Your IP : 216.73.216.91
<?php require_once('header.php');?>
<div class="container container-margin">
<div class="mx-auto col-10 col-md-10 col-lg-10">
<form method="post" id="create_donor_form">
<input type="hidden" name="id" id="id" value="<?=(isset($_GET['id']) && !empty($_GET['id'])) ? $_GET['id'] : "-1";?>">
<fieldset>
<h2 class="form-heading">Create Donor</h2>
<hr class="colorgraph">
<div class="row form-group">
<div class="offset-lg-12 col-lg-12 col-md-12 col-sm-1">
<label>Donor Name</label>
<input value="<?php if(isset($_GET['donor_name']) && !empty($_GET['donor_name'])){echo $_GET['donor_name'];}?>" type="text" name="donor_name" id="donor_name" class="form-control input-lg" placeholder="Enter Donor Name">
</div>
</div>
<div class="row form-group">
<div class="col-lg-6 col-md-6 col-sm-1">
<label>Donor Whatsapp #</label>
<input type="text" name="donor_whatsapp" id="donor_whatsapp" class="form-control input-lg" placeholder="Enter Donor Whatsapp #">
</div>
<div class="col-lg-6 col-md-6 col-sm-1">
<label>Donor Whatsapp # Secondary</label>
<input type="text" name="donor_whatsapp_sec" id="donor_whatsapp_sec" class="form-control input-lg" placeholder="Enter Donor Whatsapp # Secondary">
</div>
</div>
<div class="row form-group">
<div class="offset-lg-12 col-lg-12 col-md-12 col-sm-1">
<label>Donor Reference Name</label>
<input type="text" name="donor_ref_name" id="donor_ref_name" class="form-control input-lg" placeholder="Enter Donor Reference Name">
</div>
</div>
<hr class="colorgraph thin">
<div class="row form-group">
<div class="col-lg-6 col-md-6 col-sm-12">
<input type="submit" id="don_submit" class="btn btn-lg btn-primary btn-block llcf-pri" value="Save">
</div>
<div class="col-lg-6 col-md-6 col-sm-12">
<a class="btn btn-lg btn-secondary btn-block" href="<?=Config::getConfig('donorGridRedirect')?>">Donor List</a>
</div>
</div>
<div class="row form-group">
<div class="col-lg-12 col-md-12 col-sm-12">
<input type="button" id="reset" class="btn btn-lg btn-danger btn-block" value="Reset">
</div>
</div>
</fieldset>
</form>
</div>
</div>
<?php require_once('footer.php');?>