Files
dinnerinthewoods.org/views/step2.php
Chris Smith dc609109e3 step 2 for form submission
add phone
2019-03-05 11:04:10 -06:00

205 lines
10 KiB
PHP

<div class="row">
<div class="col-md-4 order-md-2 mb-4">
<h4 class="d-flex justify-content-between align-items-center mb-3">
<span class="text-muted">Your cart</span>
</h4>
<ul class="list-group mb-3">
<?=shoppingCartLineItem('Table', $tableTicketPrice, $tableTicketQty . ' x table');?>
<?=shoppingCartLineItem('Dinner', $eventTicketPrice, $eventTicketQty . ' x tickets');?>
<?=shoppingCartLineItem('Ticket Enhancers', $ticketEnhancerPrice, $ticketEnhancerQty . ' x enhancers');?>
<?=shoppingCartLineItem('Additional Contribution', $additionalContribution);?>
<?=shoppingCartTotal($cartTotal);?>
</ul>
</div>
<div class="col-md-8 order-md-1">
<h4 class="mb-3">Billing address</h4>
<form class="needs-validation" novalidate method="POST" action="/checkout">
<?php
$eventTicketQty = getInteger($_POST['eventTicketQty']);
$ticketEnhancerQty = getInteger($_POST['ticketEnhancerQty']);
$additionalContribution = getInteger($_POST['additionalContribution']);
?>
<input type="hidden" name="eventTicketQty" value="<?=$eventTicketQty?>" />
<input type="hidden" name="ticketEnhancerQty" value="<?=$ticketEnhancerQty?>" />
<input type="hidden" name="additionalContribution" value="<?=$additionalContribution?>" />
<div class="row">
<div class="col-md-6 mb-3">
<label for="firstName">First name</label>
<input type="text" class="form-control" id="firstName" name="firstName" value="" required>
<div class="invalid-feedback">
Valid first name is required.
</div>
</div>
<div class="col-md-6 mb-3">
<label for="lastName">Last name</label>
<input type="text" class="form-control" id="lastName" name="lastName" value="" required>
<div class="invalid-feedback">
Valid last name is required.
</div>
</div>
</div>
<div class="mb-3">
<label for="email">Email</label>
<input type="email" class="form-control" id="email" name="email" placeholder="you@example.com" required>
<div class="invalid-feedback">
Please enter a valid email address.
</div>
</div>
<div class="mb-3">
<label for="phone">Phone</label>
<input type="phone" class="form-control" id="phone" name="phone" required>
<div class="invalid-feedback">
Please enter a valid phone number.
</div>
</div>
<div class="mb-3">
<label for="address">Address</label>
<input type="text" class="form-control" id="address" name="address" placeholder="1234 Main St" required>
<div class="invalid-feedback">
Please enter your address.
</div>
</div>
<div class="row">
<div class="col-md-4 mb-4">
<label for="city">City</label>
<input type="text" class="form-control" id="city" name="city" placeholder="" required>
<div class="invalid-feedback">
City required.
</div>
</div>
<div class="col-md-4 mb-4">
<label for="state">State</label>
<select class="custom-select d-block w-100" id="state" name="state" required>
<option value="AL">AL</option>
<option value="AK">AK</option>
<option value="AR">AR</option>
<option value="AZ">AZ</option>
<option value="CA">CA</option>
<option value="CO">CO</option>
<option value="CT">CT</option>
<option value="DC">DC</option>
<option value="DE">DE</option>
<option value="FL">FL</option>
<option value="GA">GA</option>
<option value="HI">HI</option>
<option value="IA">IA</option>
<option value="ID">ID</option>
<option value="IL">IL</option>
<option value="IN">IN</option>
<option value="KS">KS</option>
<option value="KY">KY</option>
<option value="LA">LA</option>
<option value="MA">MA</option>
<option value="MD">MD</option>
<option value="ME">ME</option>
<option value="MI">MI</option>
<option value="MN">MN</option>
<option value="MO">MO</option>
<option value="MS">MS</option>
<option value="MT">MT</option>
<option value="NC">NC</option>
<option value="NE">NE</option>
<option value="NH">NH</option>
<option value="NJ">NJ</option>
<option value="NM">NM</option>
<option value="NV">NV</option>
<option value="NY">NY</option>
<option value="ND">ND</option>
<option value="OH">OH</option>
<option value="OK">OK</option>
<option value="OR">OR</option>
<option value="PA">PA</option>
<option value="RI">RI</option>
<option value="SC">SC</option>
<option value="SD">SD</option>
<option value="TN">TN</option>
<option value="TX">TX</option>
<option value="UT">UT</option>
<option value="VT">VT</option>
<option value="VA">VA</option>
<option value="WA">WA</option>
<option value="WI" selected>WI</option>
<option value="WV">WV</option>
<option value="WY">WY</option>
</select>
<div class="invalid-feedback">
Please provide a valid state.
</div>
</div>
<div class="col-md-4 mb-4">
<label for="zip">Zip</label>
<input type="text" class="form-control" id="zip" name="zip" required>
<div class="invalid-feedback">
Zip code required.
</div>
</div>
</div>
<hr class="mb-4">
<h4 class="mb-3">Payment</h4>
<div class="d-block my-3">
<div class="custom-control custom-radio">
<input id="credit" name="paymentMethod" type="radio" class="custom-control-input" value="0" checked required>
<label class="custom-control-label" for="credit">Credit card</label>
</div>
<div class="custom-control custom-radio">
<input id="check" name="paymentMethod" type="radio" class="custom-control-input" value="1" required>
<label class="custom-control-label" for="debit">Check/Cash</label>
</div>
</div>
<div class="row" id="checkDetails" style="display: none">
<div class="col-md-12 mb-3">
<p>Mail or drop off payment within seven days of submitting this form or your tickets will be released
for others to purchase<br/>
<br/>
Mail to:<br/>
Attn: Dinner in the Woods<br/>
Nature's Classroom<br/>
PO Box 660<br/>
Mukwonago, WI 53149
</p>
</div>
</div>
<div class="row" id="creditDetails">
<div class="col-md-6 mb-3">
<label for="cc-name">Name on card</label>
<input type="text" class="form-control" id="cc-name" placeholder="" required>
<small class="text-muted">Full name as displayed on card</small>
<div class="invalid-feedback">
Name on card is required
</div>
</div>
<div class="col-md-6 mb-3">
<label for="cc-number">Credit card number</label>
<input type="text" class="form-control" id="cc-number" placeholder="" required>
<div class="invalid-feedback">
Credit card number is required
</div>
</div>
</div>
<div class="row">
<div class="col-md-3 mb-3">
<label for="cc-expiration">Expiration</label>
<input type="text" class="form-control" id="cc-expiration" placeholder="" required>
<div class="invalid-feedback">
Expiration date required
</div>
</div>
<div class="col-md-3 mb-3">
<label for="cc-expiration">CVV</label>
<input type="text" class="form-control" id="cc-cvv" placeholder="" required>
<div class="invalid-feedback">
Security code required
</div>
</div>
</div>
<hr class="mb-4">
<button class="btn btn-primary btn-lg btn-block" type="submit">Checkout</button>
</form>
</div>
</div>