{!! Html::flash_msg_front() !!} {!! Form::open(array('url' => '/checkout', 'method' => 'post', 'class' => 'row-fluid full-width uk-margin-large-top input-100 bill-info uk-form','id'=>'page_form')) !!}
  • Billing Address

    {!! HTML::decode(Form::label('firstname', 'First Name *',array( ))); !!} {!! Form::text('firstname',isset($billing->fldClientsBillingFirstname) ? $billing->fldClientsBillingFirstname : $client->fldClientFirstname,array('id'=>'firstname','required','class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('lastname', 'Last Name *',array( ))); !!} {!! Form::text('lastname',isset($billing->fldClientsBillingLastname) ? $billing->fldClientsBillingLastname : $client->fldClientLastname,array('id'=>'lastname','required','class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('company', 'Company ',array( ))); !!} {!! Form::text('company',isset($billing->fldClientsBillingCompany) ? $billing->fldClientsBillingCompany : "",array('id'=>'company','class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('email', 'Email Address *',array( ))); !!} {!! Form::email('email',isset($billing->fldClientsBillingEmail) ? $billing->fldClientsBillingEmail : $client->fldClientEmail,array('id'=>'email','required email','class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('phone', 'Phone Number *',array( ))); !!} {!! Form::text('phone',isset($billing->fldClientsBillingPhone) ? $billing->fldClientsBillingPhone : $client->fldClientContact,array('id'=>'phone','required','class'=>'form-control phone_us')) !!}
    {!! HTML::decode(Form::label('country', 'Country *')); !!} {!! Form::select('country',array('0' => 'Select one')+App\Models\Country::displayCountry(),isset($billing->fldClientsBillingCountry) ? $billing->fldClientsBillingCountry : "US",array('id'=>'country','data-placeholder'=>'Select Country','class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('address', 'Address *',array( ))); !!} {!! Form::text('address',isset($billing->fldClientsBillingAddress) ? $billing->fldClientsBillingAddress : "",array('id'=>'address','required','class'=>'form-control','placeholder'=>'Street Address')) !!}
    {!! Form::text('address1',isset($billing->fldClientsBillingAddress1) ? $billing->fldClientsBillingAddress1 : "",array('id'=>'address2','class'=>'form-control','placeholder'=>'Apartment, suite, unit, ect. (optional)')) !!}
    {!! HTML::decode(Form::label('city', 'City *',array( ))); !!} {!! Form::text('city',isset($billing->fldClientsBillingCity) ? $billing->fldClientsBillingCity : "",array('id'=>'city','required', 'class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('state', 'State *',array('id'=>'stateBillingText'))); !!} {!! Form::select('state',array('0' => 'Select one')+App\Models\State::displayState(),isset($billing->fldClientsBillingState) ? $billing->fldClientsBillingState : "0",array('onchange' => 'checkTax(this.value)', 'id'=>'state','data-placeholder'=>'Select State', 'class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('zip', 'Zip Code *',array( ))); !!} {!! Form::text('zip',isset($billing->fldClientsBillingZip) ? $billing->fldClientsBillingZip : "",array('id'=>'zip','required','class'=>'form-control')) !!}
  • Shipping Address

    Please fill out your Shipping information below.
    {!! HTML::decode(Form::label('shipping_firstname', 'First Name *',array( ))); !!} {!! Form::text('shipping_firstname',isset($shipping->fldClientsShippingFirstname) ? $shipping->fldClientsShippingFirstname : $client->fldClientFirstname,array('id'=>'shipping_firstname','required','class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('shipping_lastname', 'Last Name *',array( ))); !!} {!! Form::text('shipping_lastname',isset($shipping->fldClientsShippingLastname) ? $shipping->fldClientsShippingLastname : $client->fldClientLastname,array('id'=>'shipping_lastname','class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('shipping_email', 'Email Address *',array( ))); !!} {!! Form::text('shipping_email',isset($shipping->fldClientsShippingEmail) ? $shipping->fldClientsShippingEmail : $client->fldClientEmail,array('id'=>'shipping_email','class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('shipping_phone', 'Phone Number *',array( ))); !!} {!! Form::text('shipping_phone',isset($shipping->fldClientsShippingPhone) ? $shipping->fldClientsShippingPhone : $client->fldClientContact,array('id'=>'shipping_phone','required','class'=>'form-control phone_us')) !!}
    {!! HTML::decode(Form::label('shipping_country', 'Country *')); !!} {!! Form::select('shipping_country',array('0' => 'Select one')+App\Models\Country::displayCountry(),isset($shipping->fldClientsShippingCountry) ? $shipping->fldClientsShippingCountry : 'US',array('id'=>'shipping_country','data-placeholder'=>'Select Country','class'=>'form-control')) !!}
    {!! HTML::decode(Form::label('shipping_address', 'Address *',array( ))); !!} {!! Form::text('shipping_address',isset($shipping->fldClientsShippingAddress) ? $shipping->fldClientsShippingAddress : "",array('id'=>'shipping_address','required','class'=>'form-control')) !!}
    {!! Form::text('shipping_address1',isset($shipping->fldClientsShippingAddress1) ? $shipping->fldClientsShippingAddress1 : "",array('id'=>'shipping_address1','class'=>'form-control','placeholder'=>'Apartment, suite, unit, ect. (optional)')) !!}
    {!! HTML::decode(Form::label('shipping_city', 'City *',array( ))); !!} {!! Form::text('shipping_city',isset($shipping->fldClientsShippingCity) ? $shipping->fldClientsShippingCity : "",array('id'=>'shipping_city','required','class'=>'form-control required')) !!}
    {!! HTML::decode(Form::label('shipping_state', 'State *',array('id'=>'stateShippingText'))); !!} {!! Form::select('shipping_state',array('' => 'Select one')+App\Models\State::displayState(),isset($shipping->fldClientsShippingState) ? $shipping->fldClientsShippingState : "0",array('id'=>'shipping_state','data-placeholder'=>'Select State','class'=>'form-control required', 'required')) !!}
    {!! HTML::decode(Form::label('shipping_zip', 'Zip Code *',array( ))); !!} {!! Form::text('shipping_zip',isset($shipping->fldClientsShippingZip) ? $shipping->fldClientsShippingZip : "",array('id'=>'shipping_zip','required','class'=>'form-control required')) !!}
  • Shipping Method

    Please fill out your select your shipping method.
    {!! Html::image('_front/assets/images/ajax-loader.gif') !!}
  • Payment Method

    Please fill out your select your payment method.
    @include('home.braintree_cc')