% layout 'user';
% title 'Home';
% content_for javascript => begin
%= javascript '/static/user/js/home.js';
% end
<div class="card">
  <h3 class="card-header">Submit Receipt</h3>
  <div class="card-block">
    <form id="receipt-form" action="<%= url_for '/portal/upload' %>">
      <input id="tran-type" type="hidden" name="transaction_type" value="3" hidden>
      <div class="form-group">
        <label for="org-name">Organisation Name</label>
        <input id="org-name" type="text" class="form-control" name="organisation_name" placeholder="Organisation Name" required>
      </div>
      <div class="form-group">
        <label for="org-street">Street Address</label>
        <input id="org-street" type="text" class="form-control" name="street_name" placeholder="eg. 7 High Street">
      </div>
      <div class="form-group">
        <label for="org-town">Town</label>
        <input id="org-town" type="text" class="form-control" name="town" placeholder="eg. Lancaster" required>
      </div>
      <div class="form-group">
        <label for="org-postcode">Postcode</label>
        <input id="org-postcode" type="text" class="form-control" name="postcode" placeholder="eg. LA1 1AA">
      </div>
      <div class="form-group">
        <label for="tran-value">Receipt Value</label>
        <input id="tran-value" type="number" step="any" class="form-control" name="transaction_value" placeholder="eg. 5.99">
      </div>
      <div class="form-group">
        <label for="tran-file">Receipt Picture</label>
        <input id="tran-file" type="file" class="form-control-file" name="file">
      </div>
      <button type="submit" class="btn btn-primary">Add Receipt</button>
  </div>
</div>