34 lines
1.6 KiB
Text
34 lines
1.6 KiB
Text
= semantic_form_for(@payment, url: conference_payments_path) do |f|
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.form-group
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= f.label :first_name, 'First name(as on card)'
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= f.text_field :first_name, class: "form-control", placeholder: "John", id: "first_name"
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.form-group
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= f.label :last_name, 'Last name(as on card)'
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= f.text_field :last_name,class: "form-control", placeholder: "Doe", id: "last_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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%ul.price-tags.pull-right
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%li.text-muted
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you will pay
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%li
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%a
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= number_to_currency @total_amount_to_pay
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.form-group
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= f.submit "Charge Card", class: "btn btn-primary"
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= link_to "Cancel", conference_conference_registrations_path, class: "btn btn-danger"
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