A-1-add-new-customer/index.html at main · johnniesue/A-1-add-new-customer · GitHub

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<!DOCTYPE html>
<html lang="en">
<head>
  <meta charset="UTF-8" />
  <meta name="viewport" content="width=device-width, initial-scale=1.0"/>
  <title>Add New Customer - A-1 Plumbing</title>
  <link rel="stylesheet" href="style.css" />
</head>
<body>
  <div class="container">
    <h1>Add New Customer</h1>
    <form id="customerForm">
      <fieldset>
        <legend>Contact Info</legend>
        <input type="text" placeholder="First name" name="firstName" required />
        <input type="text" placeholder="Last name" name="lastName" required />
        <input type="text" placeholder="Display name" name="displayName" />
        <input type="text" placeholder="Mobile phone" name="mobilePhone" required />
        <input type="text" placeholder="Home phone" name="homePhone" />
        <input type="text" placeholder="Work phone" name="workPhone" />
        <input type="email" placeholder="Email" name="email" />
        <input type="text" placeholder="Company" name="company" />
        <input type="text" placeholder="Role" name="role" />
        <label><input type="radio" name="type" value="Homeowner" checked /> Homeowner</label>
        <label><input type="radio" name="type" value="Business" /> Business</label>
        <label><input type="checkbox" name="doNotService" /> Mark as Do Not Service</label>
      </fieldset>

      <fieldset>
        <legend>Address</legend>
        <input type="text" placeholder="Street" name="street" />
        <input type="text" placeholder="Unit" name="unit" />
        <input type="text" placeholder="City" name="city" />
        <input type="text" placeholder="State" name="state" />
        <input type="text" placeholder="Zip" name="zip" />
        <input type="text" placeholder="Address Notes" name="addressNotes" />
      </fieldset>

      <fieldset>
        <legend>Notes</legend>
        <input type="text" placeholder="Customer notes" name="customerNotes" />
        <input type="text" placeholder="Customer tags (press enter)" name="tags" />
        <input type="text" placeholder="This customer bills to" name="billsTo" />
        <input type="text" placeholder="Lead source" name="leadSource" />
      </fieldset>

      <fieldset>
        <legend>Referred By</legend>
        <input type="text" placeholder="Referred by" name="referredBy" />
        <label><input type="checkbox" name="prequalify" /> Send invitation to prequalify for financing</label>
        <label><input type="checkbox" name="notifications" checked /> Send notifications</label>
      </fieldset>

      <div class="form-actions">
        <button type="button" onclick="cancelForm()">Cancel</button>
        <button type="submit">Create Customer</button>
      </div>
    </form>
  </div>
  <script src="script.js"></script>
</body>
</html>