bookings_registration_form.htm

<!-- BOOKINGS MODAL STEP 2 -->
<div class="modal modal--book" id="bookings-registration-form" tabindex="-1" role="dialog" aria-labelledby="modal-bookLabel">
  <div class="modal-dialog" role="document">
      <div class="modal-content">
        <div class="modal-header">
            <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
            <h3 class="modal-title" id="modal-bookLabel">{% T Make your booking %}</h3>
        </div>
        <div class="modal-body">
            <form class="form form--book" data-bind="with: coworker">
              <div class="form-group required">
                  <label for="FullName">{% T Full name %}</label>
                  <input type="text" required="required" class="form-control" id="FullName" data-bind="value: FullName">
                  <small class="help-block validation-error" data-bind="validationMessage: FullName"></small>
              </div>
              <div class="row" style="margin-left: -15px; margin-right: -15px">
                  <div class="col-sm-6">
                    <div class="form-group required">
                        <label for="Email">{% T Email address %}</label>
                        <input type="email" required="required" class="form-control" id="Email" data-bind="value: Email">
                        <small class="help-block validation-error" data-bind="validationMessage: Email"></small>
                    </div>
                    </div>
                    <div class="col-sm-6">
                    <div class="form-group required">
                        <label for="MobilePhone">{% T Phone %}</label>
                        <input type="text" required="required" class="form-control" id="MobilePhone" data-bind="value: MobilePhone">
                        <small class="help-block validation-error" data-bind="validationMessage: MobilePhone"></small>
                    </div>
                  </div>
              </div>
              <div class="form-group required">
                  <label for="Address">{% T Address %}</label>
                  <input type="text" required="required" class="form-control" id="Address" data-bind="value: Address">
                  <small class="help-block validation-error" data-bind="validationMessage: Address"></small>
              </div>
              <div class="row" style="margin-left: -15px; margin-right: -15px">
                  <div class="col-sm-4">
                    <div class="form-group required">
                        <label for="postCode">{% T Postcode / Zip code %}</label>
                        <input type="text" required="required" class="form-control" id="PostCode" data-bind="value: PostCode">
                        <small class="help-block validation-error" data-bind="validationMessage: PostCode"></small>
                    </div>
                    </div>
                    <div class="col-sm-4">
                    <div class="form-group required">
                        <label for="CityName">{% T Town / City %}</label>
                        <input type="text" required="required" class="form-control" id="CityName" data-bind="value: CityName">
                        <small class="help-block validation-error" data-bind="validationMessage: CityName"></small>
                    </div>
                    </div>
                    <div class="col-sm-4">
                    <div class="form-group required">
                        <label for="State">{% T State / Province %}</label>
                        <input type="text" required="required" class="form-control" id="State" data-bind="value: State">
                        <small class="help-block validation-error" data-bind="validationMessage: State"></small>
                    </div>
                  </div>
              </div>

              <div class="row" style="margin-left: -15px; margin-right: -15px">
                  <div class="col-sm-4">
                    <div class="form-group ">
                        <label for="TaxIDNumber">{% T TAX/VAT Number %}</label>
                        <input type="text" class="form-control" id="TaxIDNumber" data-bind="value: TaxIDNumber">
                        <small class="help-block validation-error" data-bind="validationMessage: TaxIDNumber"></small>
                    </div>
                    </div>
                    <div class="col-sm-8">
                    <div class="form-group">
                        <label for="BillingEmail">{% T Send Invoice To %}</label>
                        <input type="email" class="form-control" id="BillingEmail" data-bind="value: BillingEmail">
                        <small class="help-block validation-error" data-bind="validationMessage: BillingEmail"></small>
                    </div>
                  </div>
              </div>

              <div class="alert alert--danger alert--icon" role="alert" data-bind="visible: $root.coworker.errors().length > 0">
                <i class="fa fa-exclamation-circle"></i>
                <b>
                    {% T Please complete or correct the form details %}
                </b>
            </div>

              <div class="btn-toolbar form-actions">
                  <button class="btn btn--primary btn--sm" data-bind="click: $root.validateRegistration" type="button">Continue</button>
                  <a href="#" class="btn btn--link btn--sm" data-bind="click: $root.closeRegistationForm">Cancel</a>
              </div>

            </form>

        </div>
      </div>
  </div>
</div>
<!-- END BOOKINGS MODAL STEP2 -->