<% content_for :page_specific_css do %> <%= stylesheet_link_tag "lib/main-forms" %> <%= stylesheet_link_tag "lib/main-list" %> <% end %> <% content_for :page_specific_javascript do %> <%= javascript_include_tag "lib/module-area" %> <% end %>
<%= 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', :placeholder=> t('nkuht_donate.graduation_year') %>
<%= f.text_field :name, :class=>"input-block-level", :placeholder=> t('nkuht_donate.name'), :required => true %>
<%= f.text_field :donors_service_unit, :class=>"input-block-level", :id=>'donors_service_unit', :placeholder=> t('nkuht_donate.donors_service_unit') %>
<%= f.text_field :tel, :class=>"input-block-level", :id=>'tel', :placeholder=> t('nkuht_donate.tel'), :required => true %>
<%= f.text_field :email, :class=>"input-block-level", :id=>'email', :placeholder=> t('nkuht_donate.email') %>
新台幣<%= f.text_field :donation_amount, :id=>'donation_amount', :placeholder=> t('nkuht_donate.donation_amount'), :required => true %> 元(請輸入數字)
<% (1..6).each do |a| %> <% end %>
<%= f.text_field :cheque_number, :placeholder=> t('nkuht_donate.cheque_number') %>
<%= 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', :placeholder=> t('nkuht_donate.receipt_number') %>
<% (1..2).each do |a| %> <% end %> <%= f.text_field :receipt_address_other, :class=>"input-block-level", :id=>'receipt_title_other' %>
<%= f.text_area :note, rows: 5, :class=>"input-block-level", :placeholder=> t('nkuht_donate.note') %>
<%= get_referer_url[:action] rescue "" %> <%= f.submit t('submit'), class: 'btn btn-primary' %> <% if !params['page'].blank? %> <% else %> <% end %> <%= link_to t('cancel'), admin_nkuht_donates_path, :class=>"btn" %>