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103 changes: 103 additions & 0 deletions index.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>Formulario con bootstrap</title>
<link href="https://cdn.jsdelivr.net/npm/[email protected]/dist/css/bootstrap.min.css" rel="stylesheet"
integrity="sha384-EVSTQN3/azprG1Anm3QDgpJLIm9Nao0Yz1ztcQTwFspd3yD65VohhpuuCOmLASjC" crossorigin="anonymous">
<script src="https://kit.fontawesome.com/072e5df971.js" crossorigin="anonymous"></script>
</head>
<body>
<div class="container mt-5">
<div class="row justify-content-center">
<div class="col-md-8">
<div class="card card-outline-secondary ">
<div class="card-header">
<h3>Payment form example</h3>
</div>
<form class="p-4">
<div class="row mt-3">
<div id="error-msg" class="alert alert-danger">Some fields are missing</div>
<div class="col-sm-5 pb-3">
<label for="exampleAccount">Card #</label>
<input class="form-control" id="exampleAccount" placeholder="XXXXXXXXXXXXXXXX" type="text" required>
</div>
<div class="col-sm-3 pb-3">
<label for="exampleCtrl">CVC #</label>
<input class="form-control" id="exampleCtrl" placeholder="0000" type="text" required>
</div>
<div class="col-sm-4 pb-3">
<label for="exampleAmount">Amount</label>
<div class="input-group">
<span class="input-group-text"><i class="fas fa-dollar-sign"></i></span>
<input class="form-control" id="exampleAmount" placeholder="Amount" type="number" required>
</div>
</div>
<div class="col-sm-6 pb-3">
<label for="exampleFirst">First Name</label>
<input class="form-control" id="exampleFirst" type="text" required>
</div>
<div class="col-sm-6 pb-3">
<label for="exampleLast">Last Name</label>
<input class="form-control" id="exampleLast" type="text" required>
</div>
<div class="col-sm-6 pb-3">
<label for="exampleCity">City</label>
<input class="form-control" id="exampleCity" type="text" required>
</div>
<div class="col-sm-3 pb-3">
<label for="exampleSt">State</label>
<select class="form-select" id="exampleSt" required>
<option class="text-white bg-warning">Pick a state</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
</select>
</div>
<div class="col-sm-3 pb-3">
<label for="exampleZip">Postal Code</label>
<input class="form-control" id="exampleZip" type="text" required>
</div>
<div class="col-md-6 pb-3">
<p>We accept:</p>
<div class="btn-group" data-toggle="buttons">
<label class="btn btn-secondary">
<input autocomplete="off" checked id="blue" name="options" type="radio">
<i class="fab fa-cc-mastercard"></i>
</label>
<label class="btn btn-secondary">
<input autocomplete="off" id="red" name="options" type="radio">
<i class="fab fa-cc-visa"></i>
</label>
<label class="btn btn-secondary">
<input autocomplete="off" id="green" name="options" type="radio">
<i class="fab fa-cc-diners-club"></i>
</label>
<label class="btn btn-secondary">
<input autocomplete="off" id="yellow" name="options" type="radio">
<i class="fab fa-cc-amex"></i>
</label>
</div>
</div>
<div class="col-md-6 pb-3">
<label for="exampleMessage">Message</label>
<textarea class="form-control" id="complexExampleMessage" rows="3"></textarea>
<small class="text-muted">Add any notes here.</small>
</div>
</div>
</form>
<div class="card-footer text-end">
<button class="btn btn-secondary" type="reset">Cancel</button>
<button id="sendForm" class="btn btn-primary" type="button">Send</button>
</div>
</div>
</div>
</div>
</div>
<script src="https://cdn.jsdelivr.net/npm/[email protected]/dist/js/bootstrap.bundle.min.js" integrity="sha384-pzjw8f+ua7Kw1TIq0v8Fq6Ndt1w0YOG3l4H5DLcL8Cz8A24K5v5JzEdb0WjhaJpo" crossorigin="anonymous"></script>
</body>
</html>