pyc-website
main website for pyc inc.
git clone https://9o.is/git/pyc-website.git
apply-atm-form.html
(3938B)
1 <div data-lift="AtmApplication" ng-controller="AtmApplicationCtrl" ng-cloak>
2 <form name="form" class="smart-form client-form" ng-submit="save()" novalidate>
3 <fieldset>
4 <section>
5 <label class="input" ng-class="{{ stateSuccessError('name') }}">
6 <i class="icon-append fa fa-briefcase"></i>
7 <input name="name" ng-model="model.name" data-lift="Placeholder?name=business_name" type="text" required>
8 <b class="tooltip tooltip-top-left"><span data-lift="Loc.business_name_tip"></span>.</b>
9 </label>
10 </section>
11
12 <section>
13 <label class="input" ng-class="{{ stateSuccessError('email') }}">
14 <i class="icon-append fa fa-envelope-o"></i>
15 <input name="email" ng-model="model.email" data-lift="Placeholder?name=Email" type="email" required>
16 <b class="tooltip tooltip-top-left"><span data-lift="Loc.business_email_tip"></span>.</b>
17 <span ng-show="form.email.$invalid && form.email.$dirty" class="text-danger small">
18 <span data-lift="Loc.invalid_email"></span>
19 </span>
20 </label>
21 </section>
22
23 <section>
24 <label class="input" ng-class="{{ stateSuccessError('phone') }}">
25 <i class="icon-append fa fa-phone"></i>
26 <input name="phone" ng-model="model.phone" ui-mask="(999) 999-9999" placeholder="(xxx) xxx-xxxx" type="text" required>
27 <b class="tooltip tooltip-top-left"><span data-lift="Loc.phone_tip"></span>.</b>
28 <span ng-show="form.phone.$invalid && form.phone.$dirty" class="text-danger small">
29 <span data-lift="Loc.invalid_phone"></span>
30 </span>
31 </label>
32 </section>
33
34 <section>
35 <label class="input" ng-class="{{ stateSuccessError('address') }}">
36 <input name="address" ng-model="model.address" data-lift="Placeholder?name=address" type="text" required>
37 <b class="tooltip tooltip-top-left"><span data-lift="Loc.business_address_tip"></span>.</b>
38 </label>
39 </section>
40
41 <div class="row">
42 <section class="col col-6">
43 <label class="input" ng-class="{{ stateSuccessError('city') }}">
44 <input name="city" ng-model="model.city" data-lift="Placeholder?name=city" type="text" required>
45 <b class="tooltip tooltip-top-left"><span data-lift="Loc.business_city_tip"></span>.</b>
46 </label>
47 </section>
48 <section class="col col-6" ng-class="{{ stateSuccessError('state') }}">
49 <label data-lift="Selector.states" class="select">
50 <select name="state" ng-model="model.state" required></select>
51 <i></i>
52 <b class="tooltip tooltip-top-left"><span data-lift="Loc.business_state_tip"></span>.</b>
53 </label>
54 </section>
55 </div>
56
57 <section>
58 <label class="input" ng-class="{{ stateSuccessError('website') }}">
59 <i class="icon-append fa fa-globe"></i>
60 <input name="website" ng-model="model.website" data-lift="Placeholder?name=website_url" type="text" ng-pattern="url_regex">
61 <b class="tooltip tooltip-top-left"><span data-lift="Loc.business_website_tip"></span>.</b>
62 <span ng-show="form.website.$error.pattern" class="text-danger small">
63 <span data-lift="Loc.invalid_website"></span>
64 </span>
65 </label>
66 </section>
67
68 <section>
69 <label class="textarea" ng-class="{{ stateSuccess('bestTime') }}">
70 <i class="icon-append fa fa-comment"></i>
71 <textarea name="bestTime" ng-model="model.bestTime"
72 data-lift="Placeholder?name=best_time" rows="2"></textarea>
73 <b class="tooltip tooltip-top-left"><span data-lift="Loc.business_bestTime_tip"></span>.</b>
74 </label>
75 <em><span data-lift="Loc.business_bestTime_example"></span>.</em>
76 </section>
77
78 </fieldset>
79
80 <footer>
81 <div ng-controller="AtmApplicationAlert" ng-cloak>
82 <span data-lift="embed?what=/templates-hidden/parts/alert"></span>
83 </div>
84
85 <button type="submit" class="btn btn-primary" ng-disabled="form.$invalid" disabler ng-model="loading"><span data-lift="Loc.apply_atm"></span></button>
86 </footer>
87 </form>
88 </div>