<%- # 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: components/forms/_offsite_fields -->
<div class='layout--four'>
  <fieldset>
    <label>Amount</label>
    <div class='prepend--dollar'>
      <input name='dollars' step='any' type='number' min='0' parsley-type='number'  required>
    </div>
  </fieldset>

  <fieldset>
    <label>Date</label>
    <input id='js-offsiteDonationDate' name='date' type='text' placeholder='MM/DD/YYYY'>
  </fieldset>

  <fieldset>
    <label>Type</label>
    <select name='offsite_payment.kind'>
      <option selected value='check'>Check</option>
      <option value='cash'>Cash</option>
      <option  value=''>Other</option>
    </select>
  </fieldset>

  <fieldset>
    <label>Check Number</label>
    <input name='offsite_payment.check_number' type='number' placeholder='1234'>
  </fieldset>
</div>
<!-- partial end: components/forms/_offsite_fields -->