Current File : /home/karenpetzb/application/modules/backoffice/views/scripts/supplier/add.phtml

 
<div class="table-box">
	<form action="<?php echo $this->baseUrl; ?>/backoffice/supplier/add" method="post" name="addSupplierForm"  enctype="multipart/form-data" >
	<table class="table">
		<thead>
			<tr>
				<th colspan="2" class="col-md-4" ><?php echo $this->titlePage; ?></th>
			</tr>
		</thead>
		<tbody>
			<?php echo $this->render("alert_tr.phtml"); ?>
			<tr >
				<td class="col-md-4"><i class="glyphicon glyphicon-asterisk"></i>&nbsp;Marque</td>
				<td class="col-md-8"><input type="text" class="form-control" name="brend" id="brend" value="<?php echo $this->populateFormBrend['BREND']; ?>"/></td>
			</tr>
			<tr >
				<td class="col-md-4"><i class="glyphicon glyphicon-asterisk"></i>&nbsp;Nom de l'entreprise</td>
				<td class="col-md-8"><input type="text" class="form-control" name="company" id="company" value="<?php echo $this->populateFormSupplier['COMPANY']; ?>"/></td>
			</tr>
			<tr >
				<td class="col-md-4"><i class="glyphicon glyphicon-asterisk"></i>&nbsp;Nom</td>
				<td class="col-md-8"><input type="text" class="form-control" name="lastname" id="lastname" value="<?php echo $this->populateFormSupplier['NOM']; ?>"/></td>
			</tr>
			<tr >
				<td class="col-md-4"><i class="glyphicon glyphicon-asterisk"></i>&nbsp;Pr�nom</td>
				<td class="col-md-8"><input type="text" class="form-control" name="firstname" id="firstname" value="<?php echo $this->populateFormSupplier['PRENOM']; ?>"/></td>
			</tr>
			<tr >
				<td class="col-md-4"><i class="glyphicon glyphicon-asterisk"></i>&nbsp;Email</td>
				<td class="col-md-8"><input type="text" class="form-control" name="email" id="email" value="<?php echo $this->populateFormSupplier['EMAIL']; ?>"/></td>
			</tr>
			<tr >
				<td class="col-md-4">T�l�phone</td>
				<td class="col-md-8"><input type="text" class="form-control" name="tel" id="tel" value="<?php echo $this->populateFormSupplier['TEL']; ?>"/></td>
			</tr>
			<tr >
				<td class="col-md-4">Fax</td>
				<td class="col-md-8"><input type="text" class="form-control" name="fax" id="fax" value="<?php echo $this->populateFormSupplier['FAX']; ?>"/></td>
			</tr>
			<tr >
				<td class="col-md-4">Adresse</td>
				<td class="col-md-8"><input type="text" class="form-control" name="address" id="address" value="<?php echo $this->populateFormSupplier['ADDRESSE']; ?>"/></td>
			</tr>
			<tr >
				<td class="col-md-4">Code Postal</td>
				<td class="col-md-8"><input type="text" class="form-control" name="cp" id="cp" value="<?php echo $this->populateFormSupplier['CP']; ?>"/></td>
			</tr>
			<tr >
				<td class="col-md-4">Ville</td>
				<td class="col-md-8"><input type="text" class="form-control" name="ville" id="ville" value="<?php echo $this->populateFormSupplier['VILLE']; ?>"/></td>
			</tr>
			<tr>
				<td class="col-md-4">Image du fournisseur</td>
				<td class="col-md-8">
					<input type="file" name="picture" id ="picture" size="50" >
						<br><i>Extensions : jpg, gif, png</i>
				</td>
			</tr>
			<tr>
				<td colspan="2" class="text-center">
					<button class="btn btn-success" type="submit" name="add"><i class="glyphicon glyphicon-plus"></i>&nbsp;Ajouter</button>
				</td>
			</tr>
		</tbody>
	</table>
	</form>
</div>
<div class="clearfix"></div>