<p>
				<input type="text" name="locality" id="locality" class="input_small" value="<?php 
echo $locality;
?>
">
				<input type="text" name="region" id="region" class="input_mini" value="<?php 
echo $region;
?>
">
				<input type="text" name="postal" id="postal" class="input_small" value="<?php 
echo $postal;
?>
">
			</p>
			<div id="place_country"><?php 
echo country_dropdown('country', config_item('countries'), $country);
?>
</div>
			<a href="#" id="place_map_it">Map It</a>
			<div class="clear"></div>
		</div>

		<div id="place_map">
			<h3>Map</h3>
			<div id="place_map_map" class="map"></div>
		</div>
		
		<div class="clear"></div>
	
		<p><input type="button" id="add_details" value="Add More Details"></p>
		<div id="place_details" style="display:none">
        	<option <?php if($profile['gender']=='male'){?>selected="selected"<?php }?> value="male">Male</option>
            <option <?php if($profile['gender']=='female'){?>selected="selected"<?php }?> value="female">Female</option>
            </select>
        </dd>
        <dt><label>Birth Date</label></dt>
        <dd>
        	<?=$formdate_birth->selectDay()?>    
			<?=$formdate_birth->selectMonth()?>    
			<?=$formdate_birth->selectYear()?>
        </dd>
		<dt><label for="mobile_no">Mobile No.</label></dt>
		<dd><input type="text" size="30" name="mobile_no" value="<?php if(isset($contact->mobile_no)) { echo $contact->mobile_no; } ?>" placeholder="Mobile Number" id="mobile_no" /></dd>
		<dt><label for="location">City</label></dt>
		<dd><input type="text" size="30" name="city" value="<?php if(isset($contact->city)) { echo $contact->city; } ?>" placeholder="City" id="city" />
		<dt><label for="country">Country</label></dt>
		<dd><?php echo country_dropdown('country', array('MY','US','GB','DE','BR','IT','ES','AU','NZ','HK'));?> </dd>
        <dt><label for="lan_speak">Language (speak)</label></dt>
        <dd><select name="lan_speak">
        		<option <?php if($profile['lan_speak']=='English'){?>selected="selected"<?php }?> value="English">English</option>
                <option <?php if($profile['lan_speak']=='Bahasa Malay'){?>selected="selected"<?php }?> value="Bahasa Malay">Bahsa Malay</option>
                <option <?php if($profile['lan_speak']=='Chinese'){?>selected="selected"<?php }?> value="Chinese">Chinese</option>
            </select>
        </dd>
        <dt><label for="lan_rw">Language (read/write)</label></dt>
        <dd><select name="lan_rw">
        		<option <?php if($profile['lan_rw']=='English'){?>selected="selected"<?php }?> value="English">English</option>
                <option <?php if($profile['lan_rw']=='Bahasa Malay'){?>selected="selected"<?php }?> value="Bahasa Malay">Bahsa Malay</option>
                <option <?php if($profile['lan_rw']=='Chinese'){?>selected="selected"<?php }?> value="Chinese">Chinese</option>
            </select>
        </dd>
        <dt><label for="specialization">Specialization</label></dt>
Exemple #3
0


        <div class="addAddressDiv">
        <?php 
echo form_open('cart/place_order');
echo form_label('Full name:', 'full_name');
echo form_input(array('name' => 'full_name', 'id' => 'full_name', 'placeholder' => ' Enter your full name'));
echo form_label('Address:', 'address');
echo form_input(array('name' => 'address', 'id' => 'address_settings', 'placeholder' => 'Enter your address'));
echo form_label('City:', 'city');
echo form_input(array('name' => 'city', 'id' => 'city', 'placeholder' => 'Enter your City'));
echo form_label('State/Province/Region', 'state');
echo form_input(array('name' => 'state', 'id' => 'state', 'placeholder' => ' Enter your state/province/region'));
echo form_label('ZIP/Postal code', 'zip_code');
echo form_input(array('name' => 'zip_code', 'id' => 'zip_code', 'placeholder' => ' Enter your ZIP/Postal code'));
echo form_label('Country:', 'country');
echo country_dropdown('country', 'cont', 'dropdown', 'BG', array('US', 'CA', 'GB'), '');
echo form_label('Phone', 'phone');
echo form_input(array('name' => 'phone', 'id' => 'phone', 'placeholder' => ' Enter your phone number'));
echo form_hidden('user_id', $user->id);
echo form_submit('submit', 'Add address');
echo form_close();
?>
        </div>
    </fieldset>
</div>


