col-sm-10">
										  <textarea name="note" rows="5" placeholder="Other details" id="input-comment" class="form-control"></textarea>
										</div>
									  </div>
									  
									<div class="row">
									  <div class="col text-end">
										<button type="submit" class="btn btn-primary"><span>Submit request</span> <i class="la la-arrow-right"></i></button>
									  </div>
									</div>

								</form>
							
							
								</div>
							</div>
						</div>
					</div>
