<% # encoding: utf-8 %> <% data = action_data @nkuht_donate = data["nkuht_donate"] @nkuht_donate_units = data["nkuht_donate_units"] @nkuht_donate_departments = data["nkuht_donate_departments"] @nkuht_donate_uses = data["nkuht_donate_uses"] %> <% flash.collect do |key, msg| %> <% msg.each do |m|%> <%= content_tag :p do content_tag :span, m, :class => [key, "alert alert-error in fade"] end %> <% end %> <% end %> <%= form_for @nkuht_donate, url: nkuht_donates_path, html: {class: "content form-horizontal" , :id=>"new-nkuht-donate"} do |f| %>
<%= t('nkuht_donate.department') %> <%= f.select :nkuht_donate_department_id, @nkuht_donate_departments.collect{|t| [ t.title, t.id ]}, {prompt: 'Select'} %>
<%= f.text_field :graduation_year, :id=>'graduation_year', :class=>"form-control", :placeholder=> t('nkuht_donate.graduation_year') %>
<%= f.text_field :name, :id=>'nkuht_donate_name', :class=>"form-control", :placeholder=> t('nkuht_donate.name'), :required => true %>
(<%= t('nkuht_donate.anonymous') %>)
<%= f.text_field :donors_service_unit, :class=>"input-medium form-control", :id=>'donors_service_unit', :placeholder=> t('nkuht_donate.donors_service_unit') %>
<%= f.text_field :tel, :class=>"input-medium form-control", :id=>'tel', :placeholder=> t('nkuht_donate.tel'), :required => true %>
<%= f.text_field :email, :class=>"input-medium form-control", :id=>'email', :placeholder=> t('nkuht_donate.email') %>
<%= t('nkuht_donate.nt') %><%= f.number_field :donation_amount, :id=>'donation_amount', :min=>"1", :max=>"", :placeholder=> t('nkuht_donate.donation_amount'), :required => true %> <%= t('nkuht_donate.dollars') %>(<%= t('nkuht_donate.amount_note') %>)
<% (1..3).each do |a| %> <% end %>
※<%= t('nkuht_donate.notice') %>:
1. <%= t('nkuht_donate.notice1') %>(<%= t('nkuht_donate.download_page') %>)<%= t('nkuht_donate.notice1_1') %>
2. <%= t('nkuht_donate.notice2') %>
3. <%= t('nkuht_donate.notice3') %>
4.其餘捐款方式請參閱捐款方式
<%= f.select :nkuht_donate_unit_id, @nkuht_donate_units.collect{|t| [ t.title, t.id ]}, {prompt: 'Select'} %>
<%= f.select :nkuht_donate_use_id, @nkuht_donate_uses.collect{|t| [ t.title, t.id ]}, {}, {:onChange=>"showOther(this)"} %> <%= t('nkuht_donate.donation_use_other') %> <%= f.text_field :donation_use_other, :id=>'donation_use_other' %>
<% (1..3).each do |a| %> <% end %> <%= f.text_field :receipt_title_other, :id=>'receipt_title_other' %>
<%= f.text_field :receipt_number, :id=>'receipt_number', :class=>"form-control", :placeholder=> t('nkuht_donate.receipt_number') %>
<% (1..2).each do |a| %> <% end %> <%= f.text_field :receipt_address_other, :class=>"input-medium form-control", :id=>'receipt_address_other' %>
<%= f.text_area :note, rows: 5, :class=>"input-medium form-control", :placeholder=> t('nkuht_donate.note') %>
<%= show_simple_captcha %>
"> <%= f.submit t('submit'), class: 'btn btn-primary', :id => 'button-mail' %> <%= f.button t('cancel'), type: 'reset', class: 'btn' %>
<% end %>