<%- # License: AGPL-3.0-or-later WITH WTO-AP-3.0-or-later
# Full license explanation at https://github.com/houdiniproject/houdini/blob/master/LICENSE -%>
<!-- partial: supporters/form_blank -->

<% require_email = nil if require_email.nil? %>
<% require_name = nil if require_name.nil? %>


<fieldset class='u-marginBottom--0'>
	<label <%= require_name && "class=required" %>>Name <small><%= require_name ? '(required)' : '' %></small></label>
	<input type='text' name='name' <%= require_name && "required"%>>
</fieldset>

<section class='layout--two'>
	<fieldset class='u-marginBottom--0'>
		<label>Email <small><%= require_email && '(required)' %></small></label>
		<input parsley-error-message='Please enter a valid email.' type='email' parsley-trigger='change' name='email' <%= require_email && 'required' %>>
	</fieldset>

	<fieldset class='u-marginBottom--0'>
		<label>Phone</label>
		<input parsley-error-message='Enter a valid phone number.' parsley-trigger='change' parsley-type='phone' type='text' name='phone'>
	</fieldset>

	<fieldset class='u-marginBottom--0'>
		<label>Address</label>
		<input type='text' name='address'>
	</fieldset>

	<fieldset class='u-marginBottom--0'>
		<label>City</label>
		<input type='text' name='city', value='<%= @nonprofit.city %>'>
	</fieldset>
</section>


<section class='layout--three'>

	<fieldset class='u-marginBottom--0'>
		<label>State/Region</label>
		<input type='text' name='state_code' value='<%= @nonprofit.state_code %>' placeholder='State/Region'>
	</fieldset>

	<fieldset class='u-marginBottom--0'>
		<label>Postal Code</label>
		<input type='text' name='zip_code' value='<%= @nonprofit.zip_code %>' placholder='Postal Code'>
	</fieldset>

	<fieldset class='u-marginBottom--0'>
		<label>Country</label>
		<input type='text' name='country' value='United States'>
	</fieldset>

</section>

<!-- partial: supporters/form_blank -->