Form Wizard
An all-in-one form wizard examples that are extremely flexible, compact and feature-rich.
Form wizard #1
Request a Payment
Request a payment
HTML:
<!-- Modal Trigger -->
<a class="btn btn-sm u-btn-primary--air transition-3d-hover" href="#requestPaymentModal"
data-modal-target="#requestPaymentModal"
data-overlay-color="#111722">
<span class="fa fa-plus font-size-13 mr-2"></span>
Request a Payment
</a>
<!-- End Modal Trigger -->
<!-- Request Payment Modal Window -->
<div id="requestPaymentModal" class="js-request-payment-window u-modal-window bg-transparent" style="width: 600px;">
<div class="bg-white rounded mb-9">
<!-- Header -->
<header class="d-flex justify-content-between align-items-center u-bg-light-blue-50 rounded-top py-3 px-5">
<h3 class="h6 mb-0">Request a payment</h3>
<button class="btn btn-xs u-btn--icon u-btn-text-secondary" type="button" onclick="Custombox.modal.close();">
<span class="fas fa-times"></span>
</button>
</header>
<!-- End Header -->
<hr class="my-0">
<!-- Request Payment Form -->
<form class="js-validate js-step-form"
data-progress-id="#progressStepForm"
data-steps-id="#contentStepForm"
novalidate="novalidate">
<!-- Progress Step Form -->
<div id="progressStepForm" class="js-step-progress row text-center u-form-steps p-5">
<div class="col-sm-4 mb-3 mb-sm-0">
<span class="d-block u-icon u-icon-secondary--air u-icon--lg rounded-circle u-form-steps__icon mx-auto mb-2">
<span class="fa fa-user-circle u-icon__inner"></span>
</span>
Select payer
</div>
<div class="col-sm-4 mb-3 mb-sm-0">
<span class="d-block u-icon u-icon-secondary--air u-icon--lg rounded-circle u-form-steps__icon mx-auto mb-2">
<span class="fa fa-file-invoice-dollar u-icon__inner"></span>
</span>
Payment details
</div>
<div class="col-sm-4 mb-3 mb-sm-0">
<span class="d-block u-icon u-icon-secondary--air u-icon--lg rounded-circle u-form-steps__icon mx-auto mb-2">
<span class="fa fa-paperclip u-icon__inner"></span>
</span>
Attach documents
</div>
</div>
<!-- End Progress Step Form -->
<hr class="my-0">
<!-- Content Step Form -->
<div id="contentStepForm" class="p-5 mb-5">
<div id="selectPlayerStep" class="active">
<!-- Recent Payers List -->
<div id="recentPayersList" data-target-group="idAddNewPayer">
<!-- Link -->
<div class="d-flex justify-content-end mb-3">
<a class="js-animation-link d-inline-block small u-link-muted" href="javascript:;"
data-target="#addNewPayer"
data-link-group="idAddNewPayer">
<span class="fa fa-plus mr-1"></span>
Add new payer
</a>
</div>
<!-- End Link -->
<!-- Add Members -->
<div class="js-focus-state input-group u-form mb-4">
<input class="form-control u-form__input" type="email" placeholder="Enter email, name, or company" aria-label="Enter email, name, or company">
</div>
<!-- End Add Members -->
<!-- Most Recent Payers List -->
<div class="mb-4">
<!-- Payers List -->
<a class="d-block d-sm-flex align-items-sm-center u-info-v2 rounded p-2 mb-2" href="javascript:;" data-next-step="#paymentDetailsStep">
<div class="media align-items-center">
<img class="u-avatar rounded-circle mr-3" src="../assets/img/100x100/img8.jpg" alt="Image Description">
<div class="media-body">
<h4 class="h6 mb-0">Sebastian Diaz</h4>
<small class="d-block text-secondary">sebastiandiaz@gmail.com</small>
</div>
</div>
</a>
<!-- End Payers List -->
<!-- Payers List -->
<a class="d-block d-sm-flex align-items-sm-center u-info-v2 rounded p-2 mb-2" href="javascript:;" data-next-step="#paymentDetailsStep">
<div class="media align-items-center">
<span class="u-icon u-icon-success--air u-icon--md rounded-circle mr-3">
<span class="u-icon__inner">CL</span>
</span>
<div class="media-body">
<h4 class="h6 mb-0">Cler Lockhart</h4>
<small class="d-block text-secondary">clerlockhart@gmail.com</small>
</div>
</div>
</a>
<!-- End Payers List -->
<!-- Payers List -->
