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frm-register.php
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frm-register.php
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<?php
use classes as cls;
require_once 'header.inc.php';
$member = new cls\member;
?>
<div class="clearfix"></div>
<div class="content">
<h2 class="title">สมัครสมชิก</h2>
<form id="register_form" name="register_form" method="POST" class="form-horizontal form-register">
<input type="hidden" value="insert" id="hidden_status" name="hidden_status">
<div class="col-md-6">
<p><b>ข้อมูลทั่วไป</b></p>
<div class="form-group">
<label for="" class="control-label col-md-3">ชื่อ *</label>
<div class="col-md-9">
<input type="text" class="form-control" id="txt_fname" name="txt_fname" value="" required>
</div>
</div>
<div class="form-group">
<label for="" class="control-label col-md-3">นามสกุล *</label>
<div class="col-md-9">
<input type="text" class="form-control" id="txt_lname" name="txt_lname" value="" required>
</div>
</div>
<div class="form-group">
<label for="" class="control-label col-md-3">เพศ *</label>
<div class="col-md-9">
<select name="gender" id="gender" class="form-control" required="required">
<option value="">เลือกเพศ</option>
<option value="male">ชาย</option>
<option value="female">หญิง</option>
</select>
</div>
</div>
<div class="form-group">
<label for="" class="control-label col-md-3">อีเมล์ *</label>
<div class="col-md-9">
<input type="email" class="form-control" id="txt_email" name="txt_email" value="" required>
</div>
</div>
<div class="form-group">
<label for="" class="control-label col-md-3">เบอร์มือถือ *</label>
<div class="col-md-9">
<input type="number" class="form-control" id="txt_mobile" name="txt_mobile" value="" required>
</div>
</div>
<div class="form-group">
<label for="" class="control-label col-md-3">เบอร์โทรศัพท์</label>
<div class="col-md-9">
<input type="number" class="form-control" id="txt_tel" name="txt_tel" value="">
</div>
</div>
</div>
<div class="col-md-6">
<p><b>ข้อมูลเข้าใช้ระบบ</b></p>
<div class="form-group">
<label for="" class="control-label col-md-3">ชื่อเข้าใช้ *</label>
<div class="col-md-9">
<input type="text" pattern="[_a-zA-Z0-9]{2,20}" class="form-control" id="txt_username" name="txt_username" required minlength="5">
</div>
</div>
<div class="form-group">
<label for="" class="control-label col-md-3">รหัสผ่าน *</label>
<div class="col-md-9">
<input type="password" pattern="[a-zA-Z0-9_]{2,20}" class="form-control" id="txt_password" name="txt_password" required minlength="6">
</div>
</div>
<div class="form-group">
<label for="" class="control-label col-md-3">ยืนยันรหัสผ่าน *</label>
<div class="col-md-9">
<input type="password" class="form-control" id="txt_repassword" name="txt_repassword" required minlength="6">
</div>
</div>
<p><b>ข้อมูลร้านค้า</b></p>
<div class="form-group">
<label for="shop_name" class="col-md-3 control-label">ชื่อร้าน *</label>
<div class="col-md-9">
<input type="text" name="shop_name" id="shop_name" class="form-control" value="" required="required" placeholder="กรอกชื่อร้านค้าของท่าน">
</div>
</div>
<div class="form-group">
<label for="shop_detail" class="control-label col-md-3">รายละเอียดร้านค้า</label>
<div class="col-md-9">
<textarea name="shop_detail" id="shop_detail" class="form-control" rows="3" aria-described="shop_detail-helpBlock"></textarea>
</div>
</div>
</div>
<div class="col-md-12">
<div class="form-group">
<div class="col-md-12">
<button type="submit" class="btn btn-raised btn-primary pull-right" id="" name="" value="บันทึกข้อมูล"><i class="fa fa-save"></i> บันทึกข้อมูล</button>
</div>
</div>
</div>
</form>
</div>
<script type="text/javascript" src="js/member.js"></script>
<?php require_once 'footer.inc.php';?>