Initial dev repository

[kcls-web.git] / local_templates / default / circ / selfcheck / payment.tt2

diff --git a/local_templates/default/circ/selfcheck/payment.tt2 b/local_templates/default/circ/selfcheck/payment.tt2
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+++ b/local_templates/default/circ/selfcheck/payment.tt2
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+<div id='oils-selfck-cc-payment-summary'>
+    Total amount to pay: $<span></span>
+</div>
+<table id='oils-selfck-cc-payment-table'>
+    <tbody>
+        <!-- Technically not needed since card type is derived from the CC number
+        <tr>
+            <td>Type of Card</td>
+            <td>
+                <select dojoType='dijit.form.FilteringSelect' jsId='oilsSelfckCCType' required='true'>
+                    <option value='VISA'>VISA</option>
+                    <option value='MasterCard'>MasterCard</option>
+                    <option value='American Express'>American Express</option>
+                </select>
+            </td>
+        </tr>
+        -->
+        <tr>
+            <td>Credit Card #</td>
+            <td><input dojoType='dijit.form.TextBox' jsId='oilsSelfckCCNumber' required='true'/></td>
+        </tr>
+        <tr>
+            <td>CVV #</td>
+            <td><input dojoType='dijit.form.TextBox' jsId='oilsSelfckCCCVV' required='true'/></td>
+        </tr>
+        <tr>
+            <td>Exipration Month</td>
+            <td>
+                <select dojoType='dijit.form.FilteringSelect' jsId='oilsSelfckCCMonth' required='true'>
+                    <option value='01' selected='selected'>Jan</option>
+                    <option value='02'>Feb</option>
+                    <option value='03'>Mar</option>
+                    <option value='04'>April</option>
+                    <option value='05'>May</option>
+                    <option value='06'>June</option>
+                    <option value='07'>July</option>
+                    <option value='08'>Aug</option>
+                    <option value='09'>Sept</option>
+                    <option value='10'>Oct</option>
+                    <option value='11'>Nov</option>
+                    <option value='12'>Dec</option>
+                </select>
+            </td>
+        </tr>
+        <tr>
+            <td>Expiration Year</td>
+            <td><input dojoType='dijit.form.NumberSpinner' constraints='{pattern:"0000", places:0, maxlength:4}' jsId='oilsSelfckCCYear' required='true'/></td>
+        </tr>
+        <tr>
+            <td>Edit Billing Details</td>
+            <td><input dojoType='dijit.form.CheckBox' jsId='oilsSelfckEditDetails'/></td>
+        </tr>
+        <tr>
+            <td>First Name</td>
+            <td><input dojoType='dijit.form.TextBox' jsId='oilsSelfckCCFName' disabled='disabled' required='true'/></td>
+        </tr>
+        <tr>
+            <td>Last Name</td>
+            <td><input dojoType='dijit.form.TextBox' jsId='oilsSelfckCCLName' disabled='disabled' required='true'/></td>
+        </tr>
+        <tr>
+            <td>Street Address</td>
+            <td><input dojoType='dijit.form.TextBox' jsId='oilsSelfckCCStreet' disabled='disabled' required='true'/></td>
+        </tr>
+        <tr>
+            <td>City</td>
+            <td><input dojoType='dijit.form.TextBox' jsId='oilsSelfckCCCity' disabled='disabled' required='true'/></td>
+        </tr>
+        <tr>
+            <td>State or Province</td>
+            <td><input dojoType='dijit.form.TextBox' jsId='oilsSelfckCCState' disabled='disabled' required='true'/></td>
+        </tr>
+        <tr>
+            <td>ZIP or Postal Code</td>
+            <td><input dojoType='dijit.form.TextBox' jsId='oilsSelfckCCZip' disabled='disabled' required='true'/></td>
+        </tr>
+        <tr>
+            <td colspan='2' align='center'>
+                <button dojoType='dijit.form.Button' jsId='oilsSelfckCCSubmit'>Submit Payment</button>
+            </td>
+        </tr>
+    </tbody>
+</table>