37 lines
1.8 KiB
HTML
37 lines
1.8 KiB
HTML
<!DOCTYPE html>
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<html
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lang="en"
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xmlns:th="http://www.thymeleaf.org"
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th:replace="~{layout/basic_page :: layout (title='Request Exchange', content=~{::#content})}"
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>
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<div id="content" class="container">
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<div class="row justify-content-center">
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<div class="col-lg-6">
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<h1 class="display-4">Request a New Exchange</h1>
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<p>
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Fill in the requested information below to submit your request
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for a new exchange.
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</p>
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<form th:action="@{/requestExchange}" method="post">
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<div class="mb-3">
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<label for="estimatedAccountCountInput" class="form-label">Estimated Number of Accounts</label>
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<input class="form-control" type="number" name="estimatedAccountCount" id="estimatedAccountCountInput" min="1" max="1000" step="1" value="5" required/>
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</div>
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<div class="mb-3">
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<label for="organizationInput" class="form-label">Organization</label>
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<small class="text-muted">The name of the organization that will use this exchange, if any.</small>
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<input class="form-control" type="text" name="organization" id="organizationInput"/>
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</div>
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<div class="mb-3">
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<label for="reasonInput" class="form-label">Reason</label>
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<small class="text-muted">Give some motivation for why you'd like to request an exchange.</small>
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<textarea id="reasonInput" name="reason" class="form-control" rows="3" required></textarea>
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</div>
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<button type="submit" class="btn btn-primary">Submit</button>
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</form>
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</div>
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</div>
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</div>
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