<%- # License: AGPL-3.0-or-later WITH Web-Template-Output-Additional-Permission-3.0-or-later -%> <% card_holder_name ||= current_user && !current_user.profile.full_name.blank? #XXX blech %> <div class='u-background--grey group u-padding--8'> <fieldset> <input type='text' class='input-medium' name='name' required parsley-trigger='change' placeholder="Cardholders' Name"> <!--= set_value donate_wiz.supporter.name --> <!--= set_value card_form.preset_name --> <!--= set_value selected_supporter.name --> </fieldset> <fieldset class='col-8'> <input type='text' name='number' required parsley-trigger='blur' parsley-card-number placeholder="Card Number"> </fieldset> <fieldset class='col-right-4 u-relative'> <input type='text' name='cvc' parsley-trigger='change' placeholder='CVC'> <%= image_tag 'graphics/cc-security-code.png', :class => 'security-code-image' %> </fieldset> <fieldset class='col-4 u-margin--0'> <select name='exp_month' class='select' required parsley-trigger='change'> <option value='' class='default' selected>Month</option> <% (1..12).each do |month| %> <option><%= month.to_s %></option> <% end %> </select> </fieldset> <fieldset class='col-left-4 u-margin--0'> <select name='exp_year' class='select' required parsley-trigger='change'> <option value='' class='default' selected>Year</option> <% expiration_years.each do |year| %> <option><%= year %></option> <% end %> </select> </fieldset> <fieldset class='col-right-4 u-margin--0'> <input type='text' name='address_zip' parsley-rangelength="[5,5]" parsley-trigger="change" required value='' placeholder='Postal Code'> </fieldset> <input type='hidden' name='profile_id' value='<%= GetData.chain(current_user, :profile, :id) %>'> </div>