class OrderForm(forms.Form):
name = forms.CharField()
company = forms.CharField()
email = forms.EmailField()
phone = forms.CharField()
interest = forms.ChoiceField(choices=((None, 'Interested in'), ('D', 'Design'), ('C', 'Development'),
('I', 'Illustration'), ('B', 'Branding'), ('V', 'Video')))
budget = forms.ChoiceField(choices=((None, 'Budget'), ('S', 'Less than $5000'), ('M', '$5000-$10000'),
('L', '$10000-$20000'), ('XL', 'More than $20000')))
start_date = forms.DateField(label="Expected start date")
finish_date = forms.DateField(label="Expected finish date")
attachment = forms.FileField(label="Include some file...")
message = forms.CharField(widget=forms.Textarea)
layout = Layout('name', 'company', 'email', 'phone',
Row('interest', 'budget'),
Row('start_date', 'finish_date'),
'attachment', 'message')
template = Template("""
{% form %}
{% part form.name prefix %}<i class="mdi-action-account-box prefix"></i>{% endpart %}
{% part form.company prefix %}<i class="mdi-communication-business prefix"></i>{% endpart %}
{% part form.email prefix %}<i class="mdi-communication-email prefix"></i>{% endpart %}
{% part form.phone prefix %}<i class="mdi-communication-call prefix"></i>{% endpart %}
{% endform %}
""")
buttons = Template("""
<button class="btn btn-primary pull-right" type="submit">Submit request</button>
""")
title = "Order services"
class ContactForm(forms.Form):
name = forms.CharField()
email = forms.EmailField()
subject = forms.CharField()
message = forms.CharField(widget=forms.Textarea)
send_copy = forms.BooleanField(required=False,
label="Send a copy to my e-mail address")
template = Template("""
{% form %}
{% part form.name prefix %}<i class="mdi-action-account-box prefix"></i>{% endpart %}
{% part form.email prefix %}<i class="mdi-communication-email prefix"></i>{% endpart %}
{% part form.subject prefix %}<i class="mdi-action-announcement prefix"></i>{% endpart %}
{% part form.message prefix %}<i class="mdi-communication-message prefix"></i>{% endpart %}
{% part form.send_copy add_group_class %}right-align{% endpart %}
{% endform %}
""")
layout = Layout(Row('name', 'email'), 'subject', 'message', 'send_copy')
buttons = Template("""
<button class="btn btn-primary pull-right" type="submit">Send message</button>
""")
title = "Contact form"
class RegistrationForm(forms.Form):
username = forms.CharField()
email = forms.EmailField(label="Email Address")
password = forms.CharField(widget=forms.PasswordInput)
password_confirm = forms.CharField(widget=forms.PasswordInput, label="Confirm password")
first_name = forms.CharField(required=False)
last_name = forms.CharField(required=False)
gender = forms.ChoiceField(choices=((None, ''), ('F', 'Female'), ('M', 'Male'), ('O', 'Other')))
receive_news = forms.BooleanField(required=False, label='I want to receive news and special offers')
agree_toc = forms.BooleanField(required=True, label='I agree with the Terms and Conditions')
layout = Layout('username', 'email',
Row('password', 'password_confirm'),
Fieldset('Pesonal details',
Row('first_name', 'last_name'),
'gender', 'receive_news', 'agree_toc'))
template = Template("""
{% form %}
{% part form.username prefix %}<i class="mdi-action-account-box prefix"></i>{% endpart %}
{% part form.email prefix %}<i class="mdi-communication-email prefix"></i>{% endpart %}
{% part form.password prefix %}<i class="mdi-action-lock-open prefix"></i>{% endpart %}
{% endform %}
""")
buttons = Template("""
<button class="waves-effect waves-light btn" type="submit">Submit</button>
""")
title = "Registration form"
class CheckoutForm(forms.Form):
first_name = forms.CharField()
last_name = forms.CharField()
email = forms.EmailField()
phone = forms.CharField()
country = forms.ChoiceField(choices=COUNTRY_CHOICES)
city = forms.CharField()
post_code = forms.IntegerField()
address = forms.CharField()