<a class="d-block d-sm-flex align-items-sm-center u-info-v2 rounded p-2 mb-2" href="javascript:;" data-next-step="#paymentDetailsStep">
<div class="media align-items-center">
<img class="u-avatar rounded-circle mr-3" src="../assets/img/100x100/img12.jpg" alt="Image Description">
<div class="media-body">
<h4 class="h6 mb-0">Joseph Mack</h4>
<small class="d-block text-secondary">josephmack@gmail.com</small>
</div>
</div>
</a>
<!-- End Payers List -->
<!-- Payers List -->
<a class="d-block d-sm-flex align-items-sm-center u-info-v2 rounded p-2 mb-2" href="javascript:;" data-next-step="#paymentDetailsStep">
<div class="media align-items-center">
<img class="u-avatar rounded-circle mr-3" src="../assets/img/100x100/img10.jpg" alt="Image Description">
<div class="media-body">
<h4 class="h6 mb-0">Eliza Donovan</h4>
<small class="d-block text-secondary">eliz@gmail.com</small>
</div>
</div>
</a>
<!-- End Payers List -->
</div>
<!-- End Most Recent Payers List -->
</div>
<!-- End Recent Payers List -->
<!-- Add New Payer -->
<div id="addNewPayer" data-target-group="idAddNewPayer" style="display: none;">
<!-- Button Group -->
<div class="btn-group btn-group-toggle d-flex mb-5">
<a class="js-animation-link btn btn-sm u-btn-secondary--air flex-fill active" href="javascript:;"
data-target="#companyType"
data-link-group="idPayerType">
Company
</a>
<a class="js-animation-link btn btn-sm u-btn-secondary--air flex-fill" href="javascript:;"
data-target="#individualType"
data-link-group="idPayerType">
Individual
</a>
</div>
<!-- End Button Group -->
<!-- Company Type Payer -->
<div id="companyType" data-target-group="idPayerType">
<div class="row">
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Company name</label>
<div class="js-form-message">
<div class="js-focus-state input-group input-group-sm u-form u-form--sm">
<input class="form-control u-form__input" type="text" name="companyName" required
placeholder="Pixeel"
aria-label="Pixeel"
data-msg="Please enter a valid name."
data-error-class="u-has-error"
data-success-class="u-has-success">
</div>
</div>
</div>
<!-- End Input Group -->
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Website URL</label>
<div class="js-form-message">
<div class="js-focus-state input-group input-group-sm u-form u-form--sm">
<input class="form-control u-form__input" type="URL" name="websiteURL" required
placeholder="example.com"
aria-label="example.com"
data-msg="Please enter a valid website URL."
data-error-class="u-has-error"
data-success-class="u-has-success">
</div>
</div>
</div>
<!-- End Input Group -->
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Contact first name</label>
<div class="js-form-message">
<div class="js-focus-state input-group input-group-sm u-form u-form--sm">
<input class="form-control u-form__input" type="text" name="contactFirstNameCompany" required
placeholder="Brian"
aria-label="Brian"
data-msg="Please enter a valid name."
data-error-class="u-has-error"
data-success-class="u-has-success">
</div>
</div>
</div>
<!-- End Input Group -->
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Contact last name</label>
<div class="js-form-message">
<div class="js-focus-state input-group input-group-sm u-form u-form--sm">
<input class="form-control u-form__input" type="text" name="contactLastNameCompany" required
placeholder="Williams"
aria-label="Williams"
data-msg="Please enter a valid name."
data-error-class="u-has-error"
data-success-class="u-has-success">
</div>
</div>
</div>
<!-- End Input Group -->
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Email</label>
<div class="js-form-message">
<div class="js-focus-state input-group input-group-sm u-form u-form--sm">
<input class="form-control u-form__input" type="email" name="emailCompany" required
placeholder="example@gmail.com"
aria-label="example@gmail.com"
data-msg="Please enter a valid email address."
