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434 lines
26 KiB
434 lines
26 KiB
7 years ago
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<div class="modal-header">
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<button type="button" class="close" ng-click="close()" aria-label="Close"><span aria-hidden="true">×</span></button>
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<h4 class="modal-title">
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<i class="fa fa-credit-card"></i>
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{{existingPaymentMethod ? 'Change Payment Method' : 'Add Payment Method'}}
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</h4>
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</div>
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<form name="form" ng-submit="form.$valid && submit()" api-form="submitPromise" autocomplete="off">
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<div class="modal-body">
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<div class="callout callout-danger validation-errors" ng-show="form.$errors">
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<h4>Errors have occurred</h4>
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<ul>
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<li ng-repeat="e in form.$errors">{{e}}</li>
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</ul>
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</div>
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<div ng-if="showPaymentOptions">
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<label class="radio-inline radio-boxed" ng-show="!hideCard">
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<input type="radio" name="PaymentMethod" value="card" ng-model="paymentMethod"
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ng-change="changePaymentMethod('card')"><i class="fa fa-fw fa-credit-card"></i> Credit Card
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</label>
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<label class="radio-inline radio-boxed" ng-show="!hidePaypal">
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<input type="radio" name="PaymentMethod" value="paypal" ng-model="paymentMethod"
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ng-change="changePaymentMethod('paypal')"><i class="fa fa-fw fa-paypal"></i> PayPal
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</label>
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<label class="radio-inline radio-boxed" ng-show="!hideBank">
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<input type="radio" name="PaymentMethod" value="bank" ng-model="paymentMethod"
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ng-change="changePaymentMethod('bank')"><i class="fa fa-fw fa-bank"></i>
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Bank<span class="hidden-xs"> Account (ACH)</span>
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</label>
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<hr />
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</div>
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<div ng-if="paymentMethod === 'paypal'">
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<div id="bt-dropin-container"></div>
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</div>
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<div ng-if="paymentMethod === 'bank'">
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<div class="callout callout-warning">
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<h4><i class="fa fa-warning"></i> You must verify your bank account</h4>
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<p>
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Payment with a bank account is <u>only available to customers in the United States</u>.
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You will be required to verify your bank account. We will make two micro-deposits within the next
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1-2 business days. Enter these amounts in the organization's billing area to verify the bank account.
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Failure to verify the bank account will result in a missed payment and your organization being
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disabled.
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</p>
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</div>
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<div class="row">
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<div class="col-md-6">
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<div class="form-group">
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<label for="routing_number">Routing Number</label>
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<input type="text" id="routing_number" name="routing_number"
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ng-model="bank.routing_number" class="form-control" required />
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</div>
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</div>
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<div class="col-md-6">
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<div class="form-group">
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<label for="account_number">Account Number</label>
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<input type="text" id="account_number" name="account_number"
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ng-model="bank.account_number" class="form-control" required />
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</div>
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</div>
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</div>
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<div class="row">
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<div class="col-md-6">
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<div class="form-group">
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<label for="account_holder_name">Account Holder Name</label>
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<input type="text" id="account_holder_name" name="account_holder_name"
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ng-model="bank.account_holder_name" class="form-control" required />
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</div>
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</div>
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<div class="col-md-6">
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<div class="form-group">
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<label for="account_holder_type">Account Type</label>
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<select id="account_holder_type" class="form-control" name="account_holder_type"
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ng-model="bank.account_holder_type" required>
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<option value="">-- Select --</option>
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<option value="company">Company (Business)</option>
