Jason Jordan
35 lines
1.6 KiB
Plaintext
35 lines
1.6 KiB
Plaintext
<div class="bg-deepcove h-full w-full flex flex-col">
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<h1 class="font-bold text-4xl text-platinum my-5">Edit Employer</h1>
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<%= form_with model: @employer, local: true, multipart: true do |f| %>
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<div class="flex flex-col space-y-6">
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<div class="flex w-full items-end" data-controller="logo-upload">
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<div class="flex flex-col space-y-6 w-3/5">
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<div class="flex space-x-10">
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<div class="w-full">
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<%= f.text_field :name, label: { text: "Employer Name" }, class: "w-full" %>
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</div>
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<div class="w-full">
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<%= f.text_field :slug, label: { text: "Slug" }, class: "w-full" %>
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</div>
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<div class="w-full">
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<%= f.text_field :group_number, label: { text: "Group/Medical Number" }, class: "w-full" %>
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</div>
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</div>
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<div class="flex space-x-10">
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<div class="w-full">
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<%= f.text_field :pl_plan_key, label: { text: "Pl Plan Key" }, class: "w-full" %>
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</div>
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<div class="w-full">
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<%= f.text_field :effective_date, label: { text: "Effective Date" }, class: "w-full" %>
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</div>
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</div>
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</div>
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</div>
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<div class="flex py-8 space-x-4">
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<%= f.submit "Save Employer" %>
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<%= link_to "Back", employer_path(@employer.slug), class: "flex justify-center items-center cursor-pointer bg-atmosphere hover:bg-deepcove border-2 border-atmosphere text-platinum font-bold px-3 rounded-sm h-10 transition duration-100" %>
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</div>
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</div>
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<% end %>
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</div>
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