data-error-class="u-has-error"
data-success-class="u-has-success">
</div>
</div>
</div>
<!-- End Input Group -->
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Country</label>
<div class="js-form-message">
<div class="js-focus-state input-group u-form">
<select class="custom-select custom-select-sm">
<option selected>Select country</option>
<option value="AF">Afghanistan</option>
<option value="AX">Åland Islands</option>
<option value="AL">Albania</option>
<option value="DZ">Algeria</option>
<option value="AS">American Samoa</option>
<option value="AD">Andorra</option>
<option value="AO">Angola</option>
<option value="AI">Anguilla</option>
<option value="AQ">Antarctica</option>
<option value="AG">Antigua and Barbuda</option>
<option value="AR">Argentina</option>
<option value="AM">Armenia</option>
<option value="AW">Aruba</option>
<option value="AU">Australia</option>
<option value="AT">Austria</option>
<option value="AZ">Azerbaijan</option>
<option value="BS">Bahamas</option>
<option value="BH">Bahrain</option>
<option value="BD">Bangladesh</option>
<option value="BB">Barbados</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium</option>
<option value="BZ">Belize</option>
<option value="BJ">Benin</option>
<option value="BM">Bermuda</option>
<option value="BT">Bhutan</option>
<option value="BO">Bolivia, Plurinational State of</option>
<option value="BQ">Bonaire, Sint Eustatius and Saba</option>
<option value="BA">Bosnia and Herzegovina</option>
<option value="BW">Botswana</option>
<option value="BV">Bouvet Island</option>
<option value="BR">Brazil</option>
<option value="IO">British Indian Ocean Territory</option>
<option value="BN">Brunei Darussalam</option>
<option value="BG">Bulgaria</option>
<option value="BF">Burkina Faso</option>
<option value="BI">Burundi</option>
<option value="KH">Cambodia</option>
<option value="CM">Cameroon</option>
<option value="CA">Canada</option>
<option value="CV">Cape Verde</option>
<option value="KY">Cayman Islands</option>
<option value="CF">Central African Republic</option>
<option value="TD">Chad</option>
<option value="CL">Chile</option>
<option value="CN">China</option>
<option value="CX">Christmas Island</option>
<option value="CC">Cocos (Keeling) Islands</option>
<option value="CO">Colombia</option>
<option value="KM">Comoros</option>
<option value="CG">Congo</option>
<option value="CD">Congo, the Democratic Republic of the</option>
<option value="CK">Cook Islands</option>
<option value="CR">Costa Rica</option>
<option value="CI">Côte d'Ivoire</option>
<option value="HR">Croatia</option>
<option value="CU">Cuba</option>
<option value="CW">Curaçao</option>
<option value="CY">Cyprus</option>
<option value="CZ">Czech Republic</option>
<option value="DK">Denmark</option>
<option value="DJ">Djibouti</option>
<option value="DM">Dominica</option>
<option value="DO">Dominican Republic</option>
<option value="EC">Ecuador</option>
<option value="EG">Egypt</option>
<option value="SV">El Salvador</option>
<option value="GQ">Equatorial Guinea</option>
<option value="ER">Eritrea</option>
<option value="EE">Estonia</option>
<option value="ET">Ethiopia</option>
<option value="FK">Falkland Islands (Malvinas)</option>
<option value="FO">Faroe Islands</option>
<option value="FJ">Fiji</option>
<option value="FI">Finland</option>
<option value="FR">France</option>
<option value="GF">French Guiana</option>
<option value="PF">French Polynesia</option>
<option value="TF">French Southern Territories</option>
<option value="GA">Gabon</option>
<option value="GM">Gambia</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GH">Ghana</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece</option>
<option value="GL">Greenland</option>
<option value="GD">Grenada</option>
<option value="GP">Guadeloupe</option>
<option value="GU">Guam</option>
<option value="GT">Guatemala</option>
<option value="GG">Guernsey</option>
<option value="GN">Guinea</option>
<option value="GW">Guinea-Bissau</option>
<option value="GY">Guyana</option>
<option value="HT">Haiti</option>
<option value="HM">Heard Island and McDonald Islands</option>
<option value="VA">Holy See (Vatican City State)</option>
<option value="HN">Honduras</option>
<option value="HK">Hong Kong</option>
<option value="HU">Hungary</option>
<option value="IS">Iceland</option>
<option value="IN">India</option>
<option value="ID">Indonesia</option>
<option value="IR">Iran, Islamic Republic of</option>
<option value="IQ">Iraq</option>
<option value="IE">Ireland</option>
<option value="IM">Isle of Man</option>
<option value="IL">Israel</option>
<option value="IT">Italy</option>
<option value="JM">Jamaica</option>
<option value="JP">Japan</option>
<option value="JE">Jersey</option>
<option value="JO">Jordan</option>
<option value="KZ">Kazakhstan</option>
<option value="KE">Kenya</option>
<option value="KI">Kiribati</option>
<option value="KP">Korea, Democratic People's Republic of</option>
<option value="KR">Korea, Republic of</option>
<option value="KW">Kuwait</option>
<option value="KG">Kyrgyzstan</option>
<option value="LA">Lao People's Democratic Republic</option>
<option value="LV">Latvia</option>
<option value="LB">Lebanon</option>
<option value="LS">Lesotho</option>
<option value="LR">Liberia</option>
<option value="LY">Libya</option>
<option value="LI">Liechtenstein</option>
<option value="LT">Lithuania</option>
<option value="LU">Luxembourg</option>
