xp-dev.com Git - namibia/blob - public/templates/page/register.html

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  15
  16
  17                         <form id="frmRegister" action="">
  18                                 <div class="row-fluid page-title-wrapper">
  19                                         <div class="span12">
  20                                                 <h1>Registration</h1>
  21                                                 <p class="page-title-header">
  22                                                         Welcome to Bid4Cars registration section, please ensure you have your company registration and VAT information at hand.
  23                                                 </p>
  24                                         </div>
  25                                 </div>
  26
  27
  28
  29                                 <div class="row-fluid page-top-forms-wrapper">
  30                                         <div class="customer-details-form span4">
  31                                                 <div class="visible-phone mobile-form-headers">
  32                                                         <p>
  33                                                                 <span class="btn-content">
  34                                                                         <i class="icon-user"></i>
  35                                                                 </span>
  36                                                                 Personal information
  37                                                         </p>
  38                                                 </div>
  39                                                 <p class="hidden-phone form-header"><i class="icon-user icon-white"></i> Personal information</p>
  40                                                 <div class="form-horizontal">
  41                                                         <div class="control-group mobile-control-group" id="[tid]_firstName">
  42                                                                 [firstName]
  43                                                     </div>
  44                                                         <div class="control-group mobile-control-group" id="[tid]_familyName">
  45                                                                 [familyName]
  46                                                     </div>
  47                                                         <div class="control-group mobile-control-group" id="[tid]_permissions">
  48                                                                 [permissions]
  49                                                     </div>
  50                                                         <div class="control-group mobile-control-group" id="[tid]_email">
  51                                                                 [email]
  52                                                     </div>
  53                                                         <div class="control-group mobile-control-group" id="[tid]_confirmEmail">
  54                                                                 [confirmEmail]
  55                                                     </div>
  56                                                         <div class="control-group mobile-control-group" id="[tid]_pin">
  57                                                                 [pin]
  58                                                     </div>
  59                                                         <div class="control-group mobile-control-group" id="[tid]_confirmPin">
  60                                                                 [confirmPin]
  61                                                     </div>
  62                                                         <div class="control-group mobile-control-group" id="[tid]_idNumber">
  63                                                                 [idNumber]
  64                                                     </div>
  65                                                         <div class="control-group mobile-control-group" id="[tid]_dateOfBirth">
  66                                                                 [dateOfBirth]
  67                                                     </div>
  68                                                         <div class="control-group mobile-control-group" id="[tid]_mobile">
  69                                                                 [mobile]
  70                                                     </div>
  71                                                     <hr/>
  72                                                     <h5>Dealership contact</h5>
  73                                                         <div class="control-group mobile-control-group" id="[tid]_contactFirstName">
  74                                                                 [contactFirstName]
  75                                                     </div>
  76                                                         <div class="control-group mobile-control-group" id="[tid]_contactFamilyName">
  77                                                                 [contactFamilyName]
  78                                                     </div>
  79                                                         <div class="control-group mobile-control-group" id="[tid]_contactOffice">
  80                                                                 [contactOffice]
  81                                                     </div>
  82                                                         <div class="control-group mobile-control-group" id="[tid]_contactMobile">
  83                                                                 [contactMobile]
  84                                                     </div>
  85                                                         <div class="control-group mobile-control-group" id="[tid]_contactEmail">
  86                                                                 [contactEmail]
  87                                                     </div>
  88                                                 </div>
  89                                         </div>
  90
  91                                         <div class="customer-details-form span4">
  92                                                 <div class="visible-phone mobile-form-headers">
  93                                                         <p>
  94                                                                 <span class="btn-content">
  95                                                                         <i class="icon-home"></i>
  96                                                                 </span>
  97                                                                 Dealership details
  98                                                         </p>
  99                                                 </div>
 100                                                 <p class="hidden-phone form-header"><i class="icon-home icon-white"></i> Dealership details</p>
 101                                                 <div class="form-horizontal">
 102                                                         <div class="control-group mobile-control-group" id="[tid]_dealerType">
 103                                                                 [dealerType]
 104                                                     </div>
 105                                                         <div class="control-group mobile-control-group" id="[tid]_clientType">
 106                                                                 [clientType]
 107                                                     </div>
 108                                                         <div class="control-group mobile-control-group" id="[tid]_group">
 109                                                                 [group]
 110                                                     </div>
 111                                                         <div class="control-group mobile-control-group" id="[tid]_groupDivision">
