mirror of https://github.com/itflow-org/itflow
95 lines
4.0 KiB
PHP
95 lines
4.0 KiB
PHP
<div class="modal" id="addLocationModal" tabindex="-1">
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<div class="modal-dialog">
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<div class="modal-content bg-dark">
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<div class="modal-header text-white">
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<h5 class="modal-title"><i class="fa fa-fw fa-map-marker-alt mr-2"></i>New Location</h5>
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<button type="button" class="close text-white" data-dismiss="modal">
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<span aria-hidden="true">×</span>
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</button>
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</div>
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<form action="post.php" method="post" autocomplete="off">
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<input type="hidden" name="client_id" value="<?php echo $client_id; ?>">
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<div class="modal-body bg-white">
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<div class="form-group">
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<label>Location Name</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text"><i class="fa fa-fw fa-map-marker"></i></span>
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</div>
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<input type="text" class="form-control" name="name" placeholder="Name of location" required autofocus>
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</div>
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</div>
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<div class="form-group">
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<label>Address</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text"><i class="fa fa-fw fa-map-marker-alt"></i></span>
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</div>
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<input type="text" class="form-control" name="address" placeholder="Address" required>
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</div>
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</div>
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<div class="form-group">
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<label>City</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text"><i class="fa fa-fw fa-city"></i></span>
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</div>
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<input type="text" class="form-control" name="city" placeholder="City" required>
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</div>
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</div>
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<div class="form-group">
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<label>State</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text"><i class="fa fa-fw fa-flag"></i></span>
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</div>
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<select class="form-control selectpicker show-tick" data-live-search="true" name="state" required>
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<option value="">- State -</option>
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<?php foreach($states_array as $state_abbr => $state_name) { ?>
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<option value="<?php echo $state_abbr; ?>"><?php echo $state_name; ?></option>
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<?php } ?>
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</select>
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</div>
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</div>
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<div class="form-group">
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<label>Zip</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text"><i class="fab fa-fw fa-usps"></i></span>
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</div>
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<input type="text" class="form-control" name="zip" placeholder="Zip" required data-inputmask="'mask': '99999'">
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</div>
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</div>
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<div class="form-group">
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<label>Phone</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text"><i class="fa fa-fw fa-phone"></i></span>
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</div>
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<input type="text" class="form-control" name="phone" placeholder="Phone Number" data-inputmask="'mask': '999-999-9999'" required>
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</div>
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</div>
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<div class="form-group">
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<label>Hours</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text"><i class="fa fa-fw fa-clock"></i></span>
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</div>
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<input type="text" class="form-control" name="hours" placeholder="Hours of operation">
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</div>
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</div>
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</div>
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<div class="modal-footer bg-white">
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<button type="button" class="btn btn-secondary" data-dismiss="modal">Cancel</button>
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<button type="submit" name="add_location" class="btn btn-primary">Save</button>
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</div>
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</form>
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</div>
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</div>
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</div>
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