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<option value="individual">Individual (Personal)</option>
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</select>
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</div>
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</div>
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</div>
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</div>
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<div ng-if="paymentMethod === 'card'">
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<div class="row">
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<div class="col-md-6">
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<div class="form-group" show-errors>
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<label for="card_number">Card Number</label>
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<input type="text" id="card_number" name="card_number" ng-model="card.number"
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class="form-control" cc-number required api-field />
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</div>
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</div>
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</div>
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<ul class="list-inline">
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<li><div class="cc visa"></div></li>
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<li><div class="cc mastercard"></div></li>
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<li><div class="cc amex"></div></li>
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<li><div class="cc discover"></div></li>
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<li><div class="cc diners"></div></li>
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<li><div class="cc jcb"></div></li>
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</ul>
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<div class="row">
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<div class="col-sm-4">
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<div class="form-group" show-errors>
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<label for="exp_month">Expiration Month</label>
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<select id="exp_month" class="form-control" ng-model="card.exp_month" required cc-exp-month
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name="exp_month" api-field>
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<option value="">-- Select --</option>
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<option value="01">01 - January</option>
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<option value="02">02 - February</option>
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<option value="03">03 - March</option>
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<option value="04">04 - April</option>
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<option value="05">05 - May</option>
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<option value="06">06 - June</option>
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<option value="07">07 - July</option>
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<option value="08">08 - August</option>
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<option value="09">09 - September</option>
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<option value="10">10 - October</option>
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<option value="11">11 - November</option>
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<option value="12">12 - December</option>
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</select>
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</div>
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</div>
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<div class="col-sm-4">
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<div class="form-group" show-errors>
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<label for="exp_year">Expiration Year</label>
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<select id="exp_year" class="form-control" ng-model="card.exp_year" required cc-exp-year
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name="exp_year" api-field>
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<option value="">-- Select --</option>
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<option value="17">2017</option>
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<option value="18">2018</option>
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<option value="19">2019</option>
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<option value="20">2020</option>
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<option value="21">2021</option>
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<option value="22">2022</option>
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<option value="23">2023</option>
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<option value="24">2024</option>
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<option value="25">2025</option>
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<option value="26">2026</option>
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</select>
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</div>
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</div>
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<div class="col-sm-4">
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<div class="form-group" show-errors>
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<label for="cvc">
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CVC
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<a href="https://www.cvvnumber.com/cvv.html" target="_blank" title="What is this?"
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rel="noopener noreferrer">
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<i class="fa fa-question-circle"></i>
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</a>
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</label>
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<input type="text" id="cvc" ng-model="card.cvc" class="form-control" name="cvc"
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cc-type="number.$ccType" cc-cvc required api-field />
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</div>
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</div>
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</div>
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<div class="row">
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<div class="col-sm-6">
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<div class="form-group" show-errors>
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<label for="address_country">Country</label>
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<select id="address_country" class="form-control" ng-model="card.address_country"
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required name="address_country" api-field>