 112                                                                 [groupDivision]
 113                                                     </div>
 114                                                         <div class="control-group mobile-control-group" id="[tid]_companyType">
 115                                                                 [companyType]
 116                                                     </div>
 117                                                         <div class="control-group mobile-control-group" id="[tid]_businessName">
 118                                                                 [businessName]
 119                                                     </div>
 120                                                         <div class="control-group mobile-control-group" id="[tid]_name">
 121                                                                 [name]
 122                                                     </div>
 123                                                         <div class="control-group mobile-control-group" id="[tid]_companyRegistrationNumber">
 124                                                                 [companyRegistrationNumber]
 125                                                     </div>
 126                                                         <div class="control-group mobile-control-group" id="[tid]_vatNumber">
 127                                                                 [vatNumber]
 128                                                     </div>
 129                                                         <div class="control-group mobile-control-group" id="[tid]_turmiNumber">
 130                                                                 [turmiNumber]
 131                                                     </div>
 132                                                         <div class="control-group mobile-control-group" id="[tid]_dealerStockNumber">
 133                                                                 [dealerStockNumber]
 134                                                     </div>
 135                                                         <div class="control-group mobile-control-group" id="[tid]_turnover">
 136                                                                 [turnover]
 137                                                     </div>
 138                                                         <div class="control-group mobile-control-group" id="[tid]_foundMethod">
 139                                                                 [foundMethod]
 140                                                     </div>
 141                                                         <div class="control-group mobile-control-group" id="[tid]_foundMethodDetail">
 142                                                                 [foundMethodDetail]
 143                                                     </div>
 144                                                 </div>
 145                                         </div>
 146
 147                                         <div class="customer-details-form span4">
 148                                                 <div class="visible-phone mobile-form-headers">
 149                                                         <p>
 150                                                                 <span class="btn-content">
 151                                                                         <i class="icon-user"></i>
 152                                                                 </span>
 153                                                                 Billing information
 154                                                         </p>
 155                                                 </div>
 156                                                 <p class="hidden-phone form-header"><i class="icon-user icon-white"></i> Billing information</p>
 157                                                 <div class="form-horizontal">
 158                                                     <h5>Business address</h5>
 159                                                         <div class="control-group mobile-control-group" id="[tid]_country">
 160                                                                 [country]
 161                                                     </div>
 162                                                         <div class="control-group mobile-control-group" id="[tid]_region">
 163                                                                 [region]
 164                                                     </div>
 165                                                         <div class="control-group mobile-control-group" id="[tid]_city">
 166                                                                 [city]
 167                                                     </div>
 168                                                         <div class="control-group mobile-control-group" id="[tid]_street">
 169                                                                 [street]
 170                                                     </div>
 171                                                         <div class="control-group mobile-control-group" id="[tid]_postalCode">
 172                                                                 [postalCode]
 173                                                     </div>
 174                                                     <hr/>
 175                                                     <h5>Billing address</h5>
 176                                                         <div class="control-group mobile-control-group" id="[tid]_sameAsBusinessAddress">
 177                                                                 [sameAsBusinessAddress]
 178                                                     </div>
 179                                                         <div class="control-group mobile-control-group" id="[tid]_billingCountry">
 180                                                                 [billingCountry]
 181                                                     </div>
 182                                                         <div class="control-group mobile-control-group" id="[tid]_billingRegion">
 183                                                                 [billingRegion]
 184                                                     </div>
 185                                                         <div class="control-group mobile-control-group" id="[tid]_billingCity">
 186                                                                 [billingCity]
 187                                                     </div>
 188                                                         <div class="control-group mobile-control-group" id="[tid]_billingStreet">
 189                                                                 [billingStreet]
 190                                                     </div>
 191                                                         <div class="control-group mobile-control-group" id="[tid]_billingPostalCode">
 192                                                                 [billingPostalCode]
 193                                                     </div>
 194                                                     <hr/>
 195                                                     <h5>Billing contact</h5>
 196                                                         <div class="control-group mobile-control-group" id="[tid]_sameAsDealerContact">
 197                                                                 [sameAsDealerContact]
 198                                                     </div>
 199                                                         <div class="control-group mobile-control-group" id="[tid]_billingFirstName">
 200                                                                 [billingFirstName]
 201                                                     </div>
 202                                                         <div class="control-group mobile-control-group" id="[tid]_billingFamilyName">
