Jason Jordan
39 lines
1.6 KiB
Plaintext
39 lines
1.6 KiB
Plaintext
<div class="bg-deepcove h-full w-full flex flex-col">
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<div class="flex justify-between">
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<h1 class="font-bold text-4xl text-platinum my-5">New Employer</h1>
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<%= form_with model: @employer, url: import_employers_path, data: { turbo: false }, local: true, multipart: true do |form| %>
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<div class="flex items-end space-x-4">
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<div class="flex flex-col">
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<%= form.label :import_from_word, 'ID Card Setup Word Doc', class: "block text-platinum font-bold mb-1 md:mb-0 pr-4" %>
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<%= form.file_field :import_from_word %>
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</div>
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<%= form.submit "Import", class: "h-[40px]" %>
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</div>
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<% end %>
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</div>
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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 pb-10">
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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-2/5">
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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" }, data: { logo_upload_target: "employer" }, 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 :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="py-8">
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<%= f.submit "Create New Employer" %>
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</div>
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</div>
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<% end %>
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</div>
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