25 lines
1.4 KiB
Text
25 lines
1.4 KiB
Text
= semantic_form_for(@payment, url: conference_payments_path) do |f|
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.form-group
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= f.label :full_name, 'Full name (as on card)'
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= f.text_field :full_name, class: "form-control", placeholder: "John Doe", id: "full_name"
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%span.pull-right
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%img.img-responsive{:src => image_url('credit_card.png')}
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.form-group
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= f.label :credit_card_number, "Credit Card number (without spaces)"
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.input-group
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= f.text_field :credit_card_number, class: "form-control", placeholder: "XXXX XXXX XXXX XXXX", id: "credit_card_number"
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%span.input-group-addon
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%i.fa.fa-credit-card
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.form-group.col-md-6
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= f.label :expiration_month
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= f.select :expiration_month, months, {}, class: "form-control", id: "expiration_month"
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.form-group.col-md-6
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= f.label :expiration_year
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= f.select :expiration_year, years, {}, class: "form-control", id: "expiration_year"
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.form-group.col-md-10
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= f.label :card_verification_value, 'Security Code (3 on back, AmEx: 4 on front)'
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= f.text_field :card_verification_value, class: "form-control", placeholder: "XXX", id: "card_verification_value"
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= f.number_field :amount, value: @total_amount_to_pay, class: "form-control", type: 'hidden'
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.form-group.text-center
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= f.submit "Pay #{number_to_currency @total_amount_to_pay, unit: @total_amount_to_pay.symbol}", class: "btn btn-primary", id: "Charge Card"
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= link_to "Cancel", conference_conference_registration_path, class: "btn btn-danger"
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