">Honduras</option>
                    <option class="ember-view" value="Hong Kong">Hong Kong</option>
                    <option class="ember-view" value="Hungary">Hungary</option>
                    <option class="ember-view" value="Iceland">Iceland</option>
                    <option class="ember-view" value="India">India</option>
                    <option class="ember-view" value="Indonesia">Indonesia</option>
                    <option class="ember-view" value="Iran, Islamic Republic of">Iran, Islamic Republic of</option>
                    <option class="ember-view" value="Iraq">Iraq</option>
                    <option class="ember-view" value="Ireland">Ireland</option>
                    <option class="ember-view" value="Isle Of Man">Isle Of Man</option>
                    <option class="ember-view" value="Israel">Israel</option>
                    <option class="ember-view" value="Italy">Italy</option>
                    <option class="ember-view" value="Jamaica">Jamaica</option>
                    <option class="ember-view" value="Japan">Japan</option>
                    <option class="ember-view" value="Jersey">Jersey</option>
                    <option class="ember-view" value="Jordan">Jordan</option>
                    <option class="ember-view" value="Kazakhstan">Kazakhstan</option>
                    <option class="ember-view" value="Kenya">Kenya</option>
                    <option class="ember-view" value="Kiribati">Kiribati</option>
                    <option class="ember-view" value="Korea, Republic Of">Korea, Republic Of</option>
                    <option class="ember-view" value="Korea,Democratic People's Republic of">Korea,Democratic People's Republic of</option>
                    <option class="ember-view" value="Kuwait">Kuwait</option>
                    <option class="ember-view" value="Kyrgzstan">Kyrgzstan</option>
                    <option class="ember-view" value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
                    <option class="ember-view" value="Latvia">Latvia</option>
                    <option class="ember-view" value="Lebanon">Lebanon</option>
                    <option class="ember-view" value="Lesotho">Lesotho</option>
                    <option class="ember-view" value="Liberia">Liberia</option>
                    <option class="ember-view" value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
                    <option class="ember-view" value="Liechtenstein">Liechtenstein</option>
                    <option class="ember-view" value="Lithuania">Lithuania</option>
                    <option class="ember-view" value="Luxembourg">Luxembourg</option>
                    <option class="ember-view" value="Macao">Macao</option>
                    <option class="ember-view" value="Macedonia">Macedonia</option>
                    <option class="ember-view" value="Madagascar">Madagascar</option>
                    <option class="ember-view" value="Malawi">Malawi</option>
                    <option class="ember-view" value="Malaysia">Malaysia</option>
                    <option class="ember-view" value="Maldives">Maldives</option>
                    <option class="ember-view" value="Mali">Mali</option>
                    <option class="ember-view" value="Malta">Malta</option>
                    <option class="ember-view" value="Marshall Islands">Marshall Islands</option>
                    <option class="ember-view" value="Martinique">Martinique</option>
                    <option class="ember-view" value="Mauritania">Mauritania</option>
                    <option class="ember-view" value="Mauritius">Mauritius</option>
                    <option class="ember-view" value="Mayotte">Mayotte</option>
                    <option class="ember-view" value="Mexico">Mexico</option>
                    <option class="ember-view" value="Micronesia, Federated States of">Micronesia, Federated States of</option>
                    <option class="ember-view" value="Moldova, Republic of">Moldova, Republic of</option>
                    <option class="ember-view" value="Monaco">Monaco</option>
                    <option class="ember-view" value="Mongolia">Mongolia</option>
                    <option class="ember-view" value="Montenegro">Montenegro</option>
                    <option class="ember-view" value="Montserrat">Montserrat</option>
                    <option class="ember-view" value="Morocco">Morocco</option>
                    <option class="ember-view" value="Mozambique">Mozambique</option>
                    <option class="ember-view" value="Myanmar">Myanmar</option>
                    <option class="ember-view" value="Namibia">Namibia</option>
                    <option class="ember-view" value="Nauru">Nauru</option>
                    <option class="ember-view" value="Nepal">Nepal</option>
                    <option class="ember-view" value="Netherlands">Netherlands</option>
                    <option class="ember-view" value="Netherlands Antilles">Netherlands Antilles</option>
                    <option class="ember-view" value="New Caledonia">New Caledonia</option>
                    <option class="ember-view" value="New Zealand">New Zealand</option>
                    <option class="ember-view" value="Nicaragua">Nicaragua</option>
                    <option class="ember-view" value="Niger">Niger</option>
                    <option class="ember-view" value="Nigeria">Nigeria</option>
                    <option class="ember-view" value="Niue">Niue</option>
                    <option class="ember-view" value="Norfolk Island">Norfolk Island</option>
                    <option class="ember-view" value="Northern Mariana Islands">Northern Mariana Islands</option>
                    <option class="ember-view" value="Norway">Norway</option>
                    <option class="ember-view" value="Oman">Oman</option>