<option value="MO">Macao</option>
<option value="MK">Macedonia, the former Yugoslav Republic of</option>
<option value="MG">Madagascar</option>
<option value="MW">Malawi</option>
<option value="MY">Malaysia</option>
<option value="MV">Maldives</option>
<option value="ML">Mali</option>
<option value="MT">Malta</option>
<option value="MH">Marshall Islands</option>
<option value="MQ">Martinique</option>
<option value="MR">Mauritania</option>
<option value="MU">Mauritius</option>
<option value="YT">Mayotte</option>
<option value="MX">Mexico</option>
<option value="FM">Micronesia, Federated States of</option>
<option value="MD">Moldova, Republic of</option>
<option value="MC">Monaco</option>
<option value="MN">Mongolia</option>
<option value="ME">Montenegro</option>
<option value="MS">Montserrat</option>
<option value="MA">Morocco</option>
<option value="MZ">Mozambique</option>
<option value="MM">Myanmar</option>
<option value="NA">Namibia</option>
<option value="NR">Nauru</option>
<option value="NP">Nepal</option>
<option value="NL">Netherlands</option>
<option value="NC">New Caledonia</option>
<option value="NZ">New Zealand</option>
<option value="NI">Nicaragua</option>
<option value="NE">Niger</option>
<option value="NG">Nigeria</option>
<option value="NU">Niue</option>
<option value="NF">Norfolk Island</option>
<option value="MP">Northern Mariana Islands</option>
<option value="NO">Norway</option>
<option value="OM">Oman</option>
<option value="PK">Pakistan</option>
<option value="PW">Palau</option>
<option value="PS">Palestinian Territory, Occupied</option>
<option value="PA">Panama</option>
<option value="PG">Papua New Guinea</option>
<option value="PY">Paraguay</option>
<option value="PE">Peru</option>
<option value="PH">Philippines</option>
<option value="PN">Pitcairn</option>
<option value="PL">Poland</option>
<option value="PT">Portugal</option>
<option value="PR">Puerto Rico</option>
<option value="QA">Qatar</option>
<option value="RE">Réunion</option>
<option value="RO">Romania</option>
<option value="RU">Russian Federation</option>
<option value="RW">Rwanda</option>
<option value="BL">Saint Barthélemy</option>
<option value="SH">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="KN">Saint Kitts and Nevis</option>
<option value="LC">Saint Lucia</option>
<option value="MF">Saint Martin (French part)</option>
<option value="PM">Saint Pierre and Miquelon</option>
<option value="VC">Saint Vincent and the Grenadines</option>
<option value="WS">Samoa</option>
<option value="SM">San Marino</option>
<option value="ST">Sao Tome and Principe</option>
<option value="SA">Saudi Arabia</option>
<option value="SN">Senegal</option>
<option value="RS">Serbia</option>
<option value="SC">Seychelles</option>
<option value="SL">Sierra Leone</option>
<option value="SG">Singapore</option>
<option value="SX">Sint Maarten (Dutch part)</option>
<option value="SK">Slovakia</option>
<option value="SI">Slovenia</option>
<option value="SB">Solomon Islands</option>
<option value="SO">Somalia</option>
<option value="ZA">South Africa</option>
<option value="GS">South Georgia and the South Sandwich Islands</option>
<option value="SS">South Sudan</option>
<option value="ES">Spain</option>
<option value="LK">Sri Lanka</option>
<option value="SD">Sudan</option>
<option value="SR">Suriname</option>
<option value="SJ">Svalbard and Jan Mayen</option>
<option value="SZ">Swaziland</option>
<option value="SE">Sweden</option>
<option value="CH">Switzerland</option>
<option value="SY">Syrian Arab Republic</option>
<option value="TW">Taiwan, Province of China</option>
<option value="TJ">Tajikistan</option>
<option value="TZ">Tanzania, United Republic of</option>
<option value="TH">Thailand</option>
<option value="TL">Timor-Leste</option>
<option value="TG">Togo</option>
<option value="TK">Tokelau</option>
<option value="TO">Tonga</option>
<option value="TT">Trinidad and Tobago</option>
<option value="TN">Tunisia</option>
<option value="TR">Turkey</option>
<option value="TM">Turkmenistan</option>
<option value="TC">Turks and Caicos Islands</option>
<option value="TV">Tuvalu</option>
<option value="UG">Uganda</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom</option>
<option value="US">United States</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="UY">Uruguay</option>
<option value="UZ">Uzbekistan</option>
<option value="VU">Vanuatu</option>
<option value="VE">Venezuela, Bolivarian Republic of</option>
<option value="VN">Viet Nam</option>
<option value="VG">Virgin Islands, British</option>
<option value="VI">Virgin Islands, U.S.</option>
<option value="WF">Wallis and Futuna</option>
<option value="EH">Western Sahara</option>
<option value="YE">Yemen</option>
<option value="ZM">Zambia</option>
<option value="ZW">Zimbabwe</option>
</select>
</div>
</div>
</div>
<!-- End Input Group -->
</div>
</div>
<!-- End Company Type Payer -->
<!-- Individual Type Payer -->
<div id="individualType" data-target-group="idPayerType" style="display: none;">
<div class="row">
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Contact first name</label>
<div class="js-form-message">
<div class="js-focus-state input-group input-group-sm u-form u-form--sm">
<input class="form-control u-form__input" type="text" name="contactFirstNameIndividual" required
placeholder="Brian"
aria-label="Brian"
data-msg="Please enter a valid name."
