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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<title>付款資訊</title>
<link rel="stylesheet" href="./css/input4.css">
<link rel="stylesheet" href="./css/input-pay-form.css">
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.5.1/css/all.min.css" integrity="sha512-DTOQO9RWCH3ppGqcWaEA1BIZOC6xxalwEsw9c2QQeAIftl+Vegovlnee1c9QX4TctnWMn13TZye+giMm8e2LwA==" crossorigin="anonymous" referrerpolicy="no-referrer" />
</head>
<body>
<!-- header -->
<div class="banner">
<div class="header">
<div class="logo">
<img src="./sub-page-Img/contract/logo-small.svg" alt="">
</div>
</div>
</div>
<!-- 進度條 -->
<section class="loading">
<div class="un-compelet">
<div class="step-icon">
<p>1</p>
</div>
<div class="step-txt">
<p>預覽契約</p>
</div>
</div>
<!-- <div class="line"></div> -->
<div class="compelet">
<div class="step-icon">
<p>2</p>
</div>
<div class="step-txt">
<p>填寫付款資訊</p>
</div>
</div>
<!-- <div class="line"></div> -->
<div class="un-compelet">
<div class="step-icon">
<p>3</p>
</div>
<div class="step-txt">
<p>確認資訊</p>
</div>
</div>
<!-- <div class="line"></div> -->
<div class="un-compelet">
<div class="step-icon">
<p>4</p>
</div>
<div class="step-txt">
<p>下載文件</p>
</div>
</div>
</section>
<!-- 介面 -->
<section class="contain-main">
<h2>選取購買方案</h2>
<div class="buy-sel-cardlist">
<label class="buy-sel-card">
<input type="radio" name="plan" value="basic" required>
<p>方案：基本版</p>
<p>金額NT$699~1299</p>
</label>
<label class="buy-sel-card">
<input type="radio" name="plan" value="basic" required>
<p>方案：專業版</p>
<p>金額NT$2000</p>
</label>
</div>
<br><hr><br>
<h2>購買資訊</h2>
<form class="payment-form">
<div class="buy-name1">
<label for="firstName">First name</label>
<label for="lastName">Last name</label>
</div>
<div class="buy-name2">
<input type="text" id="firstName" name="firstName" required>
<input type="text" id="lastName" name="lastName" required>
</div>
<br>
<div class="buy-email1">
<label for="email">Email</label>
</div>
<div class="buy-email2">
<input type="email" id="email" name="email" required>
</div>
<br>
<div class="buy-tel1">
<label for="contactPhone">手機號碼(請依格式填入，如：0912345678 或 +886912345678)</label>
</div>
<div class="buy-tel2">
<input type="tel" id="contactPhone" name="contactPhone" required>
</div>
<br><hr><br>
<h2>信用卡付款資訊</h2>
<div class="cradicard" > <h3>本次消費金額：NT <span style="color: red;"> 1000 </span>元 </h3>
<div class="form-row">
<div class="form-col">
<label for="cardType">信用卡類型</label>
<div class="cc-card-icon">
<i class="fab fa-cc-visa"></i>
<i class="fab fa-cc-mastercard"></i>
<i class="fab fa-cc-jcb"></i>
</div>
<select id="cardType" name="cardType">
<option value="Visa">Visa</option>
<option value="Master">Master</option>
<option value="JCB">JCB</option>
</select>
</div>
<div class="form-col">
<label>信用卡有效期限</label>
<div class="expiry-group">
<select name="expMonth" required>
<option value="" disabled selected>月</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select>
<select name="expYear" required>
<option value="" disabled selected>年</option>
<option value="2025">25</option>
<option value="2026">26</option>
<option value="2027">27</option>
<option value="2028">28</option>
<option value="2029">29</option>
</select>
</div>
</div>
</div>
<div class="form-row">
<div class="form-col">
<label for="cardHolderName">持卡人姓名</label>
<input type="text" id="cardHolderName" name="cardHolderName" required>
</div>
<div class="form-col">
<label for="cvc">信用卡背後末三碼</label>
<input type="text" id="cvc" name="cvc" maxlength="3" required>
</div>
</div>
<div class="form-row">
<div class="form-col">
<label>信用卡卡號</label>
<div class="card-number-group">
<input type="text" name="cardNumber1" maxlength="4" required>
<input type="text" name="cardNumber2" maxlength="4" required>
<input type="text" name="cardNumber3" maxlength="4" required>
<input type="text" name="cardNumber4" maxlength="4" required>
</div>
</div>
<div class="form-col">
<label for="paymentPhone">手機號碼</label>
<input type="tel" id="paymentPhone" name="paymentPhone" required>
</div>
</div>
</div>
</section>
<!-- 按鍵處 -->
<section class="button-all">
<a href="./input3.html"><div class="goback">
<img src="./sub-page-Img/contract/backicon.svg" alt="">
<p>返回上一步</p>
</div></a>
<button type="submit" >
<div class="button">
<p>下一步</p>
</div>
</button>
</section>
</form>
</div>
<script src="./js/vendors/jquery/jquery-3.7.1.min.js"></script>
<script src="./js/input4-submit.js"></script>
</body>
</html>