2018-03-25 17:20:54 +00:00
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<%- # License: AGPL-3.0-or-later WITH Web-Template-Output-Additional-Permission-3.0-or-later -%>
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2018-03-25 17:30:42 +00:00
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<!-- partial: components/forms/_offsite_fields -->
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<div class='layout--four'>
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<fieldset>
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<label>Amount</label>
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<div class='prepend--dollar'>
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<input name='dollars' step='any' type='number' min='0' parsley-type='number' required>
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</div>
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</fieldset>
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<fieldset>
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<label>Date</label>
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<input id='js-offsiteDonationDate' name='date' type='text' placeholder='MM/DD/YYYY'>
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</fieldset>
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<fieldset>
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<label>Type</label>
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<select name='offsite_payment.kind'>
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<option selected value='check'>Check</option>
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<option value='cash'>Cash</option>
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<option value=''>Other</option>
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</select>
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</fieldset>
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<fieldset>
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<label>Check Number</label>
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<input name='offsite_payment.check_number' type='number' placeholder='1234'>
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</fieldset>
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</div>
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<!-- partial end: components/forms/_offsite_fields -->
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