additional_info = forms.CharField(widget=forms.Textarea)
card_type = forms.ChoiceField(choices=(('V', 'Visa'), ('M', 'MasterCard'), ('P', 'Paypal')), widget=forms.RadioSelect)
card_holder = forms.CharField(label="Name on card")
card_number = forms.CharField(label="Card number")
card_ccv2 = forms.IntegerField(label="CVV2")
card_exp_month = forms.ChoiceField(choices=((1, 'January'), (2, 'February'), (3, 'March'),
(4, 'April'), (5, 'May'), (6, 'June'),
(7, 'July'), (8, 'August'), (9, 'September'),
(10, 'October'), (11, 'November'), (12, 'December')))
card_exp_year = forms.IntegerField(label="Year")
layout = Layout(
Row('first_name', 'last_name'),
Row('email', 'phone'),
Row(Span5('country'), Span5('city'), Span2('post_code')),
'address',
'additional_info',
Fieldset('Card Details',
Row(Column('card_type', span_columns=4),
Column('card_holder',
Row(Span10('card_number'), Span2('card_ccv2')),
Row('card_exp_month', 'card_exp_year'),
span_columns=8))))
template = Template("""
{% form %}
{% part form.first_name prefix %}<i class="mdi-action-account-box prefix"></i>{% endpart %}
{% part form.last_name prefix %}<i class="mdi-action-account-box prefix"></i>{% endpart %}
{% part form.email prefix %}<i class="mdi-communication-email prefix"></i>{% endpart %}
{% part form.phone prefix %}<i class="mdi-communication-call prefix"></i>{% endpart %}
{% part form.card_type label %}{% endpart %}
{% endform %}
""")
buttons = Template("""
<button class="btn btn-primary pull-right" type="submit">Submit request</button>
""")
title = "Checkout form"
css = """
class CommentForm(forms.Form):
name = forms.CharField()
email = forms.EmailField()
website = forms.URLField()
comment = forms.CharField(widget=forms.Textarea)
layout = Layout(Row('name', 'email'),
'website', 'comment')
template = Template("""
{% form %}
{% part form.name prefix %}<i class="mdi-action-account-box prefix"></i>{% endpart %}
{% part form.email prefix %}<i class="mdi-communication-email prefix"></i>{% endpart %}
{% part form.website prefix %}<i class="mdi-action-wallet-travel prefix"></i>{% endpart %}
{% part form.comment prefix %}<i class="mdi-communication-chat prefix"></i>{% endpart %}
{% endform %}
""")
buttons = Template("""
<button class="btn btn-primary pull-right" type="submit">Add comment</button>
""")
title = "Comment form"
class LoginForm(forms.Form):
email = forms.EmailField()
password = forms.CharField(widget=forms.PasswordInput)
keep_logged = forms.BooleanField(required=False, label="Keep me logged in")
template = Template("""
{% form %}
{% part form.email prefix %}<i class="mdi-communication-email prefix"></i>{% endpart %}
{% part form.password prefix %}<i class="mdi-action-lock prefix"></i>{% endpart %}
{% part form.keep_logged add_group_class %}right-align{% endpart %}
{% endform %}
""")
buttons = Template("""
<button class="waves-effect waves-teal btn-flat">Register</button>
<button class="waves-effect waves-light btn" type="submit">Login</button>
""")
title = "Login form"
class LoginForm(forms.Form):
email = forms.EmailField()
password = forms.CharField(widget=forms.PasswordInput)
keep_logged = forms.BooleanField(required=False, label="Keep me logged in")
template = Template("""
{% form %}
{% part form.email prefix %}<i class="mdi-communication-email prefix"></i>{% endpart %}
{% part form.password prefix %}<i class="mdi-action-lock prefix"></i>{% endpart %}
{% part form.keep_logged add_group_class %}right-align{% endpart %}
{% endform %}
""")
buttons = Template("""
<button class="waves-effect waves-teal btn-flat">Register</button>
<button class="waves-effect waves-light btn" type="submit">Login</button>
""")
title = "Login form"
def clean(self):
cleaned_data = super(LoginForm, self).clean()
if cleaned_data.get('email') == '*****@*****.**':
raise forms.ValidationError('John, come on. You are blocked.')
