File: /home/imensosw/www/imenso.co/demo/mcm/review-payment.php
<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<title>MCM School | Welcome to MCM School</title>
<meta name="viewport" content="width=device-width, initial-scale=1.0"/>
<link rel="stylesheet" type="text/css" href="css/bootstrap.min.css"/>
<link href="style.css" rel="stylesheet" type="text/css"/>
<link href="css/responsive.css" rel="stylesheet" type="text/css"/>
<link href="//maxcdn.bootstrapcdn.com/font-awesome/4.2.0/css/font-awesome.min.css" rel="stylesheet">
</head>
<body>
<section class="" id="myModal">
<nav class="navbar-default">
<div class="wrapper">
<div class="navbar-header">
<a class="navbar-brand" href="#"><img src="images/mcm_school_logo.png" class="img-responsive"></a>
</div>
</div>
</nav>
<div class="pad-t-20">
<div class="container">
<div class="row review-header">
<div class="col-md-6">
<p> <i class="fa fa-lock" aria-hidden="true"></i> Secure Checkout </p>
</div>
<div class="col-md-6 text-right review_header_text">
<p> <i class="fa fa-phone" aria-hidden="true"></i> 1-000-000-0000 </p>
</div>
</div>
</div>
<div class="pad-t-20 bdr_bt"></div>
<div class="container">
<div class="row mt3 review_flex review-header">
<div class="divider_review"><p> <span class="review_tab"> 1 </span><br> Review & Pay </p></div>
<div class=""><p><span class="review_tab_grey"> 2 </span> <br/> Receipt </p> </div>
</div>
<div class="row pad-t-50">
<h2> Review & Pay </h2>
<div class="bdr_bt mt15"></div>
<div class="col-md-8 col-md-offset-2 pad-t-50">
<div class="review_form">
<div class="row">
<div class="col-md-6"> <h3> Payment Details </h3> </div>
<div class="col-md-6 text-right">
<img width="100" src="images/card-payment-icons.png" alt="">
</div>
</div>
<div class="bdr_bt mt15"></div>
<form action="" method="POST" class="pad-t-50">
<input type="text" id="name" name="Daniel" class="hidden input_field form-control" placeholder="Daniel">
<input type="text" name="week" id="week" class="form-control input_field hidden" placeholder="week">
<input type="text" name="surname" class="input_field form-control hidden" placeholder="Appelbee">
<input type="text" name="email" id="name" class="input_field form-control hidden" placeholder="dan@test.com">
<h3> Your Billing Address </h3>
<div class="bdr_bt mt15"></div>
<div class="row mt3">
<div class="col-md-2">
<p> Title </p>
<input type="text" name="title" id="title" class="form-control input_field" placeholder="Mr">
</div>
<div class="col-md-5">
<p> First Name </p>
<input type="text" id="firstname" class="form-control input_field" placeholder="Daniel" name="firstname">
</div>
<div class="col-md-5">
<p> Last Name </p>
<input type="text" id="surname" class="form-control input_field" placeholder="Appelbee" name="surname">
</div>
</div>
<div class="row">
<div class="col-md-6">
<p> Country </p>
<select class="form-control input_field" id="" name="">
<option> country </option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select>
</div>
<div class="col-md-6"></div>
</div>
<div class="row">
<div class="col-md-6">
<p> House number or name (optional) </p>
<input type="text" class="form-control input_field" id="house_no" placeholder="House number">
</div>
<div class="col-md-6"></div>
</div>
<div class="row">
<div class="col-md-4">
<p> Zip Code / Post Code </p>
<input type="text" id="zipcode" class="form-control input_field" placeholder="HG1 3EW">
</div>
<div class="col-md-8"></div>
</div>
<div class="row">
<div class="col-md-6"><h4 class="add_search"> Search by address </h4></div>
<div class="col-md-6"></div>
</div>
<div class="row">
<div class="col-md-12 pad-t-20"> <h3> Review Your Order </h3> </div>
</div>
<div class="bdr_bt mt15"></div>
<h4 class="pad-t-20 review_heading_h4"> Billing Details </h4>
<p class="mt15 review_form_text"> Mr Daniel Appelbee <br/>
Flat 22, Ritchie House Hazelville Road <br/>
London <br/>
N19 4LC
</p>
<h4 class="pad-t-20 review_heading_h4"> Contact Telephone Number: </h4>
<p class="review_form_text"> 07506729350 </p>
<p class="mt2"> <button id="submit" type="submit" class="btn-alpha btn-l no-nav btn-l-marg">Edit Address
</button></p>
<div class="row mt2">
<div class="col-md-12 pad-t-20">
<h4 class="review_heading_h4"> Your Course Summary </h4> </div>
</div>
<div class="bdr_bt mt15 mb2"></div>
<h4 class="review_course_item"> BACHELORS COURSE </h4>
<h3 class="review_heading_h4"> $4,999.00 </h3>
<h4 class="review_course_item"> Duration: 7 week </h4>
<p class="review_form_text"> <i class="fa fa-map-marker fa-2x marg-r-20" aria-hidden="true"></i>
Location: 2809 Martha Ellen Drive, Reno, Nevada, 89506 </p>
<P class="review_form_text mt2"> Course Start Date: <span id="week_start_date"></span></P>
<P class="review_form_text">Course End Date: <span id="week_end_date"></span></P>
<div class="total_pay">
<div class="row">
<div class="col-lg-6">
<h4> Total to pay </h4>
</div>
<div class="col-lg-6 text-right">
<h4> $4,999.00 </h4>
</div>
</div>
<p class="text-right mt3">
<button id="submit_payment" type="submit" class="btn-alpha btn-l no-nav btn-l-marg">Pay Now </button>
</p>
</form>
</div>
</div>
</div>
</div>
</div>
<div class="bdr_bt mt10"></div>
<div class="container">
<div class="row mb5">
<div class="pad-t-20">
<div class="col-md-6">
<p class="review_form_text"> © 2017 MCM School. All rights reserved. </p>
<p class="pad-t-20 review_form_text"> MCM School <br/>
2809 Martha Ellen Drive, <br/>
Reno, Nevada, 89506 <br/>
Registered in North America <br/>
Company registration number: 2446778 </p>
</div>
<div class="col-md-6">
<p class="text-right review_form_text"> mcm.com is secure and your <br/>
details are protected</p>
<img class="footer_img mt2" src="images/paypal-icon.png.jpeg" class="img-responsive" alt="" />
</div>
</div>
<!-- <button type="button" class="btn btn-default" data-dismiss="modal" style="float: right; margin-top: 30px;">Close</button> -->
</div>
</div>
</section>
</body>
</html>