161 lines
8.9 KiB
PHP
161 lines
8.9 KiB
PHP
<fieldset>
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<div class="wpcf-coborrower pt-5 d-none">
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<div class="form-row">
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<legend>Co Emprunteur</legend>
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<div class="form-group col-md-6"><label for="IDcofirstname">Prénom</label>
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<input name="cofirstname" type="text" class="form-control" id="IDcofirstname">
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</div>
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<div class="form-group col-md-6">
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<label for="IDcolastname">Nom</label>
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<input name="colastname" type="text" class="form-control" id="IDcolastname">
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</div>
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<div class="form-group col-md-3">
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<label for="IDcocivilstatus">État civil</label>
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<?php $etatCivil = $wpdb->get_results("SELECT * FROM cdf_Etat_civil"); ?>
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<select name="cocivilstatus" id="IDcocivilstatus" class="form-control">
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<option value="" selected="">Veuillez faire un choix</option>
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<?php foreach ($etatCivil as $ec) : ?>
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<option value="<?php echo $ec->idetat_civil ?>"><?php echo $ec->nom_etat_civil ?></option>
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<?php endforeach ?>
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</select>
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</div>
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<div class="form-group col-md-4">
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<label for="IDcojob">Profession</label>
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<?php $professions = $wpdb->get_results("SELECT * FROM cdf_Profession"); ?>
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<select name="cojob" id="IDcojob" class="form-control">
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<option value="">Veuillez faire un choix</option>
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<?php foreach ($professions as $p) : ?>
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<option value="<?php echo $p->idprofession ?>"><?php echo $p->nom_profession ?></option>
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<?php endforeach ?>
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</select>
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</div>
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<div class="form-group col-md-4">
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<label for="IDcocontract_type">Type de contrat</label>
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<select name="cocontract_type" id="IDcocontract_type" class="form-control">
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<option value=""></option>
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<?php foreach ($contractTypes as $key => $contractType) : ?>
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<option value="<?php echo $key ?>"><?php echo $contractType ?></option>
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<?php endforeach ?>
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</select>
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</div>
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<div class="form-group col-md-4">
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<label for="IDcoemname">Nom <span>de l'employeur/organisme de paiement</span></label>
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<input name="coemname" type="text" class="form-control" id="IDcoemname">
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</div>
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<div class="form-group col-md-12 d-none">
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<label for="IDcoemnumber">Numéro d'entreprise</label>
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<input name="coemnumber" type="text" class="form-control" id="IDcoemnumber">
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</div>
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<div class="form-group col-md-3">
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<label for="IDcoemaddress">Adresse <span>de l'employeur/organisme de paiement</span></label>
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<input name="coemaddress" type="text" class="form-control" id="IDcoemaddress">
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</div>
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<div class="form-group col-md-3">
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<label for="IDcoemzip">Code postal <span>de l'employeur/organisme de paiement</span></label>
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<input name="coemzip" type="text" class="form-control" id="IDcoemzip">
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</div>
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<div class="form-group col-md-3">
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<label for="IDcoemcity">Localité <span>de l'employeur/organisme de paiement</span></label>
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<input name="coemcity" type="text" class="form-control" id="IDcoemcity">
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</div>
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<div class="form-group col-md-3">
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<label for="IDcoemcountry">Pays <span>de l'employeur/organisme de paiement</span></label>
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<input name="coemcountry" type="text" class="form-control" id="IDcoemcountry">
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</div>
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<div class="form-group col-md-6">
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<label for="IDcocommitmentdate">Date <span>d'engagement</span></label>
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<input name="cocommitmentdate" type="date" class="form-control" id="IDcocommitmentdate">
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</div>
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<div class="form-group col-md-6">
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<label for="IDcosalary"><span>Salaire net mensuel</span></label>
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<input name="cosalary" type="number" class="form-control" id="IDcosalary" min="0" step="0.01" required>
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</div>