 203                                                                 [billingFamilyName]
 204                                                     </div>
 205                                                         <div class="control-group mobile-control-group" id="[tid]_billingOffice">
 206                                                                 [billingOffice]
 207                                                     </div>
 208                                                         <div class="control-group mobile-control-group" id="[tid]_billingMobile">
 209                                                                 [billingMobile]
 210                                                     </div>
 211                                                         <div class="control-group mobile-control-group" id="[tid]_billingEmail">
 212                                                                 [billingEmail]
 213                                                     </div>
 214                                                 </div>
 215                                         </div>
 216                                 </div>
 217
 218
 219                                 <div class="row-fluid page-top-forms-wrapper">
 220                                         <div class="customer-details-form span4">
 221                                                 <div class="visible-phone mobile-form-headers">
 222                                                         <p>
 223                                                                 <span class="btn-content">
 224                                                                         <i class="icon-home"></i>
 225                                                                 </span>
 226                                                                 Directors / Owners
 227                                                         </p>
 228                                                 </div>
 229                                                 <p class="hidden-phone form-header"><i class="icon-home icon-white"></i> Directors / Owners</p>
 230                                                 <div class="form-horizontal">
 231                                                         <div class="control-group mobile-control-group" id="[tid]_ownerFirstName">
 232                                                                 [ownerFirstName]
 233                                                     </div>
 234                                                         <div class="control-group mobile-control-group" id="[tid]_ownerFamilyName">
 235                                                                 [ownerFamilyName]
 236                                                     </div>
 237                                                         <div class="control-group mobile-control-group" id="[tid]_ownerIdNumber">
 238                                                                 [ownerIdNumber]
 239                                                     </div>
 240                                                     <button type="button" class="btn" id="btnAddOwner">Add</button>
 241                                                     <hr/>
 242                                                         <div class="control-group mobile-control-group" id="[tid]_owners">
 243                                                                 [owners]
 244                                                     </div>
 245                                                 </div>
 246                                         </div>
 247                                         <div class="customer-details-form span4">
 248                                                 <div class="visible-phone mobile-form-headers">
 249                                                         <p>
 250                                                                 <span class="btn-content">
 251                                                                         <i class="icon-home"></i>
 252                                                                 </span>
 253                                                                 Upload documents
 254                                                         </p>
 255                                                 </div>
 256                                                 <p class="hidden-phone form-header"><i class="icon-home icon-white"></i> Upload documents</p>
 257                                                 <div class="form-horizontal">
 258                                                         <div class="control-group mobile-control-group" id="[tid]_docStockCertificate">
 259                                                                 [docStockCertificate]
 260                                                     </div>
 261                                                         <div class="control-group mobile-control-group" id="[tid]_docAddressProof">
 262                                                                 [docAddressProof]
 263                                                     </div>
 264                                                         <div class="control-group mobile-control-group" id="[tid]_docCopyOfId">
 265                                                                 [docCopyOfId]
 266                                                     </div>
 267                                                         <div class="control-group mobile-control-group" id="[tid]_docCopyOfDirectorId">
 268                                                                 [docCopyOfDirectorId]
 269                                                     </div>
 270                                                         <div class="control-group mobile-control-group" id="[tid]_docCompanyRegistration">
 271                                                                 [docCompanyRegistration]
 272                                                     </div>
 273                                                 </div>
 274                                         </div>
 275                                 </div>
 276
 277
 278                                 <div class="row-fluid page-top-forms-wrapper">
 279                                         <div class="span8">
 280                                                 <div class="btn-wrapper">
 281                                                         <div class="top-grey-set">
 282                                                                 <div class="control-group mobile-control-group" id="[tid]_subscribeNewsletter">
 283                                                                         [subscribeNewsletter]
 284                                                             </div>
 285                                                                 <div class="control-group mobile-control-group" id="[tid]_acceptTermsAndConditions">
 286                                                                         [acceptTermsAndConditions]
 287                                                             </div>
 288                                                         </div>
 289                                                         <div class="top-grey-set">
 290                                                                 <hr/>
 291                                                         </div>
 292                                                         <div class="top-grey-set">
 293                                                                 <button type="submit" class="btn btn-success" id="btnUpdate" disabled>Submit Registration</button>
 294                                                         </div>
 295                                                         <div class="top-grey-set">
 296                                                                 <hr/>
 297                                                         </div>
 298                                                 </div>
 299                                         </div>
 300                                 </div>
 301
 302                         </form>
 303