-
Notifications
You must be signed in to change notification settings - Fork 0
/
donate.php
44 lines (38 loc) · 1.86 KB
/
donate.php
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
<!DOCTYPE html>
<html>
<head>
<title></title>
<link rel="stylesheet" type="text/css" href="main.css">
<style>
body {
height: 100%;
background-repeat: no-repeat;
background: #000000
}
</style>
</head>
<body>
<div class="container">
<CENTER><h1 class="welcome textCenter">WELCOME</h1></CENTER>
<div class="card card-container">
<CENTER><h2>DONATE</h2></CENTER>
<hr>
<form action="summary.php" target="_blank" method="POST">
<p class="input_title">Name :</p>
<input type="text" name="donar" id="inputName" class="login_box" placeholder="Name" autofocus style="margin-bottom: 0px;">
<p class="input_title">Email :</p>
<input type="email" name="d_email" id="inputEmail" class="login_box" placeholder="[email protected]" style="margin-bottom: 0px;" >
<p class="input_title">Mobile No. :</p>
<input type="tel" name="m_no" id="inputMobile" class="login_box" placeholder="10 Digit Mobile Number" style="margin-bottom: 0px;">
<p class="input_title">Amount :</p>
<input type="number" name="amt" id="inputamount" class="login_box" name="num1" placeholder="0.0" required="" style="margin-bottom: 0px;">
<p class="input_title">Payment Type :</p>
<input type="radio" name="p_type" value="Credit Card">Credit Card
<input type="radio" name="p_type" value="Debit Card">Debit Card
<input type="radio" name="p_type" value="Pay Pal" style="margin-bottom: 40px;">Pay Pal
<button type="submit" id="signup_btn" class="btn btn-signin">Confirm</button>
</form>
</div><!-- /card-container -->
</div><!-- /container -->
</body>
</html>