demarches-normaliennes/app/views/dossiers/etapes/etape_2/_individual.html.haml
2018-01-08 17:14:51 +01:00

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.col-xs-3.center
%h3 Mes informations
%p
Les informations de bases
%br
vous concernant.
.etape.etapes-informations.col-xs-9
= form_for @facade.dossier, url: { controller: '/users/dossiers', action: :update } do |f|
.row
.col-xs-12.padding-left-30
= f.hidden_field :id
= f.fields_for :individual, @facade.individual do |ff|
.form-group
%label
%h4
Civilité
= ff.select :gender, ['M.', 'Mme']
.form-group
%label
%h4
Nom *
= ff.text_field :nom, { class: 'form-control', required: true }
.form-group
%label
%h4
Prénom *
= ff.text_field :prenom, { class: 'form-control', required: true }
.form-group
%label
%h4
Date de naissance *
= ff.date_field :birthdate, { value: @facade.individual.birthdate, class: 'form-control', placeholder: 'jj/mm/aaaa', required: true }
%p
%label{ style: 'font-weight: normal;' }
= f.check_box :autorisation_donnees
 J'accepte <a href="https://tps.gitbooks.io/tps-documentation/content/conditions-generales-dutilisation.html" target="_blank">les CGU</a>.
.row
.col-xs-5.col-xs-5
.col-xs-2.col-xs-2
= f.submit 'Etape suivante', class: "action", id: 'etape_suivante'
.col-xs-5.col-xs-5