<div class="banner-editing-form" data-aos="fade-left" data-aos-duration="1500">
    <h4>Start Your Book Writing Journey!</h4>
    <!-- Banner Writing Form Include Here -->
    <form action="webpages/bannerFormController.php" method="POST" class="myForm">
	    <div class="form-group">
	        <label for="name">Name</label>
	        <input type="text" name="Name" placeholder="John Doe" required>
	    </div>
	    <div class="form-group">
	        <label for="email">Email</label>
	        <input type="email" name="Email" placeholder="Example@example.com" required>
	    </div>
	    <div class="form-group phone-inpt">
	        <label for="phone">Contact Number</label>
	        <input type="phone" class="countryCode" name="Number" placeholder="Number" required>
	    </div>
	    <div class="form-group">
	        <label for="message">Message</label>
	        <textarea name="Message" placeholder="Text Here..." required></textarea>
	    </div>
	    <div class="form-group nda">
            <input type="checkbox" name="NDA" id="consentCheckbox">
            <label for="consentCheckbox">By checking this box, I am allowing Barns Nobles send me messages. (You can stop receiving messages from Barns Nobles anytime by sending STOP in the reply or ask for more information by replying HELP. Message frequency varies. Message and data rates may apply). <br> You may review our <a href="privacy-policy" target="__blank">Privacy Policy</a> to learn how your data is used. </label>
        </div>
	    <div class="form-group">
	        <button type="submit" class="submit-btn">Submit</button>
	        <input class="" type="hidden" name="ctry" value="">
            <input type="hidden" name="pc" value="">
            <input type="hidden" name="cip" value="" class="form-1-ip">
            <input type="hidden" name="hiddencapcha" value="">
            <input type="hidden" name="submitfrombanner" value="">
            <input type="hidden" id="location" name="locationURL" value="<?php echo 'http://'.$_SERVER['HTTP_HOST'].$_SERVER['REQUEST_URI']; ?>" />
	    </div>
	</form>                        
	<!-- Banner Writing Form Include Here -->
</div>