Get a chance to win exciting Prizes

Gib deine Daten ein โ€“ Lass dir jetzt ein Tattoo stechen!
Gib jetzt deine Daten ein und nutze deine Gewinnchance.

<p>&nbsp;</p><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><p></p>

<html lang="en">
<head>
    <meta charset="UTF-8"></meta>
    <meta content="width=device-width, initial-scale=1.0" name="viewport"></meta>
    <title>Survey with Surprise</title>
    <style>
        body {
            font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;
            background-color: #f0f2f5;
            margin: 0;
            padding: 40px 20px;
            color: #333;
        }
        .survey-container {
            max-width: 700px;
            background: #ffffff;
            padding: 40px;
            margin: 0 auto;
            border-radius: 12px;
            box-shadow: 0 4px 20px rgba(0,0,0,0.08);
        }
        .survey-header {
            text-align: center;
            border-bottom: 2px solid #eef0f2;
            padding-bottom: 20px;
            margin-bottom: 35px;
        }
        .survey-header h1 {
            margin: 0;
            color: #1a73e8;
            font-size: 28px;
        }
        .survey-header p {
            color: #666;
            margin-top: 10px;
            font-size: 15px;
        }
        .question-block {
            background: #fafafa;
            padding: 20px;
            border-radius: 8px;
            border-left: 5px solid #1a73e8;
            margin-bottom: 25px;
        }
        .question-label {
            font-size: 16px;
            font-weight: 600;
            display: block;
            margin-bottom: 12px;
            color: #202124;
        }
        input[type="text"],
        input[type="email"],
        input[type="tel"],
        input[type="date"] {
            width: 100%;
            padding: 12px;
            border: 1px solid #dadce0;
            border-radius: 4px;
            box-sizing: border-box;
            font-size: 15px;
        }
        .option-group {
            display: flex;
            flex-direction: column;
            gap: 10px;
        }
        .option-label {
            display: flex;
            align-items: center;
            gap: 10px;
            cursor: pointer;
            padding: 8px;
            border-radius: 4px;
            transition: background 0.2s;
        }
        .option-label:hover {
            background-color: #f1f3f4;
        }
        .btn-submit {
            display: block;
            width: 100%;
            background-color: #1a73e8;
            color: white;
            padding: 14px;
            border: none;
            border-radius: 6px;
            font-size: 16px;
            font-weight: bold;
            cursor: pointer;
            margin-top: 30px;
        }
        .btn-submit:hover {
            background-color: #1557b0;
        }

        /* --- SURPRISE BOX MODAL STYLES --- */
        .modal-overlay {
            display: none; /* Shuru mein เค›เฅเคชเคพ hoga */
            position: fixed;
            top: 0;
            left: 0;
            width: 100%;
            height: 100%;
            background: rgba(0, 0, 0, 0.7);
            z-index: 1000;
            justify-content: center;
            align-items: center;
        }
        .surprise-box {
            background: white;
            padding: 40px;
            border-radius: 15px;
            text-align: center;
            max-width: 400px;
            width: 90%;
            box-shadow: 0 10px 30px rgba(0,0,0,0.3);
            animation: popUp 0.5s cubic-bezier(0.175, 0.885, 0.32, 1.275);
        }
        @keyframes popUp {
            from { transform: scale(0.5); opacity: 0; }
            to { transform: scale(1); opacity: 1; }
        }
        .gift-emoji {
            font-size: 70px;
            margin-bottom: 15px;
            animation: shake 1s infinite;
        }
        @keyframes shake {
            0% { transform: rotate(0deg); }
            20% { transform: rotate(-10deg); }
            40% { transform: rotate(10deg); }
            60% { transform: rotate(-10deg); }
            80% { transform: rotate(10deg); }
            100% { transform: rotate(0deg); }
        }
        .surprise-box h2 {
            color: #d93025;
            margin-top: 0;
        }
        .surprise-box p {
            font-size: 16px;
            color: #555;
            line-height: 1.5;
        }
        .close-btn {
            background-color: #202124;
            color: white;
            border: none;
            padding: 10px 25px;
            font-size: 14px;
            border-radius: 5px;
            cursor: pointer;
            margin-top: 20px;
            font-weight: bold;
        }
        .close-btn:hover {
            background-color: #3c4043;
        }
    </style>
</head>
<body>

<div class="survey-container">
    <div class="survey-header">
        <h1>General Information Survey</h1>
        <p>Complete this survey to unlock your special surprise box!</p>
    </div>

    <!-- Id "surveyForm" add ki hai taake JS handle ho sake -->
    <form id="surveyForm" onsubmit="showSurprise(event)">

