@extends('public.header') @section('content') {{ Former::vertical_open($url)->rules(array( 'first_name' => 'required', 'last_name' => 'required', 'card_number' => 'required', 'expiration_month' => 'required', 'expiration_year' => 'required', 'cvv' => 'required', 'address1' => 'required', 'city' => 'required', 'state' => 'required', 'postal_code' => 'required', 'country' => 'required', 'phone' => 'required', 'email' => 'required|email' )) }} @if ($client) {{ Former::populate($client) }} {{ Former::populateField('first_name', $contact->first_name) }} {{ Former::populateField('last_name', $contact->last_name) }} @endif

 

@if ($client)

{{{ $client->getDisplayName() }}}

{{{ trans('texts.invoice') . ' ' . $invoiceNumber }}}|  {{ trans('texts.amount_due') }}: {{ Utils::formatMoney($amount, $currencyId) }}

@elseif ($paymentTitle)

{{ $paymentTitle }}
{{ $paymentSubtitle }}

@endif
@if (Request::secure() || Utils::isNinjaDev())

{{ trans('texts.secure_payment') }}

{{ trans('texts.256_encryption') }}
@endif

 
 

{{ trans('texts.contact_information') }}

{{ Former::text('first_name')->placeholder(trans('texts.first_name'))->raw() }}
{{ Former::text('last_name')->placeholder(trans('texts.last_name'))->raw() }}
@if (isset($paymentTitle))
{{ Former::text('email')->placeholder(trans('texts.email'))->raw() }}
@endif

 
 

{{ trans('texts.billing_address') }}  {{ trans('texts.payment_footer1') }}

{{ Former::text('address1')->placeholder(trans('texts.address1'))->raw() }}
{{ Former::text('address2')->placeholder(trans('texts.address2'))->raw() }}
{{ Former::text('city')->placeholder(trans('texts.city'))->raw() }}
{{ Former::text('state')->placeholder(trans('texts.state'))->raw() }}
{{ Former::text('postal_code')->placeholder(trans('texts.postal_code'))->raw() }}

 
 

{{ trans('texts.billing_method') }}

{{ Former::text('card_number')->placeholder(trans('texts.card_number'))->raw() }}
{{ Former::text('cvv')->placeholder(trans('texts.cvv'))->raw() }}
{{ Former::select('expiration_month')->placeholder(trans('texts.expiration_month')) ->addOption('01 - January', '1') ->addOption('02 - February', '2') ->addOption('03 - March', '3') ->addOption('04 - April', '4') ->addOption('05 - May', '5') ->addOption('06 - June', '6') ->addOption('07 - July', '7') ->addOption('08 - August', '8') ->addOption('09 - September', '9') ->addOption('10 - October', '10') ->addOption('11 - November', '11') ->addOption('12 - December', '12')->raw(); }}
{{ Former::select('expiration_year')->placeholder(trans('texts.expiration_year')) ->addOption('2015', '2015') ->addOption('2016', '2016') ->addOption('2017', '2017') ->addOption('2018', '2018') ->addOption('2019', '2019') ->addOption('2020', '2020') ->addOption('2021', '2021') ->addOption('2022', '2022') ->addOption('2023', '2023') ->addOption('2024', '2024') ->addOption('2025', '2025')->raw(); }}
@if ($client && $account->showTokenCheckbox()) selectTokenCheckbox() ? 'CHECKED' : '' }} value="1" style="margin-left:0px; vertical-align:top"> {{ trans('texts.token_billing_secure', ['stripe_link' => link_to('https://stripe.com/', 'Stripe.com', ['target' => '_blank'])]) }} @endif
@if (isset($acceptedCreditCardTypes))
@foreach ($acceptedCreditCardTypes as $card) {{ $card['alt'] }} @endforeach
@endif

 
 

{{ Button::block_success_submit_lg(strtoupper(trans('texts.pay_now') . ' - ' . Utils::formatMoney($amount, $currencyId) )) }}

 

 

{{ Former::close() }} @stop