59 lines
3.1 KiB
HTML
59 lines
3.1 KiB
HTML
{{ define "content" }}
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<section class="dialog-content">
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<h2>{{(pgettext "Tax Details" "title")}}</h2>
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<form method="POST">
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<div class="input">
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<input type="text" name="business_name" id="business_name" required="required" value="{{ .BusinessName }}" placeholder="{{( pgettext "Business name" "input" )}}">
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<label for="business_name">{{( pgettext "Business name" "input" )}}</label>
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</div>
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<div class="input">
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<input type="text" name="vatin" id="vatin" required="required" value="{{ .VATIN }}" placeholder="{{( pgettext "VAT number" "input" )}}">
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<label for="vatin">{{( pgettext "VAT number" "input" )}}</label>
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</div>
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<div class="input">
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<input type="text" name="trade_name" id="trade_name" value="{{ .TradeName }}" placeholder="{{( pgettext "Trade name" "input" )}}">
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<label for="trade_name">{{( pgettext "Trade name" "input" )}}</label>
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</div>
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<div class="input">
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<input type="tel" name="phone" id="phone" required="required" value="{{ .Phone }}" placeholder="{{( pgettext "Phone" "input" )}}">
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<label for="phone">{{( pgettext "Phone" "input" )}}</label>
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</div>
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<div class="input">
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<input type="email" name="email" id="email" required="required" value="{{ .Email }}" placeholder="{{( pgettext "Email" "input" )}}">
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<label for="email">{{( pgettext "Email" "input" )}}</label>
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</div>
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<div class="input">
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<input type="url" name="web" id="web" value="{{ .Web }}" placeholder="{{( pgettext "Web" "input" )}}">
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<label for="web">{{( pgettext "Web" "input" )}}</label>
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</div>
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<div class="input">
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<input type="text" name="address" id="address" class="width-2x" required="required" value="{{ .Address }}" placeholder="{{( pgettext "Address" "input" )}}">
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<label for="address">{{( pgettext "Address" "input" )}}</label>
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</div>
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<div class="input">
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<input type="text" name="city" id="city" required="required" value="{{ .City }}" placeholder="{{( pgettext "City" "input" )}}">
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<label for="city">{{( pgettext "City" "input" )}}</label>
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</div>
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<div class="input">
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<input type="text" name="province" id="province" required="required" value="{{ .City }}" placeholder="{{( pgettext "Province" "input" )}}">
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<label for="province">{{( pgettext "Province" "input" )}}</label>
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</div>
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<div class="input">
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<input type="text" name="postal_code" id="postal_code" required="required" value="{{ .PostalCode }}" placeholder="{{( pgettext "Postal code" "input" )}}">
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<label for="postal_code">{{( pgettext "Postal code" "input" )}}</label>
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</div>
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<div class="input">
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<select id="country" name="country" class="width-fixed">
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{{- range $country := .Countries }}
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<option value="{{ .Code }}" {{ if eq .Code $.CountryCode }}selected="selected"{{ end }}>{{ .Name }}</option>
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{{- end }}
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</select>
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<label for="country">{{( pgettext "Country" "input" )}}<label>
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</div>
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<button type="submit">{{( pgettext "Save changes" "action" )}}</button>
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</form>
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</section>
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{{- end }}
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