<div class="modal" id="delete-modal" tabindex="-1" role="dialog" aria-labelledby="myModalLabel" aria-hidden="true" style="display: none;">
    	  <div class="modal-dialog " >
          <div class="row">
              <div class="col-md-8 col-md-offset-2">
                <div class="panel panel-login">
                  <div class="panel-heading">
                  
                    <div class="row">
                         <button aria-label="Close" data-dismiss="modal" class="close" type="button">
                            x
                          </button>
                      <div class="col-xs-12 pad_0">
                        <a href="#" class="active" id="login-form-link"> Delete account </a>
                      </div>


                    </div>

                  </div>

					<form onsubmit="return validateDeleteForm()" name="deleteForm" action="last-message.php">
					<div class="panel-body">
						<div class="row">
							<div class="col-lg-12">
								<div class="">
									<p class="text-center"> This will permanently terminate your account. Are you absolutely sure? </p>
									<p class="text-center"> Type  DELETE in the field below to confirm. </p>    
								</div>

								<div class="form-group">
									<input id="delete-confirm" placeholder="Type  DELETE  to  Confirm " class="form-control input_text" type="text" name="deleteValue">
								</div>

							</div>
						</div>
					</div>
					<div class="panel-footer">
						<div class="row">
							<div class="col-lg-12">
								<!--									<a data-toggle="modal" data-target="#delete-modal" class="comm_btn_design green_btn_back" href="#"> Terminate </a>								-->								<input type="submit" name="submit" class="comm_btn_design green_btn_back" value="Terminate" />
							</div>
						</div>
					</div>										</form>
			</div>			<script>function validateDeleteForm() {    var x = document.forms["deleteForm"]["deleteValue"].value;    if (x == null || x == "") {        alert("Field must be filled out");        return false;    }	if(x == 'delete' || x == 'DELETE') {		return true;	}	alert("Please check the input data");	return false;}</script>
</div>
</div>
</div>
</div>