layout |
---|
city-page |
Salutation
Select
Mr.
Sr.
First name *
Please provide a valid value.
Middle name - optional
Last name
Email address *
We'll never share your email with anyone else.
Confirm email address *
Confirm your email address.
Password *
Password must be between 6 to 16 characters.
Confirm password *
Confirm your Password.
Cancel
Save
</form>
</div>
<div class="col-lg-6 col-md-12 col-sm-12">
<h2>Sign In form</h2>
<form name="sign-in">
<div class="form-group">
<label for="inputEmail">Username or email address *</label>
<input type="email" class="form-control" id="inputEmail" aria-describedby="emailHelp" placeholder="Enter email">
</div>
<div class="form-group">
<label for="inputPasswordsi">Password *</label>
<input type="password" class="form-control" id="inputPasswordsi" placeholder="Enter password">
<a href="#" class="btn btn-link btn-sm float-right">Show Password</a>
</div>
<div class="form-group">
<button class="btn btn-primary btn-lg">Sign in</button>
</div>
<div class="form-group">
<a href="#" class="btn btn-link">Forgot username?</a><br>
<a href="#" class="btn btn-link">Forgot password?</a>
</div>
</form>
<hr>
<h2 class="mt-5">Reset Password</h2>
<form name="reset-password">
<div class="mb-2 alert alert-primary" role="alert">
<div class="alert-icon-lg"><i class="fas fa-info-circle"></i></div>
<div class="alert-content">
<h4 class="alert-heading">Password Information</h4>
<p>Instructions and usefull information to provide to users.</p>
</div>
</div>
<div class="form-group">
<label for="inputPasswordFp">Password *</label>
<input type="password" class="form-control" id="inputPasswordFp" placeholder="Enter password">
</div>
<div class="form-group">
<label for="inputPasswordFpc">Confirm password *</label>
<input type="password" class="form-control" id="inputPasswordFpc" placeholder="Confirm password">
<a href="#" class="btn btn-link btn-sm float-right">Show Password</a>
</div>
<div class="form-group">
<button class="btn btn-primary">Reset password</button>
</div>
</form>
</div>
</div>
<hr>
<div class="row">
<div class="col-lg-6 col-md-12 col-sm-12">
<h2>Address</h2>
<form name="address">
<div class="form-group">
<label for="inputAddress1">Address line 1 *</label>
<input type="text" class="form-control" id="inputAddress1" placeholder="Enter address line 1">
</div>
<div class="form-group">
<label for="inputAddress2">Address line 2 <small>- optional</small></label>
<input type="text" class="form-control" id="inputAddress2" placeholder="Enter address line 1">
</div>
<div class="form-row">
<div class="col">
<div class="form-group">
<label for="inputCity1">City *</label>
<input type="text" class="form-control" id="inputCity1" placeholder="Enter city name">
</div>
</div>
<div class="col">
<div class="form-group">
<label for="inputState">State *</label>
<select class="custom-select" id="inputState">
<option selected="">Select</option>
<option value="1">Illinois</option>
<option value="2">Nebraska</option>
</select>
</div>
</div>
</div>
<div class="form-row">
<div class="col-6">
<div class="form-group">
<label for="inputZip">ZIP Code *</label>
<input type="text" class="form-control" id="inputZip" placeholder="Enter ZIP code">
</div>
</div>
</div>
<div class="form-group text-right">
<button class="btn btn-outline-primary">Cancel</button>
<button class="btn btn-primary">Save</button>
</div>
</form>
</div>
<div class="col-lg-6 col-md-12 col-sm-12">
<h2>Payment</h2>
<form name="payment">
<div class="form-group">
<label for="inputCardnumber">Card number *</label>
<input type="text" class="form-control" id="inputCardnumber" placeholder="Enter credit card number">
</div>
<div class="form-row">
<div class="col">
<div class="form-group">
<label for="inputCardexp">Expiration Date *</label>
<input type="text" class="form-control" id="inputCardexp" placeholder="MM/ yyyy">
</div>
</div>
<div class="col">
<div class="form-group">
<label for="inputCardcode">Secure code *</label>
<input type="text" class="form-control" id="inputCardcode" placeholder="Enter security code">
</div>
</div>
</div>
<div class="form-group">
<label for="inputCardname">Name on card *</label>
<input type="text" class="form-control" id="inputCardname" placeholder="Enter name on credit card">
</div>
<div class="form-group text-right">
<button class="btn btn-outline-primary">Cancel</button>
<button class="btn btn-primary">Proceed</button>
</div>
</form>
</div>
</div>