<?php 
require 'Footer.php';
Exemple #4
0
			  
	       <div class="form-group">
            <label>Client City</label>
            <input class="form-control" name="client_city" value="<?php 
echo set_value('client_city');
?>
"/>
		        <?php 
echo form_error('client_city');
?>
          </div>
			  
			  <div class="form-group">
              <label>Client Country</label>
      				<?php 
echo country_dropdown('client_country', 'client_country', 'form-control', set_value('client_country'), array(), '');
?>
      				<?php 
echo form_error('client_country');
?>
              </div>
			  
			  <div class="form-group">
                <label>Client Telephone</label>
                <input class="form-control" name="client_telephone" value="<?php 
echo set_value('client_telephone');
?>
"/>
				        <?php 
echo form_error('client_telephone');
?>
Exemple #5
0
    <table class="dps-shipping-table">
        <tbody>

            <tr class="dps-shipping-location">
                <td>
                    <label for=""><?php 
_e('Ship to', 'dokan');
?>
                    <span class="dokan-tooltips-help tips" title="<?php 
_e('The country you ship to', 'dokan');
?>
">
                    <i class="fa fa-question-circle"></i></span></label>
                    <select name="dps_country_to[]" class="dokan-form-control dps_country_selection" id="dps_country_selection">
                        <?php 
country_dropdown($countries, '', false);
?>
                    </select>
                </td>
                <td class="dps_shipping_location_cost">
                    <label for=""><?php 
_e('Cost', 'dokan');
?>
                    <span class="dokan-tooltips-help tips" title="<?php 
_e('If the shipping price is same for all the states, use this field. Else add the states below', 'dokan');
?>
">
                    <i class="fa fa-question-circle"></i></span></label>
                    <div class="input-group">
                        <span class="input-group-addon"><?php 
echo get_woocommerce_currency_symbol();
Exemple #6
0
	  <?php 
$data = array("name" => "email", "id" => "email", "class" => "w98", "placeholder" => "Email");
echo form_input($data);
?>
 
	    <div class="error"><?php 
echo form_error('email');
?>
</div> 
	    <div class="email_error" style="display:none;"></div>
    </div>
	<div class="control-group country_gender"> 
	 <div class="controls controls-row">
		 <div class="span4 m0">
			 <?php 
echo country_dropdown('reg_country');
?>
			 <div class="country_error" style="display:none;"></div>	
		  </div>
		  <div class="span4 m0">
			  <?php 
$gender = array('' => 'Select Gender', 'Male' => 'Male', 'Female' => 'Female');
echo form_dropdown('gender', $gender);
?>
			  <div class="gender_error" style="display:none;"></div>
		  </div>
		</div> 
   </div>

	<div class="control-group birth_date"> 
	  <?php 
			  <div class="form-group">
                <label>Client City</label>
                <input class="form-control" name="client_city" value="<?php 
echo isset($client->client_city) ? $client->client_city : '';
?>
"/>
				        <?php 
echo form_error('client_city');
?>
        </div>
			  
			  <div class="form-group">
                <label>Client Country</label>
				<?php 
echo country_dropdown('client_country', 'client_country', 'form-control', isset($client->client_country) ? $client->client_country : '', array(), '');
?>
				<?php 
echo form_error('client_country');
?>
              </div>
			  
			  <div class="form-group">
                <label>Client Telephone</label>
                <input class="form-control" name="client_telephone" value="<?php 
echo isset($client->client_phone) ? $client->client_phone : '';
?>
"/>
				<?php 
echo form_error('client_telephone');
?>
Exemple #8
0
)
		</td>
	</tr>
	<tr><td></td><td><?php 
echo form_error('birth-date');
?>
</td></tr>
	
	<tr>
		<th><?php 
echo $this->lang->line('user_country') . ' <span class="required">*</span> : ';
?>
</th>
		<td>
			<?php 
echo country_dropdown('country', array('RO'), _set_value($userdata, 'country', 'RO'));
?>
		</td>
	</tr>
	<tr><td></td><td><?php 
echo form_error('country');
?>
</td></tr>
	
	<tr>
		<th><?php 
echo $this->lang->line('user_locality') . ' : ';
?>
</th>
		<td>
			<input type="text" name="locality" size="16" value="<?php