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Merge pull request #33446 from dimagi/bmb/b5-schedule-demo
[B5] Migrate schedule demo modal to bootstrap 5
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corehq/apps/analytics/templates/analytics/forms/bootstrap5/hubspot_cta_form.html
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| Original file line number | Diff line number | Diff line change |
|---|---|---|
| @@ -0,0 +1,125 @@ | ||
| {% load i18n %} | ||
|
|
||
| <form class="form-ko-validation" method="post"> | ||
| {% csrf_token %} | ||
| <div class="modal-body"> | ||
| <!-- ko if: showErrorMessage --> | ||
| <div class="alert alert-warning"> | ||
| <p data-bind="text: errorMessage"></p> | ||
| </div> | ||
| <!-- /ko --> | ||
| <div class="row mb-3"> | ||
| <div class="col-sm-6"> | ||
| <label class="form-label"> | ||
| {% trans "First name" %}<span class="asteriskField">*</span> | ||
| </label> | ||
| <input type="text" | ||
| name="firstname" | ||
| data-bind="textInput: firstname" | ||
| class="form-control"> | ||
| </div> | ||
| <div class="col-sm-6"> | ||
| <label class="form-label"> | ||
| {% trans "Last name" %}<span class="asteriskField">*</span> | ||
| </label> | ||
| <input type="text" | ||
| name="lastname" | ||
| data-bind="textInput: lastname" | ||
| class="form-control"> | ||
| </div> | ||
| </div> | ||
| <div class="mb-3"> | ||
| <label class="form-label"> | ||
| {% trans "Organization" %}<span class="asteriskField">*</span> | ||
| </label> | ||
| <input type="text" | ||
| name="company" | ||
| data-bind="textInput: company" | ||
| class="form-control"> | ||
| </div> | ||
| <div class="mb-3"> | ||
| <label class="form-label"> | ||
| {% trans "Professional email address" %}<span class="asteriskField">*</span> | ||
| </label> | ||
| <input type="email" | ||
| name="email" | ||
| data-bind="textInput: email" | ||
| class="form-control"> | ||
| </div> | ||
| <div class="mb-3" | ||
| data-bind="visible: showContactMethod"> | ||
| <label class="form-label"> | ||
| {% trans "How should we contact you?" %}<span class="asteriskField">*</span> | ||
| </label> | ||
| <select name="preferred_method_of_contact" | ||
| data-bind="value: preferred_method_of_contact" | ||
| class="form-select"> | ||
| <option value="">{% trans "Please Select" %}</option> | ||
| <option value="Phone">{% trans "Phone" %}</option> | ||
| <option value="Skype">{% trans "Skype" %}</option> | ||
| <!-- ko if: useWhatsApp --> | ||
| <option value="WhatsApp">{% trans "WhatsApp" %}</option> | ||
| <!-- /ko --> | ||
| <!-- ko if: useGoogleHangouts --> | ||
| <option value="Google hangouts">{% trans "Google hangouts" %}</option> | ||
| <!-- /ko --> | ||
| </select> | ||
| </div> | ||
| <div class="mb-3" | ||
| data-bind="visible: showPhoneNumber"> | ||
| <label class="form-label"> | ||
| {% trans "Preferred phone number" %}<span class="asteriskField">*</span> | ||
| </label> | ||
| <input type="text" | ||
| name="phone" | ||
| data-bind="textInput: phone" | ||
| class="form-control"> | ||
| </div> | ||
| <div class="mb-3" | ||
| data-bind="visible: showSkype"> | ||
| <label class="form-label"> | ||
| {% trans "Skype username" %}<span class="asteriskField">*</span> | ||
| </label> | ||
| <input type="text" | ||
| name="skype__c" | ||
| data-bind="textInput: skype__c" | ||
| class="form-control"> | ||
| </div> | ||
| <div class="mb-3" | ||
| data-bind="visible: showWhatsApp"> | ||
| <label class="form-label"> | ||
| {% trans "Preferred WhatsApp number" %}<span class="asteriskField">*</span> | ||
| </label> | ||
| <input type="text" | ||
| name="preferred_whatsapp_number" | ||
| data-bind="textInput: preferred_whatsapp_number" | ||
| class="form-control"> | ||
| </div> | ||
| <div class="mb-3" | ||
| data-bind="visible: showPreferredLanguage"> | ||
| <label class="form-label"> | ||
| {% trans "Preferred Language" %}<span class="asteriskField">*</span> | ||
| </label> | ||
| <select name="language__c" | ||
| data-bind="value: language__c" | ||
| class="form-select"> | ||
| <option value="">{% trans "Please Select" %}</option> | ||
| <option value="English">{% trans "English" %}</option> | ||
| <option value="French">{% trans "French" %}</option> | ||
| <option value="Spanish">{% trans "Spanish" %}</option> | ||
| </select> | ||
| </div> | ||
| {% blocktrans %} | ||
| By clicking this button, you agree to Dimagi's | ||
| <a href="http://www.dimagi.com/terms/latest/tos/" target="_blank">Terms of Service</a> and | ||
| <a href="http://www.dimagi.com/terms/latest/privacy/" target="_blank">Privacy Policy</a>. | ||
| {% endblocktrans %} | ||
| </div> | ||
| <div class="modal-footer"> | ||
| <button class="btn btn btn-primary" | ||
| data-bind="click: submitForm, disable: isSubmitDisabled" | ||
| type="button"> | ||
| <!-- ko text: nextButtonText --><!-- /ko --> | ||
| </button> | ||
| </div> | ||
| </form> |
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