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<option value="">-- Select --</option>
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<option value="US">United States</option>
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<option value="CN">China</option>
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<option value="FR">France</option>
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<option value="DE">Germany</option>
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<option value="CA">Canada</option>
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<option value="GB">United Kingdom</option>
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<option value="AU">Australia</option>
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<option value="IN">India</option>
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<option value="-" disabled></option>
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<option value="AF">Afghanistan</option>
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<option value="AX">Åland Islands</option>
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<option value="AL">Albania</option>
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<option value="DZ">Algeria</option>
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<option value="AS">American Samoa</option>
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<option value="AD">Andorra</option>
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<option value="AO">Angola</option>
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<option value="AI">Anguilla</option>
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<option value="AQ">Antarctica</option>
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<option value="AG">Antigua and Barbuda</option>
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<option value="AR">Argentina</option>
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<option value="AM">Armenia</option>
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<option value="AW">Aruba</option>
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<option value="AT">Austria</option>
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<option value="AZ">Azerbaijan</option>
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<option value="BS">Bahamas</option>
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<option value="BH">Bahrain</option>
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<option value="BD">Bangladesh</option>
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<option value="BB">Barbados</option>
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<option value="BY">Belarus</option>
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<option value="BE">Belgium</option>
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<option value="BZ">Belize</option>
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<option value="BJ">Benin</option>
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<option value="BM">Bermuda</option>
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<option value="BT">Bhutan</option>
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<option value="BO">Bolivia, Plurinational State of</option>
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<option value="BQ">Bonaire, Sint Eustatius and Saba</option>
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<option value="BA">Bosnia and Herzegovina</option>
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<option value="BW">Botswana</option>
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<option value="BV">Bouvet Island</option>
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<option value="BR">Brazil</option>
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<option value="IO">British Indian Ocean Territory</option>
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<option value="BN">Brunei Darussalam</option>
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<option value="BG">Bulgaria</option>
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<option value="BF">Burkina Faso</option>
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<option value="BI">Burundi</option>
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<option value="KH">Cambodia</option>
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<option value="CM">Cameroon</option>
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<option value="CV">Cape Verde</option>
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<option value="KY">Cayman Islands</option>
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<option value="CF">Central African Republic</option>
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<option value="TD">Chad</option>
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<option value="CL">Chile</option>
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<option value="CX">Christmas Island</option>
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<option value="CC">Cocos (Keeling) Islands</option>
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<option value="CO">Colombia</option>
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<option value="KM">Comoros</option>
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<option value="CG">Congo</option>
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<option value="CD">Congo, the Democratic Republic of the</option>
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<option value="CK">Cook Islands</option>
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<option value="CR">Costa Rica</option>
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<option value="CI">Côte d'Ivoire</option>
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<option value="HR">Croatia</option>
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<option value="CU">Cuba</option>
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<option value="CW">Curaçao</option>
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<option value="CY">Cyprus</option>
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<option value="CZ">Czech Republic</option>
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<option value="DK">Denmark</option>
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<option value="DJ">Djibouti</option>
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<option value="DM">Dominica</option>
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<option value="DO">Dominican Republic</option>
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<option value="EC">Ecuador</option>
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<option value="EG">Egypt</option>
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<option value="SV">El Salvador</option>
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<option value="GQ">Equatorial Guinea</option>
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<option value="ER">Eritrea</option>
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<option value="EE">Estonia</option>
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<option value="ET">Ethiopia</option>
