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<!doctype html>
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<html lang="en">
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<head>
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<meta charset="utf-8">
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<meta name="viewport" content="width=device-width, initial-scale=1, shrink-to-fit=no">
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<meta name="description" content="">
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<meta name="author" content="Mark Otto, Jacob Thornton, and Bootstrap contributors">
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<meta name="generator" content="Hugo 0.101.0">
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<title>Checkout example · Bootstrap v4.6</title>
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<link rel="canonical" href="https://getbootstrap.com/docs/4.6/examples/checkout/">
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<!-- Bootstrap core CSS -->
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<link href="../assets/dist/css/bootstrap.min.css" rel="stylesheet">
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<style>
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.bd-placeholder-img {
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font-size: 1.125rem;
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text-anchor: middle;
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-webkit-user-select: none;
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-moz-user-select: none;
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-ms-user-select: none;
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user-select: none;
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}
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@media (min-width: 768px) {
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.bd-placeholder-img-lg {
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font-size: 3.5rem;
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}
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}
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</style>
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<!-- Custom styles for this template -->
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<link href="form-validation.css" rel="stylesheet">
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</head>
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<body class="bg-light">
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<div class="container">
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<div class="py-5 text-center">
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<img class="d-block mx-auto mb-4" src="../assets/brand/bootstrap-solid.svg" alt="" width="72" height="72">
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<h2>Checkout form</h2>
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<p class="lead">Below is an example form built entirely with Bootstrap’s form controls. Each required form group has a validation state that can be triggered by attempting to submit the form without completing it.</p>
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</div>
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<div class="row">
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<div class="col-md-4 order-md-2 mb-4">
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<h4 class="d-flex justify-content-between align-items-center mb-3">
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<span class="text-muted">Your cart</span>
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<span class="badge badge-secondary badge-pill">3</span>
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</h4>
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<ul class="list-group mb-3">
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<li class="list-group-item d-flex justify-content-between lh-condensed">
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<div>
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<h6 class="my-0">Product name</h6>
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<small class="text-muted">Brief description</small>
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</div>
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<span class="text-muted">$12</span>
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</li>
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<li class="list-group-item d-flex justify-content-between lh-condensed">
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<div>
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<h6 class="my-0">Second product</h6>
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<small class="text-muted">Brief description</small>
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</div>
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<span class="text-muted">$8</span>
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</li>
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<li class="list-group-item d-flex justify-content-between lh-condensed">
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<div>
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<h6 class="my-0">Third item</h6>
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<small class="text-muted">Brief description</small>
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</div>
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<span class="text-muted">$5</span>
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</li>
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<li class="list-group-item d-flex justify-content-between bg-light">
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<div class="text-success">
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<h6 class="my-0">Promo code</h6>
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<small>EXAMPLECODE</small>
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</div>
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<span class="text-success">-$5</span>
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</li>
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<li class="list-group-item d-flex justify-content-between">
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<span>Total (USD)</span>
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<strong>$20</strong>
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</li>
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</ul>
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<form class="card p-2">
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<div class="input-group">
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<input type="text" class="form-control" placeholder="Promo code">
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<div class="input-group-append">
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<button type="submit" class="btn btn-secondary">Redeem</button>
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</div>
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</div>
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</form>
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</div>
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<div class="col-md-8 order-md-1">
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<h4 class="mb-3">Billing address</h4>
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<form class="needs-validation" novalidate>
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<div class="row">
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<div class="col-md-6 mb-3">
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<label for="firstName">First name</label>
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<input type="text" class="form-control" id="firstName" placeholder="" value="" required>
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<div class="invalid-feedback">
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Valid first name is required.
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</div>
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</div>
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<div class="col-md-6 mb-3">
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<label for="lastName">Last name</label>
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<input type="text" class="form-control" id="lastName" placeholder="" value="" required>
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<div class="invalid-feedback">
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Valid last name is required.
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</div>
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</div>
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</div>
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<div class="mb-3">
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<label for="username">Username</label>
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<div class="input-group">
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<div class="input-group-prepend">
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<span class="input-group-text">@</span>
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</div>
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<input type="text" class="form-control" id="username" placeholder="Username" required>
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<div class="invalid-feedback" style="width: 100%;">
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Your username is required.
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</div>
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</div>
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</div>
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<div class="mb-3">
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<label for="email">Email <span class="text-muted">(Optional)</span></label>
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<input type="email" class="form-control" id="email" placeholder="you@example.com">
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<div class="invalid-feedback">
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Please enter a valid email address for shipping updates.
