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kunden_neu.php
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kunden_neu.php
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<div class="title"><h2>Neuer Kunde</h2></div>
<div class="container">
<div class="wrapper">
<form id="contact-form" method="post" action="kunden_neu_send.php" role="form" novalidate="true">
<div class="section_title">Rechnungsadresse</div>
<div class="messages"></div>
<div class="controls">
<div class="form_company">
<div class="form-group">
<label for="form_company">Firma</label>
<input id="form_company" type="text" name="company" class="form-control" placeholder="Firma" data-error="Company is required.">
<div class="help-block with-errors"></div>
</div>
</div>
<div class="form_names">
<div class="form-group">
<label for="form_name">Vorname *</label>
<input id="form_name" type="text" name="name" class="form-control" placeholder="Max" required="required" data-error="Firstname is required.">
<div class="help-block with-errors"></div>
</div>
<div class="form-group">
<label for="form_lastname">Nachname *</label>
<input id="form_lastname" type="text" name="surname" class="form-control" placeholder="Mustermann" required="required" data-error="Lastname is required.">
<div class="help-block with-errors"></div>
</div>
</div>
<div class="form_address">
<div class="form-group">
<label for="form_street">Straße / Nr *</label>
<input id="form_street" type="text" name="street" class="form-control" placeholder="Musterstraße 11" required="required" data-error="Firstname is required.">
<div class="help-block with-errors"></div>
</div>
<div class="form-group">
<label for="form_city">PLZ / Stadt *</label>
<input id="form_city" type="text" name="city" class="form-control" placeholder="12345 Musterstadt" required="required" data-error="Lastname is required.">
<div class="help-block with-errors"></div>
</div>
</div>
<div class="form_address_ext">
<div class="form-group">
<label for="form_street_ext">Adresserweiterung</label>
<input id="form_street_ext" type="text" name="street_ext" class="form-control" placeholder="Musterstraße 11">
<div class="help-block with-errors"></div>
</div>
</div>
<div class="section_title">Kontaktdaten</div>
<div class="messages"></div>
<div class="form_contacts">
<div class="form-group">
<label for="form_email">Email *</label>
<input id="form_email" type="email" name="email" class="form-control" placeholder="[email protected]" required="required" data-error="Valid email is required.">
<div class="help-block with-errors"></div>
</div>
<div class="form-group">
<label for="form_phone">Telefon</label>
<input id="form_phone" type="tel" name="phone" class="form-control" placeholder="0123 456 798 0">
<div class="help-block with-errors"></div>
</div>
</div>
<div class="section_title">Weiteres</div>
<div class="row">
<div class="form-group">
<label form="form_memo">Memo</label>
<textarea id="form_memo" name="memo" class="form-control" placeholder="Kundenmemos ..." rows="5"></textarea>
<div class="help-block with-errors"></div>
</div>
</div>
<div class="row form_checkboxes form-group">
<div>
<div class="help-block with-errors"></div>
</div>
</div>
<div class="row">
<button type="submit" class="btn btn-send btn-block disabled" value="Send message">Speichern</button>
</div>
<div class="row">
<p class="text-muted"><strong>*</strong> Eingabe erforderlich.</p>
</div>
</div>
<input type="hidden" name="new_customer" value="new">
</form>
</div>
</div>