                    <option class="ember-view" value="Pakistan">Pakistan</option>
                    <option class="ember-view" value="Palau">Palau</option>
                    <option class="ember-view" value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
                    <option class="ember-view" value="Panama">Panama</option>
                    <option class="ember-view" value="Papua New Guinea">Papua New Guinea</option>
                    <option class="ember-view" value="Paraguay">Paraguay</option>
                    <option class="ember-view" value="Peru">Peru</option>
                    <option class="ember-view" value="Philippines">Philippines</option>
                    <option class="ember-view" value="Pitcairn">Pitcairn</option>
                    <option class="ember-view" value="Poland">Poland</option>
                    <option class="ember-view" value="Portugal">Portugal</option>
                    <option class="ember-view" value="Puerto Rico">Puerto Rico</option>
                    <option class="ember-view" value="Qatar">Qatar</option>
                    <option class="ember-view" value="Reunion">Reunion</option>
                    <option class="ember-view" value="Romania">Romania</option>
                    <option class="ember-view" value="Russia">Russia</option>
                    <option class="ember-view" value="Rwanda">Rwanda</option>
                    <option class="ember-view" value="Saint BarthÃ©lemy">Saint BarthÃ©lemy</option>
                    <option class="ember-view" value="Saint Helena">Saint Helena</option>
                    <option class="ember-view" value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
                    <option class="ember-view" value="Saint Lucia">Saint Lucia</option>
                    <option class="ember-view" value="Saint Martin">Saint Martin</option>
                    <option class="ember-view" value="Saint Pierre And Miquelon">Saint Pierre And Miquelon</option>
                    <option class="ember-view" value="Saint Vincent And The Grenadines">Saint Vincent And The Grenadines</option>
                    <option class="ember-view" value="Samoa">Samoa</option>
                    <option class="ember-view" value="San Marino">San Marino</option>
                    <option class="ember-view" value="Sao Tome and Principe">Sao Tome and Principe</option>
                    <option class="ember-view" value="Saudi Arabia">Saudi Arabia</option>
                    <option class="ember-view" value="Senegal">Senegal</option>
                    <option class="ember-view" value="Serbia">Serbia</option>
                    <option class="ember-view" value="Seychelles">Seychelles</option>
                    <option class="ember-view" value="Sierra Leone">Sierra Leone</option>
                    <option class="ember-view" value="Singapore">Singapore</option>
                    <option class="ember-view" value="Sint Maarten">Sint Maarten</option>
                    <option class="ember-view" value="Slovakia">Slovakia</option>
                    <option class="ember-view" value="Slovenia">Slovenia</option>
                    <option class="ember-view" value="Solomon Islands">Solomon Islands</option>
                    <option class="ember-view" value="Somalia">Somalia</option>
                    <option class="ember-view" value="South Africa">South Africa</option>
                    <option class="ember-view" value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
                    <option class="ember-view" value="Spain">Spain</option>
                    <option class="ember-view" value="Sri Lanka">Sri Lanka</option>
                    <option class="ember-view" value="Sudan">Sudan</option>
                    <option class="ember-view" value="Suriname">Suriname</option>
                    <option class="ember-view" value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
                    <option class="ember-view" value="Swaziland">Swaziland</option>
                    <option class="ember-view" value="Sweden">Sweden</option>
                    <option class="ember-view" value="Switzerland">Switzerland</option>
                    <option class="ember-view" value="Syria Arab Republic">Syria Arab Republic</option>
                    <option class="ember-view" value="Taiwan">Taiwan</option>
                    <option class="ember-view" value="Tajikistan">Tajikistan</option>
                    <option class="ember-view" value="Tanzania, United Republic of">Tanzania, United Republic of</option>
                    <option class="ember-view" value="Thailand">Thailand</option>
                    <option class="ember-view" value="Timor-Leste">Timor-Leste</option>
                    <option class="ember-view" value="Togo">Togo</option>
                    <option class="ember-view" value="Tokelau">Tokelau</option>
                    <option class="ember-view" value="Tonga">Tonga</option>
                    <option class="ember-view" value="Trinidad And Tobago">Trinidad And Tobago</option>
                    <option class="ember-view" value="Tunisia">Tunisia</option>
                    <option class="ember-view" value="Turkey">Turkey</option>
                    <option class="ember-view" value="Turkmenistan">Turkmenistan</option>
                    <option class="ember-view" value="Turks and Caicos Islands">Turks and Caicos Islands</option>
                    <option class="ember-view" value="Tuvalu">Tuvalu</option>
                    <option class="ember-view" value="Uganda">Uganda</option>
                    <option class="ember-view" value="Ukraine">Ukraine</option>
                    <option class="ember-view" value="United Arab Emirates">United Arab Emirates</option>
                    <option class="ember-view" value="United Kingdom">United Kingdom</option>
                    <option class="ember-view" value="United Nations">United Nations</option>
