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doughman.html
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doughman.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, maximum-scale=1" />
<title>Kuza Forms - Sell Anywhere, Grow your Business</title>
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/css/bootstrap.min.css">
<link rel="stylesheet" href="https://maxcdn.bootstrapcdn.com/font-awesome/4.7.0/css/font-awesome.min.css">
<link rel="stylesheet" href="css/forms.css">
</head>
<body>
<div class="container">
<div class="row" id="app">
<form action="" method="POST" role="form">
<div id="leftPage" class="col-lg-7 pd-tb-mini pd-r-50">
<img class="img-logo" src="https://pbs.twimg.com/profile_images/748326751349186562/XUU6O176.jpg" alt="">
<h3 class="mr-b-20">Customer information</h3>
<div class="row">
<div class="form-group col-sm-6">
<label for="" class="control-label">First Name</label>
<input type="text" class="form-control" id="" placeholder="Enter your First Name">
</div>
<div class="form-group col-sm-6">
<label for="" class="control-label">Last Name</label>
<input type="text" class="form-control" id="" placeholder="Enter your Last Name">
</div>
<div class="form-group col-sm-6">
<label for="" class="control-label">Email Address</label>
<input type="text" class="form-control" id="" placeholder="Enter your Email Address">
</div>
<div class="form-group col-sm-6">
<label for="" class="control-label">Phone #</label>
<input type="text" class="form-control" id="" placeholder="Enter your Phone #">
</div>
</div>
<hr>
<h3 class="mr-b-20">Address / Shipping Information</h3>
<div class="row">
<div class="form-group col-sm-12">
<label for="" class="control-label">Company Name</label>
<input type="text" class="form-control" id="" placeholder="Enter your Company Name">
</div>
<div class="form-group col-sm-12">
<label for="" class="control-label">Address</label>
<input type="text" class="form-control" id="" placeholder="Enter your Address">
</div>
<div class="form-group col-sm-6">
<label for="" class="control-label">City / Town</label>
<input type="text" class="form-control" id="" placeholder="Enter your City / Town">
</div>
<div class="form-group col-sm-6">
<label for="" class="control-label">Region</label>
<input type="text" class="form-control" id="" placeholder="Enter your Region">
</div>
</div>
</div>
<div id="rightPage" class="col-lg-5">
<h3 class="mr-b-20">Doughman Foods Order Form</h3>
<div class="row sm-gutter" v-for="(attendee, index) in attendees" :key="index">
<div class="form-group col-xs-5">
<label for="" class="control-label">Product</label>
<select class="form-control" required="required">
<option value="">-- Select Doughnut --</option>
<option value="">Classic Assorted</option>
<option value="">Premium Assorted</option>
<option value="">Creamy Deluxe</option>
<option value="">Rainbow Storm</option>
</select>
</div>
<div class="form-group col-xs-3">
<label for="" class="control-label">Pack</label>
<select class="form-control" required="required">
<option value="">-- Qty --</option>
<option value="">5pcs</option>
<option value="">10pcs</option>
<option value="">12pcs</option>
</select>
</div>
<div class="form-group col-xs-3">
<label for="" class="control-label">Ghc</label>
<input type="text" readonly class="form-control" placeholder="20.30">
</div>
<div class="form-group col-xs-1 dyn-btn">
<a href="#" class="text-danger"><i class="fa fa-times-circle"></i></a>
</div>
</div>
<div class="row">
<div class="col-xs-6">
<a href="#" class="btn btn-success">+ Add Product</a>
</div>
<div class="col-xs-6 col-sm-5 col-sm-offset-1 text-right">
<h4 class="mr-t-10 fs16 bold-4">Sub Total: Ghc 63.35</h4>
</div>
</div>
<hr class="mr-tb-20">
<div class="row">
<div class="form-group col-xs-12">
<textarea name="" class="form-control" placeholder="Additional notes or description." rows="5"></textarea>
</div>
</div>
<div class="row">
<div class="col-md-12 "><label for="">Delivery Location</label></div>
<div class="form-group col-xs-6">
<select class="form-control" required="required">
<option value="">-- Delivery Location --</option>
<option value="">Accra</option>
<option value="">Tema</option>
<option value="">Nungua</option>
<option value="">East Legon</option>
<option value="">Madina</option>
</select>
</div>
<div class="col-xs-6 col-sm-5 col-sm-offset-1 text-right">
<h4 class="mr-t-10 fs16 bold-4">Delivery: Ghc 5.35</h4>
</div>
</div>
<div class="row">
<div class="form-group col-md-12 mr-t-20 text-center">
<button type="submit" class="btn btn-lg btn-primary">Pay (Ghc 68.70)</button>
</div>
</div>
</div>
</form>
</div>
</div>
</body>
</html>