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| 1 | <form class="form-horizontal" style="margin-bottom: 0;" id="validateSubmitForm" method="get" autocomplete="off" novalidate="novalidate"> | |
| 2 | ||
| 3 | <div class="well" style="padding-bottom: 20px; margin: 0;"> | |
| 4 | <h4>Personal info</h4> | |
| 5 | <hr class="separator"> | |
| 6 | <div class="row-fluid"> | |
| 7 | <div class="span6"> | |
| 8 | <div class="control-group"> | |
| 9 | <label class="control-label" for="firstname">Lastname</label> | |
| 10 | <div class="controls"><input class="span12" id="firstname" name="firstname" type="text"></div> | |
| 11 | </div> | |
| 12 | <div class="control-group"> | |
| 13 | <label class="control-label" for="lastname">Firstname</label> | |
| 14 | <div class="controls"><input class="span12" id="lastname" name="lastname" type="text"></div> | |
| 15 | </div> | |
| 16 | <div class="control-group"> | |
| 17 | <label class="control-label" for="inputPhone"><?php echo $translate->_('phone'); ?></label>
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| 18 | <div class="controls"> | |
| 19 | <div class="input-prepend"> | |
| 20 | <span class="add-on glyphicons phone"><i></i></span> | |
| 21 | <input type="text" id="inputPhone" class="span11" placeholder="01234567897" /> | |
| 22 | </div> | |
| 23 | </div> | |
| 24 | </div> | |
| 25 | </div> | |
| 26 | </div> | |
| 27 | ||
| 28 | <hr class="separator"> | |
| 29 | ||
| 30 | <div class="form-actions"> | |
| 31 | <button type="button" class="btn btn-icon btn-primary glyphicons circle_ok"><i></i>Save</button> | |
| 32 | <button type="button" class="btn btn-icon btn-default glyphicons circle_remove"><i></i>Cancel</button> | |
| 33 | </div> | |
| 34 | </div> | |
| 35 | ||
| 36 | </form> |