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<option value="FK">Falkland Islands (Malvinas)</option>
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<option value="FO">Faroe Islands</option>
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<option value="FJ">Fiji</option>
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<option value="FI">Finland</option>
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<option value="GF">French Guiana</option>
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<option value="PF">French Polynesia</option>
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<option value="TF">French Southern Territories</option>
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<option value="GA">Gabon</option>
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<option value="GM">Gambia</option>
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<option value="GE">Georgia</option>
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<option value="GH">Ghana</option>
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<option value="GI">Gibraltar</option>
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<option value="GR">Greece</option>
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<option value="GL">Greenland</option>
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<option value="GD">Grenada</option>
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<option value="GP">Guadeloupe</option>
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<option value="GU">Guam</option>
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<option value="GT">Guatemala</option>
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<option value="GG">Guernsey</option>
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<option value="GN">Guinea</option>
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<option value="GW">Guinea-Bissau</option>
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<option value="GY">Guyana</option>
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<option value="HT">Haiti</option>
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<option value="HM">Heard Island and McDonald Islands</option>
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<option value="VA">Holy See (Vatican City State)</option>
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<option value="HN">Honduras</option>
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<option value="HK">Hong Kong</option>
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<option value="HU">Hungary</option>
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<option value="IS">Iceland</option>
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<option value="ID">Indonesia</option>
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<option value="IR">Iran, Islamic Republic of</option>
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<option value="IQ">Iraq</option>
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<option value="IE">Ireland</option>
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<option value="IM">Isle of Man</option>
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<option value="IL">Israel</option>
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<option value="IT">Italy</option>
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<option value="JM">Jamaica</option>
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<option value="JP">Japan</option>
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<option value="JE">Jersey</option>
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<option value="JO">Jordan</option>
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<option value="KZ">Kazakhstan</option>
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<option value="KE">Kenya</option>
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<option value="KI">Kiribati</option>
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<option value="KP">Korea, Democratic People's Republic of</option>
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<option value="KR">Korea, Republic of</option>
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<option value="KW">Kuwait</option>
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<option value="KG">Kyrgyzstan</option>
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<option value="LA">Lao People's Democratic Republic</option>
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<option value="LV">Latvia</option>
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<option value="LB">Lebanon</option>
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<option value="LS">Lesotho</option>
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<option value="LR">Liberia</option>
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<option value="LY">Libya</option>
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<option value="LI">Liechtenstein</option>
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<option value="LT">Lithuania</option>
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<option value="LU">Luxembourg</option>
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<option value="MO">Macao</option>
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<option value="MK">Macedonia, the former Yugoslav Republic of</option>
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<option value="MG">Madagascar</option>
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<option value="MW">Malawi</option>
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<option value="MY">Malaysia</option>
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<option value="MV">Maldives</option>
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<option value="ML">Mali</option>
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<option value="MT">Malta</option>
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<option value="MH">Marshall Islands</option>
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<option value="MQ">Martinique</option>
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<option value="MR">Mauritania</option>
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<option value="MU">Mauritius</option>
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<option value="YT">Mayotte</option>
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<option value="MX">Mexico</option>
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<option value="FM">Micronesia, Federated States of</option>
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<option value="MD">Moldova, Republic of</option>
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<option value="MC">Monaco</option>
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<option value="MN">Mongolia</option>
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<option value="ME">Montenegro</option>
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<option value="MS">Montserrat</option>
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<option value="MA">Morocco</option>