class EmergencyContractForm(forms.Form):
name = forms.CharField()
relationship = forms.CharField()
daytime_phone = forms.CharField()
evening_phone = forms.CharField(required=False)
class HospitalRegistrationForm(forms.Form):
class EmergencyContractForm(forms.Form):
name = forms.CharField()
relationship = forms.CharField()
daytime_phone = forms.CharField()
evening_phone = forms.CharField(required=False)
registration_date = forms.DateField(initial=datetime.date.today)
full_name = forms.CharField()
birth_date = forms.DateField()
height = forms.IntegerField(help_text='cm')
weight = forms.IntegerField(help_text='kg')
primary_care_physician = forms.CharField()
date_of_last_appointment = forms.DateField()
home_phone = forms.CharField()
work_phone = forms.CharField(required=False)
procedural_questions = forms.MultipleChoiceField(
widget=forms.CheckboxSelectMultiple, required=False,
choices=QUESTION_CHOICES)
cardiovascular_risks = forms.MultipleChoiceField(
widget=forms.CheckboxSelectMultiple, required=False,
choices=CARDIOVASCULAR_RISK_CHOICES)
apnia_risks = forms.MultipleChoiceField(
widget=forms.CheckboxSelectMultiple, required=False,
choices=APNIA_RISK_CHOICES)
emergency_numbers = FormSetField(formset_factory(EmergencyContractForm, extra=2, can_delete=True))
layout = Layout(Row(Column('full_name', 'birth_date',
Row('height', 'weight'), span_columns=3), 'registration_date'),
Row(Span3('primary_care_physician'), 'date_of_last_appointment'),
Row('home_phone', 'work_phone'),
Fieldset('Procedural Questions', 'procedural_questions'),
Fieldset('Clinical Predictores of Cardiovascular Risk', 'cardiovascular_risks'),
Fieldset('Clinical Predictors of sleep Apnia Risk', 'apnia_risks'),
Fieldset('Emergence Numbers', 'emergency_numbers'))
template = Template("""
{% form %}
{% part form.registration_date prefix %}<i class="mdi-editor-insert-invitation prefix"></i>{% endpart %}
{% part form.date_of_last_appointment prefix %}<i class="mdi-editor-insert-invitation prefix"></i>{% endpart %}
{% part form.primary_care_physician prefix %}<i class="mdi-action-face-unlock prefix"></i>{% endpart %}
{% part form.home_phone prefix %}<i class="mdi-communication-call prefix"></i>{% endpart %}
{% part form.work_phone prefix %}<i class="mdi-communication-call prefix"></i>{% endpart %}
{% part form.procedural_questions label %}{% endpart %}
{% part form.cardiovascular_risks label %}{% endpart %}
{% part form.cardiovascular_risks columns %}2{% endpart %}
{% part form.apnia_risks label %}{% endpart %}
{% part form.apnia_risks columns %}3{% endpart %}
{% part form.emergency_numbers label %}{% endpart %}
{% endform %}
""")
buttons = Template("""
<button class="btn btn-primary pull-right" type="submit">Registration</button>
""")
title = "Hospital registration form"
css = """
.section h5 {
font-size: 1.2rem;
padding-bottom: 0.2rem;
border-bottom: 3px solid black;
}
"""
blockclass = "col s12 m12 l9 offset-l1"
class WizardForm2(forms.Form):
message = forms.CharField(widget=forms.Textarea)
class WizardForm1(forms.Form):
subject = forms.CharField(max_length=100)
sender = forms.EmailField()
class BankForm(forms.Form):
branch_name = forms.CharField()
""" Personal Details """
person_title = forms.ChoiceField(choices=(('Mr', 'Mr.'), ('Mrs.', 'Mrs.'), ('Ms.', 'Ms.')), label='Title')
full_name = forms.CharField()
date_of_birth = forms.DateField()
email = forms.EmailField()
parent_name = forms.CharField(label='In case of a minor please provide details')
nationality = forms.ChoiceField(choices=COUNTRY_CHOICES)
mobile_no = forms.CharField()
existing_bank_account = forms.CharField()
partner_name = forms.CharField(label='Name of father/spouse')
""" Residential address """
flat_bulding = forms.CharField(label='Flat no. and bldg. name')
road_no = forms.CharField(label='Road no./name')
area_and_landmark = forms.CharField(label='Area and landmark')
telephone_residence = forms.CharField()
city = forms.CharField()
office = forms.CharField()
fax = forms.CharField()
pin_code = forms.CharField()
""" Mailing Address """
mailing_company_details = forms.CharField(label="Company name and department/ Flat no. and bldg. name")
mailing_road_no = forms.CharField(label='Road no./name')
mailing_area_and_landmark = forms.CharField(label='Area and landmark')
mailing_city = forms.CharField(label='City')
mailing_mobile = forms.CharField(label='Mobile No.')
mailing_telephone_residence = forms.CharField(label='Telephone Residence')
mailing_office = forms.CharField(label='Office')
mailing_fax = forms.CharField(label='Fax')
mailing_pin_code = forms.CharField(label='Pin Code')
mailing_email = forms.EmailField(label='E-mail')
""" Details of Introduction by Existing Customer """
introducer_name = forms.CharField(label='Customer Name')
introducer_account_no = forms.CharField(label='Account No.')
