houdini/app/views/supporters/_manual_address_fields.html.erb

<%- # License: AGPL-3.0-or-later WITH Web-Template-Output-Additional-Permission-3.0-or-later -%>
<section class='group pastelBox--grey u-padding--5'>
  <!--= def 'selected_usa' true -->

  <label style='display: none' class='u-centered u-marginBottom--5'>Shipping address (required)</label>
  <!--= show_if donate_wiz.to_ship -->

  <%= render 'nonprofits/supporters/fieldset', cssClass: 'col-8 u-fontSize--14', profile: profile, name: 'address', placeholder: 'Address' %>

  <%= render 'nonprofits/supporters/fieldset', cssClass: 'col-right-4 u-fontSize--14', profile: profile, name: 'city', placeholder: 'City' %>
  
  <fieldset  class='u-marginBottom--0 u-floatL col-4'>

    <% supporter_region = profile ? profile['state_code'] : '' %>
    <input class='u-marginBottom--0' type='text' title="Region" name='state_code' placeholder='State/Region' value="<%= supporter_region %>">
  </fieldset>

  <fieldset class='u-marginBottom--0 u-floatL col-right-4 u-fontSize--14'>
    <input class='u-marginBottom--0' type='text' title="ZIP/Postal Code" name='zip_code' placeholder='Postal Code' value="<%= profile && profile['zip_code']%>">
  </fieldset>

  <fieldset  class='u-marginBottom--0 u-floatL col-right-4'>
    <select class='select u-fontSize--14 u-marginBottom--0' name='country'>
      <% supporter_country = profile ? profile['country'] : 'United States' %>
      <option selected="selected" value='<%=supporter_country%>'><%= supporter_country %></option>
      <% Format::Geography::Countries.each do |c| %>
        <option value='<%=c%>'><%= c %></option>
      <% end %>
    </select>
  </fieldset>
</section>