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- $ccards[] = array('visa', "<img src='" . base_url() . "images/visa.png' />");
- $ccards[] = array('mastercard', '<img src="' . base_url() . 'images/masterCard.png" />');
- $this->form
- ->open('payments/process')
- ->fieldset('Personal Information')
- ->text('name', 'Your Name', 'required|max_length[40]', $this->input->get('name'))
- ->text('license', 'License #', 'required', $this->input->get('license'))
- ->text('email', 'Email', 'required', $this->input->get('email'))
- ->fieldset('Shipping Information')
- ->text('ship_address1', 'Street Address', 'required', $this->input->get('ship_address1'))
- ->text('ship_address2', 'Address Line 2', '', $this->input->get('ship_address2'))
- ->col(150, 'left', 'right')
- ->label('City', 'ship_city', 'class=left combine')
- ->label('/Zip', 'ship_zip', 'class=left combine')
- ->label('State', 'ship_state', 'class=left')->margin(6, 'top')
- ->col()
- ->text('ship_city|ship_city', '', 'required',$this->input->get('ship_city'),'style=width:137px,element_suffix=""')
- ->text('ship_zip|ship_zip', '', 'required|exact_length[5]',$this->input->get('ship_zip'),'style=width:40px;')
- ->text('ship_state|ship_state', '', 'required', $this->input->get('ship_state'),'')
- ->col(0)
- ->fieldset('Billing Information')
- ->checkbox('same_as_ship', 'yes', 'Same as Shipping')
- ->space()
- ->text('bill_address1', 'Street Address', 'required')
- ->text('bill_address2', 'Address Line 2')
- ->col(150, 'left', 'right')
- ->label('City', 'bill_city', 'class=left combine')
- ->label('/Zip', 'bill_zip', 'class=left combine')
- ->label('State', 'bill_state', 'class=left')->margin(6, 'top')
- ->col()
- ->text('bill_city|bill_city', '', 'required','','style=width:137px,element_suffix=""')
- ->text('bill_zip|bill_zip', '', 'required|exact_length[5]','','style=width:40px;')
- ->text('bill_state|bill_state', '', 'required', '')
- ->col(0)
- ->fieldset('Credit Card Information')
- ->text('amount', 'Payment Amount', 'required')
- ->radiogroup('card_type', $ccards, 'CC Type', '', 'required')
- ->space()
- ->text('card_number', 'Card Number', 'required')
- ->text('cvv', 'CVV#', 'required', '', 'style=width:100px;')
- ->text('exp', 'Exp(MMYY)', 'required', '', 'style=width:100px;')
- ->indent(150)
- ->submit()
- ->reset()
- ->margin(10)
- ;
- $this->wform = $this->form->get();
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