introducer_signature = forms.CharField(label="Introducer's signature")
""" Account Details """
account_type = forms.ChoiceField(
choices=(('S', 'Savings'), ('C', 'Current'), ('F', 'Fixed deposits')),
label='Choice of account',
widget=forms.RadioSelect)
account_mode = forms.ChoiceField(
choices=(('CS', 'Cash'), ('CQ', 'Cheque'), ('NF', 'NEFT')),
label='Mode of funding',
widget=forms.RadioSelect)
account_amount = forms.FloatField(label='Amount')
""" Details of Fixed Deposit """
deposit_type = forms.ChoiceField(
choices=(('O', 'Ordinary'), ('C', 'Cumulative')),
label='Types of deposit',
widget=forms.RadioSelect)
deposit_mode = forms.ChoiceField(
choices=(('CS', 'Cash'), ('CQ', 'Cheque'), ('NF', 'NEFT')),
label='Mode of funding',
widget=forms.RadioSelect)
deposit_amount = forms.FloatField(label='Amount')
deposit_no = forms.CharField(label='No. of deposits')
deposit_individual_amount = forms.FloatField(label='Individual Deposit Amount')
""" Personal Details """
occupation = forms.ChoiceField(
choices=(('NE', 'Non-executive'), ('HW', 'Housewife'), ('RT', 'Retired'),
('ST', 'Student'), ('OT', 'Other'), ('UN', 'Unemployed')),
widget=forms.RadioSelect)
job_title = forms.CharField()
department = forms.CharField()
nature_of_business = forms.CharField()
education = forms.ChoiceField(
choices=(('UG', 'Under graduate'), ('GR', 'Graduate'), ('OT', 'Others')),
widget=forms.RadioSelect)
montly_income = forms.ChoiceField(
choices=(('000', 'Zero Income'), ('L10', 'Less than $10,000'), ('G10', '$10,000+')),
widget=forms.RadioSelect)
martial_status = forms.ChoiceField(
choices=(('M', 'Married'), ('S', 'Single')),
widget=forms.RadioSelect)
spouse_name = forms.CharField()
""" Other existing bank accounts, if any """
other_account1 = forms.CharField(label='Name of the Bank / branch')
other_account2 = forms.CharField(label='Name of the Bank / branch')
""" Reason for Account opening """
reason = forms.CharField(label="Please specify", widget=forms.Textarea)
""" Terms And Conditions """
terms_accepted = forms.BooleanField(
label="I/We confirm having read and understood the account rules of The Banking Corporation Limited"
" ('the Bank'), and hereby agree to be bound by the terms and conditions and amendments governing the"
" account(s) issued by the Bank from time-to-time.")
layout = Layout(
Fieldset("Please open an account at",
'branch_name'),
Fieldset("Personal Details (Sole/First Accountholder/Minor)",
Row(Span2('person_title'), Span10('full_name')),
Row(Column('date_of_birth',
'email',
'parent_name'),
Column('nationality',
Row('mobile_no', 'existing_bank_account'),
'partner_name'))),
Fieldset('Residential address',
Row('flat_bulding', 'road_no'),
Row(Span10('area_and_landmark'), Span2('city')),
Row('telephone_residence', 'office', 'fax', 'pin_code')),
Fieldset("Mailing Address (If different from the First Accountholder's address)",
'mailing_company_details',
Row('mailing_road_no', 'mailing_area_and_landmark', 'mailing_city', 'mailing_mobile'),
Row('mailing_telephone_residence', 'mailing_office', 'mailing_fax', 'mailing_pin_code'),
'mailing_email'),
Fieldset("Details of Introduction by Existing Customer (If applicable)",
Row('introducer_name', 'introducer_account_no'),
'introducer_signature'),
Fieldset("Account Details",
Row('account_type', 'account_mode'),
'account_amount'),
Fieldset("Details of Fixed Deposit",
Row('deposit_type', 'deposit_mode'),
Row(Span6('deposit_amount'), Span3('deposit_no'), Span3('deposit_individual_amount'))),
Fieldset("Personal Details",
Row('occupation', 'education', 'montly_income'),
'job_title',
Row('department', 'nature_of_business'),
Row('martial_status', 'spouse_name')),
Fieldset("Other existing bank accounts, if any",
Row('other_account1', 'other_account2')),
Fieldset("Reason for Account opening",
'reason'),
Fieldset("Terms And Conditions",
'terms_accepted')
)
template = Template("""
{% form %}
{% part form.account_type add_group_class %}inline{% endpart %}
{% part form.account_mode add_group_class %}inline{% endpart %}
{% part form.deposit_type add_group_class %}inline{% endpart %}
{% part form.deposit_mode add_group_class %}inline{% endpart %}
{% part form.martial_status add_group_class %}inline{% endpart %}
{% endform %}
""")
buttons = Template("""
<button class="btn btn-primary pull-right" type="submit">Save application</button>
""")
title = "Personal Bank Account Initial Application"
css = """
.section h5 {
font-size: 1.2rem;
padding-bottom: 0.2rem;
border-bottom: 3px solid black;
}
"""
blockclass = "col s12 m12 l9 offset-l1"
