gcg-website/static/admin/previews/page-previews/anmeldeformular-preview.js

160 lines
4.9 KiB
JavaScript

import { PageHeader } from "./components/index.js";
const AnmeldeformularPreview = ({ widgetFor, entry }) => {
return [
PageHeader(entry),
h(
"section",
{ className: "section bg-body-tertiary" },
h(
"div",
{ className: "container" },
h(
"div",
{ className: "row" },
h(
"div",
{ className: "col-lg-8 mb-4 mb-lg-0" },
h(
"form",
{},
h(
"div",
{ className: "input-group" },
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Name (Schüler/in)",
}),
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Vorname",
})
),
h(
"div",
{ className: "input-group mb-3" },
h("span", { className: "input-group-text" }, "Geburtsdatum"),
h("input", { className: "form-control", type: "date" })
),
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Straße",
}),
h(
"div",
{ className: "input-group" },
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Hausnummer",
}),
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Adresszusatz",
})
),
h(
"div",
{ className: "input-group" },
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "PLZ",
}),
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Stadt",
})
),
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Landkreis",
}),
h(
"div",
{ className: "input-group" },
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Telefon privat",
}),
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Telefon dienstl.",
})
),
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Abweichender Elternname",
}),
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Grundschule",
}),
h("input", {
className: "form-control mb-3",
type: "text",
placeholder: "Ihre E-Mail-Adresse",
}),
h("textarea", {
className: "form-control mb-3",
placeholder: "Bemerkungen",
}),
h(
"div",
{ className: "input-group mb-3" },
h("input", { className: "form-control", type: "file" }),
h(
"span",
{ className: "input-group-text" },
"Zeugnis (Vorderseite)"
)
),
h(
"div",
{ className: "input-group mb-3" },
h("input", { className: "form-control", type: "file" }),
h(
"span",
{ className: "input-group-text" },
"Zeugnis (Rückseite)"
)
),
h(
"div",
{ className: "input-group mb-3" },
h(
"div",
{ className: "input-group-text" },
h("input", {
className: "form-check-input",
type: "checkbox",
})
),
h(
"p",
{ className: "form-control mb-0" },
"Hiermit melden wir unser Kind verbindlich zur Aufnahmeprüfung an."
)
),
h("button", { className: "btn btn-primary" }, "Senden")
)
),
h("div", { className: "col-lg-4" }, widgetFor("body"))
)
)
),
];
};
export default AnmeldeformularPreview;