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invoiceninja/resources/views/billing-portal/v3/rff-basic.blade.php
2024-03-14 16:18:49 +01:00

47 lines
1.6 KiB
PHP

<div>
<div>
<form wire:submit="handleSubmit">
@csrf
<label for="contact_first_name">
<span class="input-label">{{ ctrans('texts.first_name') }}</span>
<input wire:model="contact_first_name" type="text" class="input w-full" />
@error('contact_first_name')
<p class="validation validation-fail block w-full" role="alert">
{{ $message }}
</p>
@enderror
</label>
<label for="contact_last_name">
<span class="input-label">{{ ctrans('texts.last_name') }}</span>
<input wire:model="contact_last_name" type="text" class="input w-full" />
@error('contact_last_name')
<p class="validation validation-fail block w-full" role="alert">
{{ $message }}
</p>
@enderror
</label>
<label for="contact_email">
<span class="input-label">{{ ctrans('texts.email_address') }}</span>
<input wire:model="contact_email" type="email" class="input w-full" />
@error('contact_email')
<p class="validation validation-fail block w-full" role="alert">
{{ $message }}
</p>
@enderror
</label>
<button
type="submit"
class="button button-block bg-primary text-white mt-4">
{{ ctrans('texts.next') }}
</button>
</form>
</div>
</div>