83 lines
2.7 KiB
Text
83 lines
2.7 KiB
Text
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<div class='modal' id='offlineCampaignDonation'>
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<%= render 'common/modal_header', title: 'New Offsite Donation' %>
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<div class='modal-body'>
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<form class='donate-info-form' parsley-validate>
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<!--= on 'submit' (create_offline_donation form_object) -->
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<input type='hidden' name='campaign_id' value='<%= @campaign.id %>'>
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<input type='hidden' name='nonprofit_id' value='<%= @nonprofit.id %>'>
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<input type='hidden' name='supporter.nonprofit_id' value='<%= @nonprofit.id %>'>
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<input type='hidden' name='designation' value='<%= @campaign.name %>'>
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<p class='u-centered highlight u-marginBottom--15'>Add an offsite donation to this campaign</p>
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<%= render 'components/forms/offsite_fields' %>
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<section class='layout--two'>
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<fieldset>
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<label>Full Name <small>(recommended)</small></label>
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<input type='text' name='supporter.name'>
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</fieldset>
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<fieldset>
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<label>Email <small>(recommended)</small></label>
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<input parsley-error-message='Please enter a valid email.' type='email' parsley-trigger='change' name='supporter.email'>
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</fieldset>
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<fieldset>
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<label>Address</label>
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<input type='text' name='supporter.address'>
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</fieldset>
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<fieldset>
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<label>City</label>
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<input type='text' name='supporter.city'>
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</fieldset>
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<fieldset class='layout--two u-marginBottom--0'>
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<fieldset>
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<label>State</label>
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<select class='u-marginBottom--0' name='supporter.state_code'>
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<option selected value=''>
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</option>
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<% us_states.each do |state, code| %>
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<option value="<%= code %>"><%= state %></option>
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<% end %>
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</select>
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</fieldset>
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<fieldset>
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<label>Zipcode</label>
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<input parsley-error-message='Enter a valid zip code.' parsley-trigger='change' parsley-type='number' type='text' name='supporter.zip_code'>
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</fieldset>
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</fieldset>
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<fieldset>
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<label>Phone</label>
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<input parsley-error-message='Enter a valid phone number.' parsley-trigger='change' parsley-type='phone' type='text' name='supporter.phone'>
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</fieldset>
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</section>
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<fieldset>
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<label>Notes <small> (optional) </small> </label>
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<textarea name='comment' rows='3' placeholder='Notes'></textarea>
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</fieldset>
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<div class='u-centered'>
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<input type='hidden' value='false'>
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<input type='checkbox' id='anonymize' name='supporter.anonymous'>
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<label id='anon-label' for='anonymize'>
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Make this donation anonymous
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</label>
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</div>
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<%= render 'components/forms/submit_button', button_text: 'Save', loading_text: 'Saving...' %>
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</form>
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</div>
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</div>
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</div>
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