data-error-class="u-has-error"
data-success-class="u-has-success">
</div>
</div>
</div>
<!-- End Input Group -->
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Contact last name</label>
<div class="js-form-message">
<div class="js-focus-state input-group input-group-sm u-form u-form--sm">
<input class="form-control u-form__input" type="text" name="contactLasttNameIndividual" required
placeholder="Williams"
aria-label="Williams"
data-msg="Please enter a valid name."
data-error-class="u-has-error"
data-success-class="u-has-success">
</div>
</div>
</div>
<!-- End Input Group -->
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Email</label>
<div class="js-form-message">
<div class="js-focus-state input-group input-group-sm u-form u-form--sm">
<input class="form-control u-form__input" type="email" name="emailIndividual" required
placeholder="example@gmail.com"
aria-label="example@gmail.com"
data-msg="Please enter a valid email address."
data-error-class="u-has-error"
data-success-class="u-has-success">
</div>
</div>
</div>
<!-- End Input Group -->
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Country</label>
<div class="js-form-message">
<div class="js-focus-state input-group u-form">
<select class="custom-select custom-select-sm">
<option selected>Select country</option>
<option value="AF">Afghanistan</option>
<option value="AX">Åland Islands</option>
<option value="AL">Albania</option>
<option value="DZ">Algeria</option>
<option value="AS">American Samoa</option>
<option value="AD">Andorra</option>
<option value="AO">Angola</option>
<option value="AI">Anguilla</option>
<option value="AQ">Antarctica</option>
<option value="AG">Antigua and Barbuda</option>
<option value="AR">Argentina</option>
<option value="AM">Armenia</option>
<option value="AW">Aruba</option>
<option value="AU">Australia</option>
<option value="AT">Austria</option>
<option value="AZ">Azerbaijan</option>
<option value="BS">Bahamas</option>
<option value="BH">Bahrain</option>
<option value="BD">Bangladesh</option>
<option value="BB">Barbados</option>
<option value="BY">Belarus</option>
<option value="BE">Belgium</option>
<option value="BZ">Belize</option>
<option value="BJ">Benin</option>
<option value="BM">Bermuda</option>
<option value="BT">Bhutan</option>
<option value="BO">Bolivia, Plurinational State of</option>
<option value="BQ">Bonaire, Sint Eustatius and Saba</option>
<option value="BA">Bosnia and Herzegovina</option>
<option value="BW">Botswana</option>
<option value="BV">Bouvet Island</option>
<option value="BR">Brazil</option>
<option value="IO">British Indian Ocean Territory</option>
<option value="BN">Brunei Darussalam</option>
<option value="BG">Bulgaria</option>
<option value="BF">Burkina Faso</option>
<option value="BI">Burundi</option>
<option value="KH">Cambodia</option>
<option value="CM">Cameroon</option>
<option value="CA">Canada</option>
<option value="CV">Cape Verde</option>
<option value="KY">Cayman Islands</option>
<option value="CF">Central African Republic</option>
<option value="TD">Chad</option>
<option value="CL">Chile</option>
<option value="CN">China</option>
<option value="CX">Christmas Island</option>
<option value="CC">Cocos (Keeling) Islands</option>
<option value="CO">Colombia</option>
<option value="KM">Comoros</option>
<option value="CG">Congo</option>
<option value="CD">Congo, the Democratic Republic of the</option>
<option value="CK">Cook Islands</option>
<option value="CR">Costa Rica</option>
<option value="CI">Côte d'Ivoire</option>
<option value="HR">Croatia</option>
<option value="CU">Cuba</option>
<option value="CW">Curaçao</option>
<option value="CY">Cyprus</option>
<option value="CZ">Czech Republic</option>
<option value="DK">Denmark</option>
<option value="DJ">Djibouti</option>
<option value="DM">Dominica</option>
<option value="DO">Dominican Republic</option>
<option value="EC">Ecuador</option>
<option value="EG">Egypt</option>
<option value="SV">El Salvador</option>
<option value="GQ">Equatorial Guinea</option>
<option value="ER">Eritrea</option>
<option value="EE">Estonia</option>
