-
Notifications
You must be signed in to change notification settings - Fork 0
/
Copy pathdonate.html
129 lines (118 loc) · 5.36 KB
/
donate.html
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>CSE Active | Donate</title>
<link rel="stylesheet" href="styles/style2.css">
<!-- <link rel="stylesheet" href="http://maxcdn.bootstrapcdn.com/font-awesome/4.2.0/css/font-awesome.min.css"> -->
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/5.15.3/css/all.min.css"/>
</head>
<body>
<div class="wrapper">
<h2>Donate to CSE Active</h2>
<form action="" method="post">
<!--Account Information Start-->
<h4>Account</h4>
<div class="input_group">
<!-- <div class="input_box">
<input type="text" placeholder="Full Name" required class="name">
<i class="fa fa-user icon"></i>
</div> -->
<div class="input_box">
<input type="text" placeholder="Name on Card" required class="name">
<i class="fa fa-user icon"></i>
</div>
</div>
<div class="input_group">
<div class="input_box">
<input type="email" placeholder="Email Address" required class="name">
<i class="fa fa-envelope icon"></i>
</div>
</div>
<div class="input_group">
<div class="input_box">
<input type="text" placeholder="Address" required class="name">
<i class="fas fa-map-marker-alt icon" aria-hidden="true"></i>
</div>
</div>
<div class="input_group">
<div class="input_box">
<input type="text" placeholder="City" required class="name">
<i class="fas fa-university icon"></i>
</div>
</div>
<!--Account Information End-->
<!--DOB & Gender Start-->
<div class="input_group">
<!-- <div class="input_box">
<h4>Date Of Birth</h4>
<input type="text" placeholder="DD" required class="dob">
<input type="text" placeholder="MM" required class="dob">
<input type="text" placeholder="YYYY" required class="dob">
</div> -->
<div class="input_box">
<h4>Gender</h4>
<input type="radio" name="gender" class="radio" id="b1" checked>
<label for="b1">Male</label>
<input type="radio" name="gender" class="radio" id="b2">
<label for="b2">Female</label>
<input type="radio" name="gender" class="radio" id="b3">
<label for="b3">Other</label>
</div>
</div>
<!--DOB & Gender End-->
<!--Payment Details Start-->
<div class="input_group">
<div class="input_box">
<h4>Payment Details</h4>
<input type="radio" name="pay" class="radio" id="bc1" checked>
<label for="bc1"><span>
<i class="fab fa-cc-visa"></i> Visa Card</span></label>
<input type="radio" name="pay" class="radio" id="bc2">
<label for="bc2"><span>
<i class="fab fa-cc-mastercard"></i> MasterCard</span></label>
<input type="radio" name="pay" class="radio" id="bc3">
<label for="bc3"><span>
<i class="fa fa-credit-card"></i> Other</span></label>
</div>
</div>
<div class="input_group">
<div class="input_box">
<input type="tel" name="" class="name" placeholder="Card Number 1111-2222-3333-4444" required>
<i class="fa fa-credit-card icon"></i>
</div>
</div>
<div class="input_group">
<div class="input_box">
<input type="tel" name="" class="name" placeholder="Card CVV" required>
<i class="fa fa-user icon"></i>
</div>
</div>
<div class="input_group">
<div class="input_box">
<div class="input_box">
<input type="number" placeholder="Exp Month" required class="name">
<i class="fa fa-calendar icon" aria-hidden="true"></i>
</div>
</div>
<div class="input_box">
<input type="number" placeholder="Exp Year" required class="name">
<i class="fa fa-calendar-alt icon" aria-hidden="true"></i>
</div>
</div>
<div class="input_box">
<input type="number" placeholder="Enter Amount" required class="name">
<i class="fas fa-money-bill icon" aria-hidden="true"></i>
</div>
<!--Payment Details End-->
<div class="input_group">
<div class="input_box">
<button type="submit">PAY NOW</button>
</div>
</div>
</form>
</div>
</body>
</html>