                    <option class="ember-view" value="United States">United States</option>
                    <option class="ember-view" value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
                    <option class="ember-view" value="Unknown">Unknown</option>
                    <option class="ember-view" value="Uruguay">Uruguay</option>
                    <option class="ember-view" value="Uzbekistan">Uzbekistan</option>
                    <option class="ember-view" value="Vanuatu">Vanuatu</option>
                    <option class="ember-view" value="Venezuela">Venezuela</option>
                    <option class="ember-view" value="Vietnam">Vietnam</option>
                    <option class="ember-view" value="Virgin Islands, British">Virgin Islands, British</option>
                    <option class="ember-view" value="Virgin Islands, US">Virgin Islands, US</option>
                    <option class="ember-view" value="Wallis and Futuna">Wallis and Futuna</option>
                    <option class="ember-view" value="Western Sahara">Western Sahara</option>
                    <option class="ember-view" value="Yemen">Yemen</option>
                    <option class="ember-view" value="Yugoslavia">Yugoslavia</option>
                    <option class="ember-view" value="Zambia">Zambia</option>
                    <option class="ember-view" value="Zimbabwe">Zimbabwe</option>
                  </select>
                </li>
              </ul>
            </fieldset>
            <fieldset class="column columns-half top-label first-row">
              <legend>Room & Service request Information:</legend>
              <ul>
                <li>
                  <label>Arrive with flight number:</label>
                  <input id="arriveflight" autocomplete="off" class="ember-view ember-text-field englishOnly" maxlength="80" name="cardName" type="text">
                </li>
                <li>
                  <label>Arrival time:</label>
                  <input id="arrivalTime" autocomplete="off" class="ember-view ember-text-field" maxlength="20" name="cardNumber" type="text">
                </li>
                <li>
                  <label>Request Airport Transfer:</label>
                  <select style="height: 100%; width: 100%;" id="idAirportTransfer" class="ember-view ember-select field-select-select" name="cardType" onchange=" SelectAT() ">
                    <option class="ember-view" value="" selected="selected">No...</option>
                    <option value="4-seater car (VND 460,000) US$20.00">4-seater car (VND 460,000) US$20.00</option>
                    <option value="7-seater car (VND 506,000) US$22.00">7-seater car (VND 506,000) US$22.00</option>
                    <option value="16-seater van (VND 759,000) US$33.00">16-seater van (VND 759,000) US$33.00</option>
                    <option value="25-seater coach (VND 1,380,000) US$60.00">25-seater coach (VND 1,380,000) US$60.00</option>
                  </select>
                </li>
                <li>
                  <label>Other Requests:</label>
                  <textarea id="otherRequests" class="ember-view ember-text-area englishOnly" maxlength="500" name="special-requests"></textarea>
                </li>
                <li>
                  <div class="note mandatory-note richtext">
                    <p>Mandatory fields are marked as "*", but&nbsp;providing more information&nbsp;allows us to better address your needs.</p>
                  </div>
                </li>
              </ul>
            </fieldset>
          </div>
        </section>
           <section class="terms-and-conditions">
          <h3 class="reverse">Terms &amp; Conditions</h3>
          <div class="richtext">
            <h5>Rate terms and conditions</h5>
            <p style="color:#e8c04e; cursor:pointer;" id="conditions">Click here to see rate terms &amp; conditions and cancellation policy.</p>
          </div>
          <ul class="checkboxes">
            <li class="checkbox terms-checkbox">
              <label>
              <input type="checkbox" name="agreeToTerms" class="ember-view ember-checkbox" autocomplete="off" id="cbxPolicy">
              <p> I have read and agree to the above Terms and Conditions </p>
              </label>
            </li>
          </ul>
          <input type="submit" value="Send Booking" class="btAvailabilityCheck" id="cmdSignUp">
          <div id="mesg"></div>
        </section>
		  </form>
       	</div>
      </article>
    </div>
  </div>
  <div style="position: fixed; display: none;" class="back-to-top"> <span class="icon"></span> <a href="#" class="upcase">BACK TO TOP</a> </div>
</section><!--Top Bar-->
<style>
.fixed-left-sidebar-layout .content {
    overflow: hidden;
    position: relative;
    left: 180px;
    top: 0;
}
	.fixed-left-sidebar-layout .content > header, .fixed-left-sidebar-layout .content form section {
    width: 1074px;
    padding-left: 46px;
    padding-right: 46px;
}

</style>
	<script type="text/javascript">
		$().ready(function() {
	$("#validateForm").validate({
		onfocusout: false,
		onkeyup: false,
		onclick: false,
		rules: {
			"firstName": {
				required: true
			},
			"lastName": {
				required: true
			},
			"phone": {
				required: true,
				minlength: 10,
				maxlength:11,
				number:true
			},
			"email": {
				required: true,
				minlength: 8,
				email:true
			}
		},
		messages: {
			"firstName": {
				required: "Required Fields",
			},
			"lastName": {
				required: "Required Fields",
			},
			"phone": {
				required: "Required Fields",
				minlength: "Phone is number"
			},
			"email": {
				required: "Required Fields",
				minlength: "Email not true"
			}
			
			
		}
		
	});
});
	</script>
<?php $__env->stopSection(); ?>
<?php echo $__env->make('frontend.layout.layout', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>