<option value="ET">Ethiopia</option>
<option value="FK">Falkland Islands (Malvinas)</option>
<option value="FO">Faroe Islands</option>
<option value="FJ">Fiji</option>
<option value="FI">Finland</option>
<option value="FR">France</option>
<option value="GF">French Guiana</option>
<option value="PF">French Polynesia</option>
<option value="TF">French Southern Territories</option>
<option value="GA">Gabon</option>
<option value="GM">Gambia</option>
<option value="GE">Georgia</option>
<option value="DE">Germany</option>
<option value="GH">Ghana</option>
<option value="GI">Gibraltar</option>
<option value="GR">Greece</option>
<option value="GL">Greenland</option>
<option value="GD">Grenada</option>
<option value="GP">Guadeloupe</option>
<option value="GU">Guam</option>
<option value="GT">Guatemala</option>
<option value="GG">Guernsey</option>
<option value="GN">Guinea</option>
<option value="GW">Guinea-Bissau</option>
<option value="GY">Guyana</option>
<option value="HT">Haiti</option>
<option value="HM">Heard Island and McDonald Islands</option>
<option value="VA">Holy See (Vatican City State)</option>
<option value="HN">Honduras</option>
<option value="HK">Hong Kong</option>
<option value="HU">Hungary</option>
<option value="IS">Iceland</option>
<option value="IN">India</option>
<option value="ID">Indonesia</option>
<option value="IR">Iran, Islamic Republic of</option>
<option value="IQ">Iraq</option>
<option value="IE">Ireland</option>
<option value="IM">Isle of Man</option>
<option value="IL">Israel</option>
<option value="IT">Italy</option>
<option value="JM">Jamaica</option>
<option value="JP">Japan</option>
<option value="JE">Jersey</option>
<option value="JO">Jordan</option>
<option value="KZ">Kazakhstan</option>
<option value="KE">Kenya</option>
<option value="KI">Kiribati</option>
<option value="KP">Korea, Democratic People's Republic of</option>
<option value="KR">Korea, Republic of</option>
<option value="KW">Kuwait</option>
<option value="KG">Kyrgyzstan</option>
<option value="LA">Lao People's Democratic Republic</option>
<option value="LV">Latvia</option>
<option value="LB">Lebanon</option>
<option value="LS">Lesotho</option>
<option value="LR">Liberia</option>
<option value="LY">Libya</option>
<option value="LI">Liechtenstein</option>
<option value="LT">Lithuania</option>
<option value="LU">Luxembourg</option>
<option value="MO">Macao</option>
<option value="MK">Macedonia, the former Yugoslav Republic of</option>
<option value="MG">Madagascar</option>
<option value="MW">Malawi</option>
<option value="MY">Malaysia</option>
<option value="MV">Maldives</option>
<option value="ML">Mali</option>
<option value="MT">Malta</option>
<option value="MH">Marshall Islands</option>
<option value="MQ">Martinique</option>
<option value="MR">Mauritania</option>
<option value="MU">Mauritius</option>
<option value="YT">Mayotte</option>
<option value="MX">Mexico</option>
<option value="FM">Micronesia, Federated States of</option>
<option value="MD">Moldova, Republic of</option>
<option value="MC">Monaco</option>
<option value="MN">Mongolia</option>
<option value="ME">Montenegro</option>
<option value="MS">Montserrat</option>
<option value="MA">Morocco</option>
<option value="MZ">Mozambique</option>
<option value="MM">Myanmar</option>
<option value="NA">Namibia</option>
<option value="NR">Nauru</option>
<option value="NP">Nepal</option>
<option value="NL">Netherlands</option>
<option value="NC">New Caledonia</option>
<option value="NZ">New Zealand</option>
<option value="NI">Nicaragua</option>
<option value="NE">Niger</option>
<option value="NG">Nigeria</option>
<option value="NU">Niue</option>
<option value="NF">Norfolk Island</option>
<option value="MP">Northern Mariana Islands</option>
<option value="NO">Norway</option>
<option value="OM">Oman</option>
<option value="PK">Pakistan</option>
<option value="PW">Palau</option>
<option value="PS">Palestinian Territory, Occupied</option>
<option value="PA">Panama</option>
<option value="PG">Papua New Guinea</option>
<option value="PY">Paraguay</option>
<option value="PE">Peru</option>
