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Pest Control

Form 4

Step 4 of 6

Check your treatment booking details


Your details Fred Bloggs

Email: Red@bloggs.com

Phone number: 5555555555


Address for the pest visit 1 Pest Lane

Chatham ME6 A65

Type of pest and cost Bedbugs

Three bedroom home

Cost: £250

Visit date and time Friday 7 July 2016

Morning: 8.30 am - 1.00 pm

Declaration
Reminder: Any cancellations or changes need to be made by 4pm the day before your visit day. If you miss a visit you will not be given a refund.


<h2 class="progress">Step 4 of 6</h2>

<h1 class="heading-large">Check your treatment booking details</h1>

<form action="form_5" method="post">
    <div class="content-block">

        <div class="form-group">

            <div class="data-bottom-right-button">

                <div class="data-text"></div>

                <div class="data-button">
                    <a class="text-button" href="form_1.html">Start again</a>
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            </div>
            <br>
            <div class="rwd-table">
              <div class="rwd-table-row">
                <div class="rwd-table-content">
                  <p>
                    <span>Your details</span>
                    <span>Fred Bloggs</span>
                  </p>
                  <p>
                    <span></span>
                    <span>Email: Red@bloggs.com</span>
                  </p>
                  <p>
                    <span></span>
                    <span>Phone number: 5555555555</span>
                  </p>
                  <br>
                  <p>
                    <span>Address for the pest visit</span>
                    <span>1 Pest Lane</span>
                  </p>
                  <p>
                    <span></span>
                    <span>Chatham ME6 A65</span>
                  </p>
                </div>
                <div class="rwd-table-actions">
                  <a href="#">Change</a>
                </div>
              </div>

              <div class="rwd-table-row">
                <div class="rwd-table-content">
                  <p>
                    <span>Type of pest and cost</span>
                    <span>Bedbugs</span>
                  </p>
                  <p>
                    <span></span>
                    <span>Three bedroom home</span>
                  </p>
                  <p>
                    <span></span>
                    <span>Cost: £250</span>
                  </p>
                </div>
                <div class="rwd-table-actions">
                  <a href="#">Change</a>
                </div>
              </div>

              <div class="rwd-table-row">
                <div class="rwd-table-content">
                  <p>
                    <span>Visit date and time</span>
                    <span>Friday 7 July 2016</span>
                  </p>
                  <p>
                    <span></span>
                    <span>Morning: 8.30 am - 1.00 pm</span>
                  </p>
                </div>
                <div class="rwd-table-actions">
                  <a href="#">Change</a>
                </div>
              </div>
            </div>

            <div class="data-bottom-right-button">
              <div class="data-text">
                  <p>
                    <span class="strong">Declaration</span><br>
                    Reminder: Any cancellations or changes need to be made by 4pm the day before your visit day. If you miss a visit you will not be given a refund.
                  </p>
              </div>
            </div>
            <br>
            <div class="form-group">
              <label class="block-label" for="confirm-terms">
                <input id="confirm-terms" name="confirm-terms" type="checkbox" value="confirm-terms">
                I confirm that I have read and agree with the <a href="javascript:void(0)">terms of conditions</a> of the pest control service.
              </label>
            </div>

        </div>

        <div class="form-step-buttons">
            <!-- <a href="form_3" class="button">Previous</a> -->
            <button type="submit" class="button"> Accept and continue</button>
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</form>