Benjamin
2018-10-02 8997b3bc9cbdd73626d70432de70e15383bbdbf0
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<!DOCTYPE html>
<html lang="en">
<head>
    <meta name="viewport" content="width=device-width, initial-scale=1">
    <meta charset="UTF-8">
    <title>Report site</title>
 
    <link rel="stylesheet" type="text/css" href="adb_site.css">
    <script type="application/javascript" src="jquery-1.12.3.js"></script>
</head>
<body class="site_adb">
    <header class="header_title">
        <div class="content">
            <span class="symbol icon_back_arrow left"></span>
            <span class="h_text">Report this site</span>
        </div>
    </header>
    <form action="#" id="report_form"></form>
    <h3 class="pad">
        What's the problem this site?
    </h3>
    <div class="form_selector">
        <select name="rp_reason" form="report_form">
            <option value="PHISHING">Phishing</option>
            <option value="FALSE_POSITIVE" selected>Broken page</option>
            <option value="MISSED_ADS">Missed ads</option>
            <option value="CUSTOM">Custom</option>
        </select>
        <textarea style="min-height:10em;"
                  name="rp_comment"
                  form="report_form"
                  placeholder="More comments..."></textarea>
        <div class="report_submit_section">
            <button class="submit">
                Submit
            </button>
        </div>
    </div>
</body>
</html>