generated from 4GeeksAcademy/html-hello
-
Notifications
You must be signed in to change notification settings - Fork 1
/
Copy pathindex.html
116 lines (115 loc) · 5.53 KB
/
index.html
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<title>Form HTML5</title>
<meta name="viewport" content="width=device-width, initial-scale=1">
<link href="https://cdn.jsdelivr.net/npm/[email protected]/dist/css/bootstrap.min.css" rel="stylesheet" integrity="sha384-T3c6CoIi6uLrA9TneNEoa7RxnatzjcDSCmG1MXxSR1GAsXEV/Dwwykc2MPK8M2HN" crossorigin="anonymous">
<link rel="stylesheet" href="styles.css">
</head>
<script src="https://kit.fontawesome.com/63ec4f579b.js" crossorigin="anonymous"></script>
<body>
<form class="p-3">
<div class="card">
<div class="card-header">
<h1 class="text-center"> Payment form example</h1>
</div>
<div class="card-body">
<div class="alert alert-danger" role="alert">
<strong>Some fields are missing</strong>
</div>
<!--CARD# + CVC# + AMOUNT-->
<div class="row pb-3">
<div class="col-lg-4 col-md-6 mb-3">
<label for="creditcard">Card #</label>
<input type="text" class="form-control" id="creditcard" name="creditcard" pattern="[0-9]{16}" maxlength="19" required placeholder="XXXX XXXX XXXX XXXX">
</div>
<div class="col-lg-4 col-md-6 mb-3">
<label for="CVV">CVV #</label>
<input type="number" class="form-control" id="CVV" name="CVV" pattern="[0-9]{3}" maxlength="4" required placeholder="0000">
</div>
<div class="col-lg-4 col-md-6 mb-3">
<label for="amount">Amount</label>
<div class="input-group">
<span class="input-group-text">$</span>
<input type="text" class="form-control" id="amount" name="amount" pattern="[0-9]" required placeholder="Amount">
</div>
</div>
</div>
<!--FIRST NAME + LAST NAME-->
<div class="row pb-3">
<div class="col-md-6 mb-3">
<label for="first-name">First Name</label>
<input type="text" class="form-control" id="first-name" name="first-name" required>
</div>
<div class="col-md-6 mb-3">
<label for="last-name">Last Name</label>
<input type="text" class="form-control" id="last-name" name="last-name" required>
</div>
</div>
<!--CITY + STATE + POSTAL CODE-->
<div class="row pb-3">
<div class="col-md-6 mb-3">
<label for="city">City</label>
<input type="text" id="city" class="form-control" name="city" required>
</div>
<div class="col-md-3 mb-3">
<label for="state">State</label>
<select class="form-select" aria-label="Default select example">
<option selected>Pick a State</option>
<option value="1">One</option>
<option value="2">Two</option>
<option value="3">Three</option>
</select>
</div>
<div class="col-md-3 mb-3">
<label for="postal-code">Postal Code</label>
<input type="text" class="form-control" id="postal-code" name="postal-code" pattern="[0-9]" required>
</div>
</div>
<!-- WE ACCEPT + MESSAGE-->
<div class="row pb-3">
<div class="col-md-6 mb-3">
<label for="CC">We accept:</label>
<div id="cc-type" class="bg-secondary p-2 rounded d-flex justify-content-center ms-1">
<div class="form-check form-check-inline d-flex align-items-center">
<input type="radio" class="form-check-input" name="cc-type" id="mastercard" value="mastercard">
<label class="form-check-label" for="mastercard">
<i class="fa-brands fa-cc-mastercard fa-xl ms-1" style="color: white;"></i>
</label>
</div>
<div class="form-check form-check-inline d-flex align-items-center">
<input type="radio" class="form-check-input" name="cc-type" id="visa" value="visa">
<label class="form-check-label" for="visa">
<i class="fa-brands fa-cc-visa fa-xl ms-1" style="color: white;"></i>
</label>
</div>
<div class="form-check form-check-inline d-flex align-items-center">
<input type="radio" class="form-check-input" name="cc-type" id="diners" value="diners">
<label class="form-check-label" for="diners">
<i class="fa-brands fa-cc-diners-club fa-xl ms-1" style="color: white;"></i>
</label>
</div>
<div class="form-check form-check-inline d-flex align-items-center">
<input type="radio" class="form-check-input" name="cc-type" id="amex" value="amex">
<label class="form-check-label" for="amex">
<i class="fa-brands fa-cc-amex fa-xl ms-1" style="color: white;"></i>
</label>
</div>
</div>
</div>
<div class="col-md-6 mb-3">
<label for="message-help">Messages:</label>
<textarea class="form-control" name="message-help" id="message-help" cols="30" rows="5"></textarea>
<div id="message-help" class="form-text">Add any notes here.</div>
</div>
</div>
</div>
<div class="card-footer text-body-secondary d-flex justify-content-end">
<button type="reset" class="btn btn-secondary mx-1">Cancel</button>
<button type="submit" class="btn btn-primary mx-1">Send</button>
</div>
</div>
</form>
</body>
</html>