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</div>
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</div>
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<div class="mb-3">
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<label for="address">Address</label>
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<input type="text" class="form-control" id="address" placeholder="1234 Main St" required>
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<div class="invalid-feedback">
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Please enter your shipping address.
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</div>
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</div>
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<div class="mb-3">
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<label for="address2">Address 2 <span class="text-muted">(Optional)</span></label>
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<input type="text" class="form-control" id="address2" placeholder="Apartment or suite">
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</div>
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<div class="row">
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<div class="col-md-5 mb-3">
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<label for="country">Country</label>
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<select class="custom-select d-block w-100" id="country" required>
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<option value="">Choose...</option>
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<option>United States</option>
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</select>
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<div class="invalid-feedback">
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Please select a valid country.
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</div>
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</div>
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<div class="col-md-4 mb-3">
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<label for="state">State</label>
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<select class="custom-select d-block w-100" id="state" required>
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<option value="">Choose...</option>
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<option>California</option>
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</select>
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<div class="invalid-feedback">
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Please provide a valid state.
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</div>
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</div>
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<div class="col-md-3 mb-3">
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<label for="zip">Zip</label>
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<input type="text" class="form-control" id="zip" placeholder="" required>
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<div class="invalid-feedback">
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Zip code required.
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</div>
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</div>
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</div>
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<hr class="mb-4">
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<div class="custom-control custom-checkbox">
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<input type="checkbox" class="custom-control-input" id="same-address">
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<label class="custom-control-label" for="same-address">Shipping address is the same as my billing address</label>
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</div>
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<div class="custom-control custom-checkbox">
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<input type="checkbox" class="custom-control-input" id="save-info">
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<label class="custom-control-label" for="save-info">Save this information for next time</label>
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</div>
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<hr class="mb-4">
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<h4 class="mb-3">Payment</h4>
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<div class="d-block my-3">
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<div class="custom-control custom-radio">
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<input id="credit" name="paymentMethod" type="radio" class="custom-control-input" checked required>
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<label class="custom-control-label" for="credit">Credit card</label>
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</div>
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<div class="custom-control custom-radio">
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<input id="debit" name="paymentMethod" type="radio" class="custom-control-input" required>
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<label class="custom-control-label" for="debit">Debit card</label>
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</div>
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<div class="custom-control custom-radio">
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<input id="paypal" name="paymentMethod" type="radio" class="custom-control-input" required>
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<label class="custom-control-label" for="paypal">PayPal</label>
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</div>
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</div>
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<div class="row">
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<div class="col-md-6 mb-3">
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<label for="cc-name">Name on card</label>
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<input type="text" class="form-control" id="cc-name" placeholder="" required>
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<small class="text-muted">Full name as displayed on card</small>
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<div class="invalid-feedback">
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Name on card is required
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</div>
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</div>
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<div class="col-md-6 mb-3">
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<label for="cc-number">Credit card number</label>
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<input type="text" class="form-control" id="cc-number" placeholder="" required>
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<div class="invalid-feedback">
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Credit card number is required
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</div>
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</div>
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</div>
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<div class="row">
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<div class="col-md-3 mb-3">
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<label for="cc-expiration">Expiration</label>
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<input type="text" class="form-control" id="cc-expiration" placeholder="" required>
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<div class="invalid-feedback">
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Expiration date required
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</div>
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</div>
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<div class="col-md-3 mb-3">
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<label for="cc-cvv">CVV</label>
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<input type="text" class="form-control" id="cc-cvv" placeholder="" required>
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<div class="invalid-feedback">
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Security code required
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</div>
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</div>
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</div>
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<hr class="mb-4">
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<button class="btn btn-primary btn-lg btn-block" type="submit">Continue to checkout</button>
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</form>
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</div>
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</div>
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<footer class="my-5 pt-5 text-muted text-center text-small">
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<p class="mb-1">© 2017-2022 Company Name</p>
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<ul class="list-inline">
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<li class="list-inline-item"><a href="#">Privacy</a></li>
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<li class="list-inline-item"><a href="#">Terms</a></li>
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<li class="list-inline-item"><a href="#">Support</a></li>
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</ul>
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</footer>
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</div>
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<script src="https://cdn.jsdelivr.net/npm/jquery@3.5.1/dist/jquery.slim.min.js" integrity="sha384-DfXdz2htPH0lsSSs5nCTpuj/zy4C+OGpamoFVy38MVBnE+IbbVYUew+OrCXaRkfj" crossorigin="anonymous"></script>
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<script>window.jQuery || document.write('<script src="../assets/js/vendor/jquery.slim.min.js"><\/script>')</script><script src="../assets/dist/js/bootstrap.bundle.min.js"></script>
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<script src="form-validation.js"></script>
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</body>
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</html>
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