<option value="PH">Philippines</option>
<option value="PN">Pitcairn</option>
<option value="PL">Poland</option>
<option value="PT">Portugal</option>
<option value="PR">Puerto Rico</option>
<option value="QA">Qatar</option>
<option value="RE">Réunion</option>
<option value="RO">Romania</option>
<option value="RU">Russian Federation</option>
<option value="RW">Rwanda</option>
<option value="BL">Saint Barthélemy</option>
<option value="SH">Saint Helena, Ascension and Tristan da Cunha</option>
<option value="KN">Saint Kitts and Nevis</option>
<option value="LC">Saint Lucia</option>
<option value="MF">Saint Martin (French part)</option>
<option value="PM">Saint Pierre and Miquelon</option>
<option value="VC">Saint Vincent and the Grenadines</option>
<option value="WS">Samoa</option>
<option value="SM">San Marino</option>
<option value="ST">Sao Tome and Principe</option>
<option value="SA">Saudi Arabia</option>
<option value="SN">Senegal</option>
<option value="RS">Serbia</option>
<option value="SC">Seychelles</option>
<option value="SL">Sierra Leone</option>
<option value="SG">Singapore</option>
<option value="SX">Sint Maarten (Dutch part)</option>
<option value="SK">Slovakia</option>
<option value="SI">Slovenia</option>
<option value="SB">Solomon Islands</option>
<option value="SO">Somalia</option>
<option value="ZA">South Africa</option>
<option value="GS">South Georgia and the South Sandwich Islands</option>
<option value="SS">South Sudan</option>
<option value="ES">Spain</option>
<option value="LK">Sri Lanka</option>
<option value="SD">Sudan</option>
<option value="SR">Suriname</option>
<option value="SJ">Svalbard and Jan Mayen</option>
<option value="SZ">Swaziland</option>
<option value="SE">Sweden</option>
<option value="CH">Switzerland</option>
<option value="SY">Syrian Arab Republic</option>
<option value="TW">Taiwan, Province of China</option>
<option value="TJ">Tajikistan</option>
<option value="TZ">Tanzania, United Republic of</option>
<option value="TH">Thailand</option>
<option value="TL">Timor-Leste</option>
<option value="TG">Togo</option>
<option value="TK">Tokelau</option>
<option value="TO">Tonga</option>
<option value="TT">Trinidad and Tobago</option>
<option value="TN">Tunisia</option>
<option value="TR">Turkey</option>
<option value="TM">Turkmenistan</option>
<option value="TC">Turks and Caicos Islands</option>
<option value="TV">Tuvalu</option>
<option value="UG">Uganda</option>
<option value="UA">Ukraine</option>
<option value="AE">United Arab Emirates</option>
<option value="GB">United Kingdom</option>
<option value="US">United States</option>
<option value="UM">United States Minor Outlying Islands</option>
<option value="UY">Uruguay</option>
<option value="UZ">Uzbekistan</option>
<option value="VU">Vanuatu</option>
<option value="VE">Venezuela, Bolivarian Republic of</option>
<option value="VN">Viet Nam</option>
<option value="VG">Virgin Islands, British</option>
<option value="VI">Virgin Islands, U.S.</option>
<option value="WF">Wallis and Futuna</option>
<option value="EH">Western Sahara</option>
<option value="YE">Yemen</option>
<option value="ZM">Zambia</option>
<option value="ZW">Zimbabwe</option>
</select>
</div>
</div>
</div>
<!-- End Input Group -->
</div>
</div>
<!-- End Individual Type Payer -->
</div>
<!-- End Add New Payer -->
<!-- Buttons -->
<div class="d-flex justify-content-end">
<button type="button" class="btn btn-sm btn-primary u-btn-primary transition-3d-hover mr-1" data-next-step="#paymentDetailsStep">Next</button>
<button type="submit" class="btn btn-sm u-btn-secondary--air transition-3d-hover" onclick="Custombox.modal.close();">Cancel</button>
</div>
<!-- End Buttons -->
</div>
<div id="paymentDetailsStep" style="display: none;">
<div class="row">
<!-- Input Group -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Amount</label>
<div class="js-form-message">
<div class="js-focus-state input-group input-group-sm u-form u-form--sm">
<input class="form-control u-form__input" type="number" name="amount" required
placeholder="Pixeel"
aria-label="Pixeel"
data-msg="Please enter a valid name."
