mirror of https://github.com/itflow-org/itflow
66 lines
2.9 KiB
PHP
66 lines
2.9 KiB
PHP
<div class="modal" id="addClientLocationModal" tabindex="-1">
|
|
<div class="modal-dialog">
|
|
<div class="modal-content bg-dark">
|
|
<div class="modal-header text-white">
|
|
<h5 class="modal-title"><i class="fa fa-fw fa-map-marker-alt mr-2"></i>New Location</h5>
|
|
<button type="button" class="close text-white" data-dismiss="modal">
|
|
<span aria-hidden="true">×</span>
|
|
</button>
|
|
</div>
|
|
<form action="post.php" method="post" autocomplete="off">
|
|
<input type="hidden" name="client_id" value="<?php echo $client_id; ?>">
|
|
<div class="modal-body bg-white">
|
|
<div class="form-group">
|
|
<label>Location Name</label>
|
|
<div class="input-group">
|
|
<div class="input-group-prepend">
|
|
<span class="input-group-text"><i class="fa fa-fw fa-map-marker"></i></span>
|
|
</div>
|
|
<input type="text" class="form-control" name="name" placeholder="Name of location" required autofocus>
|
|
</div>
|
|
</div>
|
|
<div class="form-group">
|
|
<label>Address</label>
|
|
<div class="input-group">
|
|
<div class="input-group-prepend">
|
|
<span class="input-group-text"><i class="fa fa-fw fa-map-marker-alt"></i></span>
|
|
</div>
|
|
<input type="text" class="form-control" name="address" placeholder="Address" required>
|
|
</div>
|
|
</div>
|
|
|
|
<div class="form-group">
|
|
<label>City</label>
|
|
<input type="text" class="form-control" name="city" placeholder="City" required>
|
|
</div>
|
|
<div class="form-group">
|
|
<label>State</label>
|
|
<select class="form-control" name="state" required>
|
|
<option value="">- State -</option>
|
|
<?php foreach($states_array as $state_abbr => $state_name) { ?>
|
|
<option value="<?php echo $state_abbr; ?>"><?php echo $state_name; ?></option>
|
|
<?php } ?>
|
|
</select>
|
|
</div>
|
|
<div class="form-group">
|
|
<label>Zip</label>
|
|
<input type="text" class="form-control" name="zip" placeholder="Zip" required>
|
|
</div>
|
|
<div class="form-group">
|
|
<label>Phone</label>
|
|
<div class="input-group">
|
|
<div class="input-group-prepend">
|
|
<span class="input-group-text"><i class="fa fa-fw fa-phone"></i></span>
|
|
</div>
|
|
<input type="text" class="form-control" name="phone" placeholder="Phone Number" data-inputmask="'mask': '999-999-9999'" required>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<div class="modal-footer bg-white">
|
|
<button type="button" class="btn btn-secondary" data-dismiss="modal">Cancel</button>
|
|
<button type="submit" name="add_client_location" class="btn btn-primary">Save</button>
|
|
</div>
|
|
</form>
|
|
</div>
|
|
</div>
|
|
</div>
|