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<option value="MZ">Mozambique</option>
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<option value="MM">Myanmar</option>
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<option value="NA">Namibia</option>
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<option value="NR">Nauru</option>
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<option value="NP">Nepal</option>
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<option value="NL">Netherlands</option>
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<option value="NC">New Caledonia</option>
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<option value="NZ">New Zealand</option>
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<option value="NI">Nicaragua</option>
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<option value="NE">Niger</option>
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<option value="NG">Nigeria</option>
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<option value="NU">Niue</option>
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<option value="NF">Norfolk Island</option>
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<option value="MP">Northern Mariana Islands</option>
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<option value="NO">Norway</option>
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<option value="OM">Oman</option>
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<option value="PK">Pakistan</option>
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<option value="PW">Palau</option>
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<option value="PS">Palestinian Territory, Occupied</option>
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<option value="PA">Panama</option>
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<option value="PG">Papua New Guinea</option>
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<option value="PY">Paraguay</option>
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<option value="PE">Peru</option>
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<option value="PH">Philippines</option>
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<option value="PN">Pitcairn</option>
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<option value="PL">Poland</option>
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<option value="PT">Portugal</option>
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<option value="PR">Puerto Rico</option>
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<option value="QA">Qatar</option>
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<option value="RE">Réunion</option>
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<option value="RO">Romania</option>
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<option value="RU">Russian Federation</option>
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<option value="RW">Rwanda</option>
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<option value="BL">Saint Barthélemy</option>
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<option value="SH">Saint Helena, Ascension and Tristan da Cunha</option>
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<option value="KN">Saint Kitts and Nevis</option>
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<option value="LC">Saint Lucia</option>
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<option value="MF">Saint Martin (French part)</option>
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<option value="PM">Saint Pierre and Miquelon</option>
|
||
|
<option value="VC">Saint Vincent and the Grenadines</option>
|
||
|
<option value="WS">Samoa</option>
|
||
|
<option value="SM">San Marino</option>
|
||
|
<option value="ST">Sao Tome and Principe</option>
|
||
|
<option value="SA">Saudi Arabia</option>
|
||
|
<option value="SN">Senegal</option>
|
||
|
<option value="RS">Serbia</option>
|
||
|
<option value="SC">Seychelles</option>
|
||
|
<option value="SL">Sierra Leone</option>
|
||
|
<option value="SG">Singapore</option>
|
||
|
<option value="SX">Sint Maarten (Dutch part)</option>
|
||
|
<option value="SK">Slovakia</option>
|
||
|
<option value="SI">Slovenia</option>
|
||
|
<option value="SB">Solomon Islands</option>
|
||
|
<option value="SO">Somalia</option>
|
||
|
<option value="ZA">South Africa</option>
|
||
|
<option value="GS">South Georgia and the South Sandwich Islands</option>
|
||
|
<option value="SS">South Sudan</option>
|
||
|
<option value="ES">Spain</option>
|
||
|
<option value="LK">Sri Lanka</option>
|
||
|
<option value="SD">Sudan</option>
|
||
|
<option value="SR">Suriname</option>
|
||
|
<option value="SJ">Svalbard and Jan Mayen</option>
|
||
|
<option value="SZ">Swaziland</option>
|
||
|
<option value="SE">Sweden</option>
|
||
|
<option value="CH">Switzerland</option>
|
||
|
<option value="SY">Syrian Arab Republic</option>
|
||
|
<option value="TW">Taiwan, Province of China</option>
|
||
|
<option value="TJ">Tajikistan</option>
|
||
|
<option value="TZ">Tanzania, United Republic of</option>
|
||
|
<option value="TH">Thailand</option>
|
||
|
<option value="TL">Timor-Leste</option>
|
||
|
<option value="TG">Togo</option>
|
||
|
<option value="TK">Tokelau</option>
|
||
|
<option value="TO">Tonga</option>
|
||
|
<option value="TT">Trinidad and Tobago</option>
|
||
|
<option value="TN">Tunisia</option>
|
||
|
<option value="TR">Turkey</option>
|
||
|
<option value="TM">Turkmenistan</option>
|
||
|
<option value="TC">Turks and Caicos Islands</option>
|
||
|
<option value="TV">Tuvalu</option>
|
||
|
<option value="UG">Uganda</option>
|
||
|
<option value="UA">Ukraine</option>
|
||
|
<option value="AE">United Arab Emirates</option>
|
||
|
<option value="UM">United States Minor Outlying Islands</option>
|
||
|
<option value="UY">Uruguay</option>
|
||
|
<option value="UZ">Uzbekistan</option>
|
||
|
<option value="VU">Vanuatu</option>
|
||
|
<option value="VE">Venezuela, Bolivarian Republic of</option>
|
||
|
<option value="VN">Viet Nam</option>
|
||
|
<option value="VG">Virgin Islands, British</option>
|
||
|
<option value="VI">Virgin Islands, U.S.</option>
|
||
|
<option value="WF">Wallis and Futuna</option>
|
||
|
<option value="EH">Western Sahara</option>
|
||
|
<option value="YE">Yemen</option>
|
||
|
<option value="ZM">Zambia</option>
|
||
|
<option value="ZW">Zimbabwe</option>
|
||
|
</select>
|
||
|
</div>
|
||
|
</div>
|
||
|
<div class="col-sm-6">
|
||
|
<div class="form-group" show-errors>
|
||
|
<label for="address_zip"
|
||
|
ng-bind="card.address_country === 'US' ? 'Zip Code' : 'Postal Code'"></label>
|
||
|
<input type="text" id="address_zip" ng-model="card.address_zip"
|
||
|
class="form-control" required name="address_zip" api-field />
|
||
|
</div>
|
||
|
</div>
|
||
|
</div>
|
||
|
</div>
|
||
|
</div>
|
||
|
<div class="modal-footer">
|
||
|
<button type="submit" class="btn btn-primary btn-flat" ng-disabled="form.$loading">
|
||
|
<i class="fa fa-refresh fa-spin loading-icon" ng-show="form.$loading"></i>Submit
|
||
|
</button>
|
||
|
<button type="button" class="btn btn-default btn-flat" ng-click="close()">Close</button>
|
||
|
</div>
|
||
|
</form>
|