127 lines
7.2 KiB
HTML
127 lines
7.2 KiB
HTML
<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="utf-8">
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<meta http-equiv="X-UA-Compatible" content="IE=edge">
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<meta name="viewport" content="width=device-width, initial-scale=1">
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<title>ABC</title>
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<!-- Bootstrap -->
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<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/4.0.0/css/bootstrap.min.css" integrity="sha384-Gn5384xqQ1aoWXA+058RXPxPg6fy4IWvTNh0E263XmFcJlSAwiGgFAW/dAiS6JXm" crossorigin="anonymous">
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<link href="css/style.css" rel="stylesheet">
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<link href="css/responsive.css" rel="stylesheet">
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</head>
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</head>
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<body>
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<header>
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<div class="container">
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<div class="logo d-flex">
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<img src="img/logo.jpg" alt="">
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<span class="d-flex align-items-center justify-content-center">
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<h1>Continuing Education Registration</h1>
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</span>
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</div>
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</div>
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</header>
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<section>
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<div class="container">
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<div class="select-payment">
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<h3>Select Payment Type</h3>
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<div class="credit d-flex">
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<span> <input type="checkbox" id="host1" class="check_box"><label for="host1"></label>Credit Card / Debit Card</span>
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<span> <input type="checkbox" id="host2" class="check_box"><label for="host2"></label>Invoice Company</span>
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</div>
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</div>
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<div class="select-payment">
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<h3>Card Details</h3>
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<div class="card-detail">
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<span class="d-flex"><label for="">Card holder Name:*</label><input type="text"></span>
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<span class="d-flex"><label for="">Card Number:*</label><input type="text"></span>
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<span class="d-flex">
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<label for="">Edit Card Type:* </label>
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<select name="">
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<option value="Class1">Select</option>
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<option value="Class1">Class1</option>
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<option value="Class1">Class1</option>
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<option value="Class1">Class1</option>
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</select>
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</span>
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<span class="d-flex">
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<div class="col-md-4 d-flex no-pad"><label for="">Expiration Month:*</label><input type="text"></div>
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<div class="col-md-4 d-flex no-pad"><label for="">Exp Year:*</label><input type="text"></div>
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<div class="col-md-4 d-flex no-pad"><label for="">CVV Code:*</label><input type="text"></div>
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</span>
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<span class="d-flex"><label for="">Street Address:*</label><input type="text"></span>
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<span class="d-flex">
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<div class="col-md-4 d-flex no-pad"><label for="">City:*</label><input type="text"></div>
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<div class="col-md-4 d-flex no-pad"><label for="">State:*</label><input type="text"></div>
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<div class="col-md-4 d-flex no-pad"><label for="">Postal Code:*</label><input type="text"></div>
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</span>
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<span class="d-flex">
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<div class="col-md-6 d-flex no-pad"><label for="">Phone Number:*</label><input type="text"></div>
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<div class="col-md-6 d-flex no-pad"><label for="">Fax Number: </label><input type="text"></div>
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</span>
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<span class="d-flex"><label for="" style="width:180px;">Additional Instructions:</label><textarea class="form-control" rows="5" id="comment"></textarea></span>
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</div>
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</div>
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<div class="select-payment">
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<h3>Company Details</h3>
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<div class="credit comp-detail">
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<span class="d-flex"> <input type="checkbox" id="detail" class="check_box"><label for="detail"></label>Same as above</span>
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<div class="company-expand detail">
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<span class="d-flex"><label for="" class="m-200 align-self-center">Card holder Name:*</label><input type="text"> </span>
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<span class="d-flex"><label for="" class="m-200 align-self-center">Street Address*</label><input type="text"> </span>
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<span class="d-flex cd-sub">
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<div class="col-md-4 d-flex no-pad"><label for="" class="m-200 text-right align-self-center">Expiration Month:*</label><input type="text"></div>
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<div class="col-md-4 d-flex no-pad"><label for="" class="m-200 text-right align-self-center">Exp Year:*</label><input type="text"></div>
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<div class="col-md-4 d-flex no-pad"><label for="" class="m-200 text-right align-self-center">CVV Code:*</label><input type="text"></div>
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</span>
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<span class="d-flex cd-sub">
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<div class="col-md-6 d-flex no-pad"><label for="" class="m-200 text-right align-self-center">Phone Number:*</label><input type="text"></div>
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<div class="col-md-6 d-flex no-pad"><label for="" class="m-200 text-right align-self-center">Fax Number:*</label><input type="text"></div>
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</span>
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</div>
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</div>
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</div>
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<div class="select-payment">
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<h3>Sale Information</h3>
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<div class="credit d-flex sale-in">
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<div class="p-2">Total Sale Amount:</div>
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<div class="ml-auto p-2">$47.98</div>
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</div>
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</div>
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<div class="select-payment">
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<h3>Notifications / Receipts</h3>
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<div class="credit d-flex">
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<span class="align-self-center"> <input type="checkbox" id="host5" class="check_box"><label for="host5"></label>Credit Card / Debit Card</span>
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<span class="d-flex"> <label class="align-self-center m-200">Email Address:</label> <input type="text"></span>
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</div>
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</div>
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<div class="d-flex justify-content-center bd-highlight mb-3">
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<div class="p-2 bd-highlight"><button type="button" class="btn clear-btn">Clear</button></div>
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<div class="p-2 bd-highlight"><button type="button" class="btn process-btn">Process</button></div>
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</div>
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<div class="abc-img d-flex flex-wrap justify-content-center align-items-center">
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<img src="img/visa.png" alt="">
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<img src="img.ssl.png" alt="">
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<img src="img/data.png" alt="">
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<img src="img/abc.png" alt="">
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</div>
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</div>
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</section>
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<script src="https://cdnjs.cloudflare.com/ajax/libs/jquery/3.3.1/jquery.min.js"></script>
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<!-- Include all compiled plugins (below), or include individual files as needed -->
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<script src="https://maxcdn.bootstrapcdn.com/bootstrap/4.0.0/js/bootstrap.min.js" integrity="sha384-JZR6Spejh4U02d8jOt6vLEHfe/JQGiRRSQQxSfFWpi1MquVdAyjUar5+76PVCmYl" crossorigin="anonymous"></script>
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<script type="text/javascript">
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$(document).ready(function(){
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$('input[type="checkbox"]').click(function(){
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var inputValue = $(this).attr("id");
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$("." + inputValue).toggle();
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});
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});
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</script>
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</body>
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</html> |