84 lines
2.2 KiB
PHP
84 lines
2.2 KiB
PHP
<form action="index.php?<?php echo $_SERVER['QUERY_STRING']; ?>" method="post">
|
|
<fieldset>
|
|
<legend>Kunde hinzufügen</legend>
|
|
<h2>Kundendaten</h2>
|
|
<input type="hidden" name="new" value="new"/>
|
|
<input type="hidden" name="DSchutz" value="0"/>
|
|
<label>Firma</label>
|
|
<input type="text" name="Firma"/>
|
|
<br/>
|
|
<label>Anrede</label>
|
|
<select name="Anrede">
|
|
<option value="Herr">Herr</option>
|
|
<option value="Frau">Frau</option>
|
|
</select>
|
|
<br/>
|
|
<label>Vorname</label>
|
|
<input type="text" name="Vorname"/>
|
|
<br/>
|
|
<label>Nachname</label>
|
|
<input type="text" name="Nachname"/>
|
|
<br/>
|
|
<label>Strasse</label>
|
|
<input type="text" name="Strasse"/>
|
|
<br/>
|
|
<label>Hausnummer</label>
|
|
<input type="text" name="Nummer"/>
|
|
<br/>
|
|
<label>PLZ</label>
|
|
<input type="text" name="PLZ"/>
|
|
<br/>
|
|
<label>Ort</label>
|
|
<input type="text" name="Ort"/>
|
|
<br/>
|
|
<label>Land</label>
|
|
<input type="text" name="Land"/>
|
|
<br/>
|
|
<label>Geburtsdatum</label>
|
|
<input type="text" name="Geb_Datum"/>
|
|
<img src="img/small_info.png" alt="Datum der Form: <TT.MM.JJJJ>" title="Datum der Form: <TT.MM.JJJJ>"/>
|
|
<br/>
|
|
<label>Telefon</label>
|
|
<input type="text" name="Telefon"/>
|
|
<br/>
|
|
<label>Fax</label>
|
|
<input type="text" name="Fax"/>
|
|
<br/>
|
|
<label>Mobil</label>
|
|
<input type="text" name="Mobil"/>
|
|
<br/>
|
|
<label>Email</label>
|
|
<input type="text" name="Email"/>
|
|
<br/>
|
|
<label>Homepage</label>
|
|
<input type="text" name="Homepage"/>
|
|
<br/>
|
|
<label>Registergericht</label>
|
|
<input type="text" name="Gericht"/>
|
|
<br/>
|
|
<label>USt-ID / SteuerNr.</label>
|
|
<input type="text" name="SteuerNr"/>
|
|
<br/>
|
|
<h2>Bankverbindung</h2>
|
|
<label>Inhaber</label>
|
|
<input type="text" name="Kto_Inhaber"/>
|
|
<br/>
|
|
<label>IBAN</label>
|
|
<input type="text" name="Kto_Nummer"/>
|
|
<br/>
|
|
<label>BIC</label>
|
|
<input type="text" name="BLZ"/>
|
|
<br/>
|
|
<label>Bank</label>
|
|
<input type="text" name="Bank"/>
|
|
<br/>
|
|
<label>Datenschutzerklärung</label>
|
|
<input type="checkbox" name="DSchutz" value="1"/>
|
|
<br/>
|
|
</fieldset>
|
|
<fieldset>
|
|
<legend>Kunde speichern</legend>
|
|
<input type="submit" class="button_save" name="formaction" value="save" title="Kunde speichern"/>
|
|
<br/>
|
|
</fieldset>
|
|
</form> |