99 lines
5.9 KiB
PHP
99 lines
5.9 KiB
PHP
<div class="container">
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<div class="wp-credit-form">
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<form class="form-submit" method="POST" action="<?php echo get_site_url() ?>/credit-step4">
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<input type="hidden" name="credit-direct-token" value="<?php echo $currentCredit->token ?>">
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<section class="step-progress">
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<ul class="progressbar">
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<li class="progress-step active-step">Coordonées</li>
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<li class="progress-step active-step">Emprunteur</li>
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<li class="progress-step active-step">Crédit</li>
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</ul>
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</section>
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<fieldset class="py-5">
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<div class="form-row">
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<legend>Emprunteur</legend>
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<legend>Données personnelles</legend>
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<div class="form-group col-md-3">
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<label for="IDbirthdate">Date de naissance</label>
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<input name="birthdate" type="date" class="form-control" id="IDbirthdate" required>
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</div>
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<div class="form-group col-md-3">
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<label for="IDbirthplace">Lieu de naissance</label>
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<input name="birthplace" type="text" class="form-control" id="IDbirthplace" required>
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</div>
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<div class="form-group col-md-3">
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<label for="IDnationality">Nationalité</label>
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<input name="nationality" type="text" class="form-control" id="IDnationality" required>
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</div>
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<div class="form-group col-md-3">
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<label for="IDcardnumber">Numéro de carte d'identité</label>
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<input name="cardnumber" type="text" class="form-control" id="IDcardnumber" required>
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</div>
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<div class="form-group col-md-3">
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<label for="IDcnvaliditydate">Date de validité</label>
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<input name="cnvaliditydate" type="date" class="form-control" id="IDcnvaliditydate" required>
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</div>
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<div class="form-group col-md-3">
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<label for="IDnationalregistrationnumber">Numéro de registre national</label>
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<input name="nationalregistrationnumber" type="number" class="form-control" id="IDnationalregistrationnumber" required>
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</div>
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<div class="form-group col-md-3">
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<label for="IDbankaccountnumber">Numéro de compte bancaire</label>
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<input name="bankaccountnumber" type="text" class="form-control" id="IDbankaccountnumber" required>
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</div>
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<div class="form-group col-md-6">
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<label for="IDdependentchildren">Nombre d'enfant(s) à charge</label>
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<input name="dependentchildren" type="number" class="form-control" id="IDdependentchildren" min="0" max="24" required>
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</div>
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</div>
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</fieldset>
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<?php if (is_object($coBorrower)) : ?>
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<fieldset class="py-5">
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<div class="form-row">
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<legend>Co-Emprunteur</legend>
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<legend>Données personnelles</legend>
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<div class="form-group col-md-3">
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<label for="IDcobirthdate">Date de naissance</label>
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<input name="cobirthdate" type="date" class="form-control" id="IDcobirthdate">
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</div>
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<div class="form-group col-md-3">
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<label for="IDcobirthplace">Lieu de naissance</label>
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<input name="cobirthplace" type="text" class="form-control" id="IDcobirthplace">
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</div>
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<div class="form-group col-md-3">
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<label for="IDconationality">Nationalité</label>
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<input name="conationality" type="text" class="form-control" id="IDconationality">
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</div>
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<div class="form-group col-md-3">
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<label for="IDcocardnumber">Numéro de carte d'identité</label>
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<input name="cocardnumber" type="text" class="form-control" id="IDcocardnumber">
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</div>
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<div class="form-group col-md-3">
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<label for="IDcocnvaliditydate">Date de validité</label>
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<input name="cocnvaliditydate" type="date" class="form-control" id="IDcocnvaliditydate">
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</div>
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<div class="form-group col-md-3">
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<label for="IDconationalregistrationnumber">Numéro de registre national</label>
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<input name="conationalregistrationnumber" type="text" class="form-control" id="IDconationalregistrationnumber">
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</div>
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<div class="form-group col-md-3">
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<label for="IDcobankaccountnumber">Numéro de compte bancaire</label>
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<input name="cobankaccountnumber" type="text" class="form-control" id="IDcobankaccountnumber">
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</div>
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<div class="form-group col-md-12">
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<label for="IDcodependentchildren">Nombre d'enfant(s) à charge</label>
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<input name="codependentchildren" type="number" class="form-control" id="IDcodependentchildren" min="0" max="24">
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</div>
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</div>
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</fieldset>
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<?php endif ?>
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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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