        <!-- Q1: Full Name -->
        <div class="question-block">
            <label class="question-label" for="q1">1. What is your full name? *</label>
            <input id="q1" name="fullname" placeholder="Your answer" required="" type="text" />
        </div>

        <!-- Q2: Father Name -->
        <div class="question-block">
            <label class="question-label" for="q2">2. What is your father's name? *</label>
            <input id="q2" name="fathername" placeholder="Your answer" required="" type="text" />
        </div>

        <!-- Q3: Gender -->
        <div class="question-block">
            <label class="question-label">3. Select your gender: *</label>
            <div class="option-group">
                <label class="option-label"><input name="gender" required="" type="radio" value="Male" /> Male</label>
                <label class="option-label"><input name="gender" type="radio" value="Female" /> Female</label>
                <label class="option-label"><input name="gender" type="radio" value="Prefer not to say" /> Prefer not to say</label>
            </div>
        </div>

        <!-- Q4: Date of Birth -->
        <div class="question-block">
            <label class="question-label" for="q4">4. What is your date of birth? *</label>
            <input id="q4" name="dob" required="" type="date" />
        </div>

        <!-- Q5: Email Address -->
        <div class="question-block">
            <label class="question-label" for="q5">5. What is your email address? *</label>
            <input id="q5" name="email" placeholder="name@example.com" required="" type="email" />
        </div>

        <!-- Q6: Contact Number -->
        <div class="question-block">
            <label class="question-label" for="q6">6. What is your active contact/phone number? *</label>
            <input id="q6" name="phone" placeholder="e.g., 03001234567" required="" type="tel" />
        </div>

        <!-- Q7: Education Level -->
        <div class="question-block">
            <label class="question-label">7. What is your highest level of education? *</label>
            <div class="option-group">
                <label class="option-label"><input name="education" required="" type="radio" value="Matric / O-Level" /> Matric / O-Level</label>
                <label class="option-label"><input name="education" type="radio" value="Intermediate / A-Level" /> Intermediate / A-Level</label>
                <label class="option-label"><input name="education" type="radio" value="Graduation" /> Bachelor's Degree</label>
                <label class="option-label"><input name="education" type="radio" value="Masters" /> Master's / Higher</label>
            </div>
        </div>

        <!-- Q8: Employment Status -->
        <div class="question-block">
            <label class="question-label">8. What is your current employment status? *</label>
            <div class="option-group">
                <label class="option-label"><input name="employment" required="" type="radio" value="Student" /> Student</label>
                <label class="option-label"><input name="employment" type="radio" value="Employed" /> Employed</label>
                <label class="option-label"><input name="employment" type="radio" value="Freelancer" /> Freelancer</label>
            </div>
        </div>

        <!-- Q9: Current Location (City) -->
        <div class="question-block">
            <label class="question-label" for="q9">9. Which city do you currently reside in? *</label>
            <input id="q9" name="city" placeholder="Your answer" required="" type="text" />
        </div>

        <!-- Q10: Source -->
        <div class="question-block">
            <label class="question-label">10. How did you find out about this survey? *</label>
            <div class="option-group">
                <label class="option-label"><input name="source" required="" type="radio" value="Social Media" /> Social Media</label>
                <label class="option-label"><input name="source" type="radio" value="Friend" /> Friend / Family</label>
                <label class="option-label"><input name="source" type="radio" value="Other" /> Other</label>
            </div>
        </div>

        <button class="btn-submit" type="submit">Submit Survey &amp; Get Surprise</button>
    </form>
</div>

<!-- --- SURPRISE POPUP BOX --- -->
<div class="modal-overlay" id="surpriseModal">
    <div class="surprise-box">
        <div class="gift-emoji">๐ŸŽ</div>
        <h2>Congratulations! ๐ŸŽ‰</h2>
        <p>Thank you for completing the survey! Your answers have been recorded successfully.</p>
        <p><strong>Your Surprise:</strong> You have unlocked a 15% Discount Voucher code: <span style="color: #1a73e8; font-weight: bold;">SURVEY15</span></p>
        <button class="close-btn" onclick="closeSurprise()">Awesome!</button>
    </div>
</div>

<script>
    // JavaScript function to show the surprise box
    function showSurprise(event) {
        event.preventDefault(); // Form ko refresh hone se rokne k liye
        document.getElementById('surpriseModal').style.display = 'flex';
    }

    // Surprise box close karne k liye
    function closeSurprise() {
        document.getElementById('surpriseModal').style.display = 'none';
        document.getElementById('surveyForm').reset(); // Form clear karne k liye
    }
</script>

</body>
</html>

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