64 lines
1.5 KiB
Text
64 lines
1.5 KiB
Text
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<p class='strong u-centered u-marginBottom--20'>Please review your merge choices before submitting</p>
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<form class='supporterForm'>
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<!--= on 'submit' (merge.submit form_object) -->
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<div class='layout--two'>
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<fieldset>
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<label>Name</label>
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<input type='text' name='name'>
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<!--= set_value merge.data.new_supporter.name -->
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</fieldset>
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<fieldset>
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<label>Email</label>
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<input type='email' name='email'>
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<!--= set_value merge.data.new_supporter.email -->
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</fieldset>
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</div>
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<div class='layout--three'>
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<fieldset>
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<label>Phone</label>
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<input type='text' name='phone'>
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<!--= set_value merge.data.new_supporter.phone -->
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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='address'>
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<!--= set_value merge.data.new_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='city'>
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<!--= set_value merge.data.new_supporter.city -->
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</fieldset>
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</div>
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<div class='layout--three'>
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<fieldset>
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<label>State/Region</label>
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<input type='text' name='state_code'>
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<!--= set_value merge.data.new_supporter.state_code -->
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</fieldset>
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<fieldset>
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<label>Zip Code</label>
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<input type='text' name='zip_code'>
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<!--= set_value merge.data.new_supporter.zip_code -->
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</fieldset>
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<fieldset>
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<label>Country</label>
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<input type='text' name='country'>
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<!--= set_value merge.data.new_supporter.country -->
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</fieldset>
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</div>
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<%= render 'components/forms/submit_button', button_text: 'Merge Supporters', loading_text: 'Merging...' %>
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</form>
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