62 lines
3.3 KiB
Plaintext
62 lines
3.3 KiB
Plaintext
@page "{InvitationCode?}"
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@model EnotaryoPH.Web.Pages.Participant.Registration.IndexModel
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@{
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}
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@section Head {
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<link href="\lib\fontawesome-free-6.7.1-web\css\all.min.css" rel="stylesheet" />
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}
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<div class="container">
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<h1 class="my-4">Principal/Witness Registration</h1>
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<div class="row mb-5">
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<div class="col-12 col-md-8 col-lg-6 col-xl-5">
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<form method="post">
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<input type="hidden" asp-for="TransactionSignatory_UID" />
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<div class="row mt-3">
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<div class="col">
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<label class="form-label">Enter your Birthdate</label>
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<div class="row">
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<div class="col"><input asp-for="Year" class="form-control mb-3" type="number" placeholder="Year" required /></div>
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<div class="col"><input asp-for="Month" class="form-control mb-3" type="number" placeholder="Month" required /></div>
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<div class="col"><input asp-for="Day" class="form-control mb-3" type="number" placeholder="Day" required /></div>
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</div>
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@Html.ValidationMessage("Birthdate")
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</div>
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</div>
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<div class="row mt-3">
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<div class="col">
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<label class="form-label">Enter your Phone Number</label>
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<div class="row">
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<div class="col"><input asp-for="PhoneNumber" class="form-control mb-3" type="text" placeholder="Phone Number" required /></div>
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</div>
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</div>
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</div>
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<div class="row mt-3">
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<div class="col">
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<label class="form-label">Enter your Name</label>
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<div class="row">
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<div class="col-12 col-md-6"><input asp-for="Firstname" class="form-control mb-3" type="text" placeholder="Firstname" required /></div>
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<div class="col"><input asp-for="Lastname" class="form-control mb-3" type="text" placeholder="Lastname" required /></div>
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</div>
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<div class="row">
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<div class="col-12 col-md-6"><input asp-for="Middlename" class="form-control mb-3" type="text" placeholder="Middlename" /></div>
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<div class="col"><input asp-for="Prefix" class="form-control mb-3" type="text" placeholder="Prefix" /></div>
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<div class="col"><input asp-for="Suffix" class="form-control mb-3" type="text" placeholder="Suffix" /></div>
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</div>
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</div>
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</div>
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<div class="row mt-3 mb-0">
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<div class="col">
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<div class="form-check"><input id="EighteenYearsOrOlder" class="form-check-input" type="checkbox" required /><label class="form-check-label" for="EighteenYearsOrOlder">I am 18 years old or older</label></div>
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<button type="submit" class="btn btn-primary btn-lg">
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CONTINUE
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<i class="fas fa-chevron-right ms-2"></i>
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</button>
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</div>
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</div>
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</form>
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</div>
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</div>
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</div> |