data-error-class="u-has-error"
data-success-class="u-has-success">
</div>
</div>
</div>
<!-- End Input Group -->
<!-- Select -->
<div class="col-sm-6 mb-4">
<label class="h6 small d-block text-uppercase">Currency</label>
<div class="js-focus-state input-group u-form">
<select class="custom-select custom-select-sm">
<option value="usd">USD</option>
<option value="euro">Euro</option>
<option value="gbp">GBP</option>
</select>
</div>
</div>
<!-- End Select -->
</div>
<!-- Input -->
<div class="mb-4">
<label class="h6 small d-block text-uppercase">Description</label>
<div class="js-form-message">
<div class="js-focus-state input-group input-group-sm u-form--sm">
<textarea class="form-control u-form__input" rows="2" name="description" required
placeholder="Your payer will see this description on the payment request"
aria-label="Your payer will see this description on the payment request"
data-msg="Please enter a valid reason."
data-error-class="u-has-error"
data-success-class="u-has-success"></textarea>
</div>
</div>
</div>
<!-- End Input -->
<!-- Datepicker -->
<div class="mb-4">
<label class="d-block small text-uppercase font-weight-medium">Payment due by</label>
<div id="datepickerWrapper" class="u-datepicker u-datepicker--top input-group input-group-sm u-form u-form--sm">
<input class="js-range-datepicker form-control u-form__input bg-transparent border-right-0" type="text" placeholder="Due date" aria-label="Due date"
data-rp-wrapper="#datepickerWrapper"
data-rp-date-format="d/m/Y">
<div class="input-group-append u-form__append">
<span class="input-group-text u-form__text rounded-right">
<span class="far fa-calendar-alt u-form__text-inner"></span>
</span>
</div>
</div>
</div>
<!-- End Datepicker -->
<!-- Buttons -->
<div class="d-flex justify-content-end">
<button type="button" class="btn btn-sm btn-primary u-btn-primary transition-3d-hover mr-1" data-next-step="#attachDocumentsStep">Next</button>
<a class="btn btn-sm u-btn-secondary--air transition-3d-hover mr-1" href="javascript:;" data-previous-step="#selectPlayerStep">Back</a>
</div>
<!-- End Buttons -->
</div>
<div id="attachDocumentsStep" style="display: none;">
<div class="mb-4">
<p>Attach up to 3 documents (like your invoice or work contact) to your payment request.</p>
<p>Do not have an invoice? <a href="#">Create a professional invoice for free and upload below.</a></p>
</div>
<!-- File Attachment Input -->
<label class="u-file-attachment-input mb-4" for="fileAttachmentInput">
Browse your device and upload documents
<small class="d-block text-muted">Maximum file size 10MB</small>
<input id="fileAttachmentInput" name="file-attachment" type="file" class="u-file-attachment-input__label">
</label>
<!-- End File Attachment Input -->
<!-- Buttons -->
<div class="d-flex justify-content-end">
<button type="submit" class="btn btn-sm btn-primary u-btn-primary transition-3d-hover mr-1">Request Payment</button>
<a class="btn btn-sm u-btn-secondary--air transition-3d-hover mr-1" href="javascript:;" data-previous-step="#paymentDetailsStep">Back</a>
</div>
<!-- End Buttons -->
</div>
</div>
<!-- End Content Step Form -->
</form>
<!-- End Request Payment Form -->
</div>
</div>
<!-- End Request Payment Modal Window -->
CSS library:
<link rel="stylesheet" href="assets/vendor/custombox/dist/custombox.min.css">
<link rel="stylesheet" href="assets/vendor/flatpickr/dist/flatpickr.min.css">
JS library and initialization:
<!-- JS Implementing Plugins -->
<script src="assets/vendor/custombox/dist/custombox.min.js"></script>
<script src="assets/vendor/jquery-validation/dist/jquery.validate.min.js"></script>
<script src="assets/vendor/flatpickr/dist/flatpickr.min.js"></script>
<!-- JS Implementing Plugins -->
<script src="assets/js/helpers/hs.focus-state.js"></script>
<script src="assets/js/components/hs.validation.js"></script>
<script src="assets/js/components/hs.modal-window.js"></script>
<script src="assets/js/components/hs.step-form.js"></script>
<script src="assets/js/components/hs.show-animation.js"></script>
<script src="assets/js/components/hs.range-datepicker.js"></script>
<!-- JS Plugins Init. -->
<script>
$(document).on('ready', function () {
// initialization of forms
$.HSCore.helpers.HSFocusState.init();
// initialization of form validation
$.HSCore.components.HSValidation.init('.js-validate');
// initialization of autonomous popups
$.HSCore.components.HSModalWindow.init('[data-modal-target]', '.js-request-payment-window', {
autonomous: true
});
// initialization of step form
$.HSCore.components.HSStepForm.init('.js-step-form');
// initialization of show animations
$.HSCore.components.HSShowAnimation.init('.js-animation-link');
// initialization of range datepicker
$.HSCore.components.HSRangeDatepicker.init('.js-range-datepicker');
});
</script>