<p><a class="link" href="#" data-toggle="modal" data-target="#service_request">Request For A Quote</a></p>

<!-- Modal -->
<div class="modal fade" style="z-index: 1000000;" id="service_request" tabindex="-1" role="dialog" aria-labelledby="exampleModalCenterTitle" aria-hidden="true">
    <!-- Add .modal-dialog-centered to .modal-dialog to vertically center the modal -->
    <div class="modal-dialog modal-dialog-centered" role="document">
        <div class="modal-content">
            <div class="modal-header row" style="background-color: #383E77;">
                <h5 class="modal-title col-md-10" style="color: #FFF;" id="exampleModalLongTitle">Request A Quote</h5>
                <button type="button" class="close col-md-2" data-dismiss="modal" aria-label="Close" style="color: #FFF;">
                    <span aria-hidden="true" style="color: #FFF;">&times;</span>
                </button>
            </div>
            <div class="modal-body">
                <form id="contactform" method="post" action="mailer/">
                    <div class="row">
                        <div class="col-md-6">
                            <input name="txtOrigin" type="hidden" value="book_service">
                            <p><input name="txtName" type="text" placeholder="Your Name" required></p><br>
                            <p><input id="email" name="txtEmail" type="email" placeholder="Your Email" required></p><br>
                            <p>
                                <select class="control-select" style="width: 100%;" name="txtUnit" required>
                                    <option>Our Vehicles</option>
                                    <option>Yaris</option>
                                    <option>Corolla</option>
                                    <option>Camry</option>
                                    <option>Avensis</option>
                                    <option>Rush</option>
                                    <option>Landcruiser</option>
                                    <option>Rav 4</option>
                                    <option>Prado</option>
                                    <option>Fortuner</option>
                                    <option>Hilux</option>
                                    <option>Hiace</option>
                                    <option>Coaster</option>
                                    <option>Dyna</option>
                                </select>
                            </p>
                        </div><!-- /.col-md-6 -->

                        <div class="col-md-6">
                            <p><input id="txtNumber" name="txtNumber" type="number" placeholder="Your Phone Number" required></p><br>
                            <p><input id="subject" name="txtSubject" type="text" placeholder="Subject" required></p><br>
                            <p><textarea name="txtMessage" placeholder="Message" required></textarea></p>
                        </div><!-- /.col-md-6 -->
                    </div><!-- /.row -->
                    <div class="row">
                        <div class="col-md-12 text-right">
                            <input type="submit" class="btn btn-primary" value="Book A Service">
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>