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<%= f.label :card_name %> (*)
<%= f.text_field :card_name, :size => 30, :maxlength => User::MAXLEN_NAME %>
<%= f.label :card_number %> (*)
<%= f.text_field :card_number, :autocomplete => 'off', :size => 30, :maxlength => PaymentCard::MAXLEN_CARD_NUMBER %>
<% if ( ActiveMerchant::Billing::CreditCard.requires_verification_value? ) -%>
<%= f.label :card_cvv %> <%= help_link( :card_cvv ) %> (*)
<%= f.text_field :card_cvv, :autocomplete => 'off', :size => 4, :maxlength => PaymentCard::MAXLEN_CARD_CVV %>
<% end -%>
<%= f.label :card_type %> (*)
<%= purchasecardshelp_type_menu( f, :card_type ) %>
<%= f.label :card_to %> (*)
<%=
f.date_select(
:card_to,
:add_month_numbers => true,
:start_year => Time.now.year,
:end_year => Time.now.year + 15,
:discard_day => true,
:order => [ :month, :year ],
:include_blank => true
)
%>
<%= f.label :card_from %>
<%=
f.date_select(
:card_from,
:add_month_numbers => true,
:start_year => Time.now.year - 15,
:end_year => Time.now.year,
:discard_day => true,
:order => [ :month, :year ],
:include_blank => true
)
%>
<%= f.label :card_issue %>
<%= f.text_field :card_issue, :size => 30, :maxlength => PaymentCard::MAXLEN_CARD_ISSUE %>
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<%= f.label :address_1 %> (*)
<%= f.text_field :address_1, :size => 30, :maxlength => PaymentCard::MAXLEN_ADDRESS_1 %>
<%= f.label :address_2 %>
<%= f.text_field :address_2, :size => 30, :maxlength => PaymentCard::MAXLEN_ADDRESS_2 %>
<%= f.label :address_3 %>
<%= f.text_field :address_3, :size => 30, :maxlength => PaymentCard::MAXLEN_ADDRESS_3 %>
<%= f.label :city %> (*)
<%= f.text_field :city, :size => 30, :maxlength => PaymentCard::MAXLEN_CITY %>
<%= f.label :state %>
<%= f.text_field :state, :size => 30, :maxlength => PaymentCard::MAXLEN_STATE %>
<%= f.label :country %> (*)
<%= f.text_field :country, :size => 30, :maxlength => PaymentCard::MAXLEN_COUNTRY %>
<%= f.label :postcode %>
<%= f.text_field :postcode, :size => 30, :maxlength => PaymentCard::MAXLEN_POSTCODE %>
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<%= apphelp_submit( f, apphelp_view_hint( :review_order ), ' ' ) %>
<%=
apphelp_protected_button_to(
:delete,
{
:method => :delete_poll_payment_gateway_onsite_path,
:controller => PaymentGatewayOnsiteController,
:model => PaymentGateway,
:icon => :cancel,
:variant => :negative
},
{ :poll_id => params[ :poll_id ] } # NOT just 'params' or URL generation fails
)
-%>
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