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</div>
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<div class="form-row py-3">
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<div class="col-form-label pr-3">Autres revenus</div>
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<div class="form-check form-check-inline">
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<input name="cohasotherincome" type="radio" class="form-check-input" id="ID1cohasotherincome" value="0" checked="">
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<label class="form-check-label" for="ID1cohasotherincome">Non</label>
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</div>
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<div class="form-check form-check-inline">
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<input name="cohasotherincome" type="radio" class="form-check-input" id="ID2cohasotherincome" value="1">
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<label class="form-check-label" for="ID2cohasotherincome">Oui</label>
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</div>
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</div>
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<div class="py-3 co wpcf-otherincome d-none">
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<div class="form-row">
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<div class="col-md-3 col-xs-12">
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<div class="form-row">
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<div class="form-check form-check-inline col-md-12">
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<input name="cohasoimealvoucher" type="checkbox" class="form-check-input wpcf-otherincome--oitype" id="ID0cooitype" value="mealvoucher">
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<label class="form-check-label" for="ID0cooitype">Chèque repas</label>
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</div>
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<div class="form-group col-md-12 wpcf-otherincome--amouth wpcf-otherincome--amouth-mealvoucher d-none">
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<input name="cooiamouthmealvoucher" type="number" class="form-control" id="IDcooiamouthmealvoucher" placeholder="Montant" min="0" step="0.01">
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</div>
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</div>
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</div>
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<div class="col-md-3 col-xs-12">
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<div class="form-row">
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<div class="form-check form-check-inline col-md-12">
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<input name="cohasoirentalincome" type="checkbox" class="form-check-input wpcf-otherincome--oitype" id="ID1cooitype" value="rentalincome">
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<label class="form-check-label" for="ID1cooitype">Revenus locatif</label>
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</div>
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<div class="form-group col-md-12 wpcf-otherincome--amouth wpcf-otherincome--amouth-rentalincome d-none">
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<input name="cooiamouthrentalincome" type="number" class="form-control" id="IDcooiamouthrentalincome" placeholder="Montant" min="0" step="0.01">
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</div>
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</div>
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</div>
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<div class="col-md-3 col-xs-12">
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<div class="form-row">
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<div class="form-check form-check-inline col-md-12">
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<input name="cohasoiunemployment" type="checkbox" class="form-check-input wpcf-otherincome--oitype" id="ID2cooitype" value="unemployment">
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<label class="form-check-label" for="ID2cooitype">Chômage</label>
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</div>
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<div class="form-group col-md-12 wpcf-otherincome--amouth wpcf-otherincome--amouth-unemployment d-none">
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<input name="cooiamouthunemployment" type="number" class="form-control" id="IDcooiamouthunemployment" placeholder="Montant" min="0" step="0.01">
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</div>
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</div>
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</div>
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<div class="col-md-3 col-xs-12">
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<div class="form-row">
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<div class="form-check form-check-inline col-md-12">
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<input name="cohasoiother" type="checkbox" class="form-check-input wpcf-otherincome--oitype" id="ID3cooitype" value="other">
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<label class="form-check-label" for="ID3cooitype">Autre</label>
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</div>
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<div class="form-group col-md-12 wpcf-otherincome--amouth wpcf-otherincome--amouth-other d-none">
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<input name="cooiamouthother" type="number" class="form-control" id="IDcooiamouthother" placeholder="Montant" min="0" step="0.01">
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</div>
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<div class="form-group col-md-12 wpcf-otherincome--amouth wpcf-otherincome--amouth-other d-none">
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<input name="cooiothertext" type="text" class="form-control" id="IDcooiothertext" placeholder="Type de revenu">
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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</fieldset>
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<!--
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<div class="form-row">
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<input type="hidden" name="wpcfstep" value="step2">
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</div>
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-->
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<button class="btn btn-primary mt-5" type="submit">Étape suivante</button>
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</form>
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</div>
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</div>
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