198 lines
6.4 KiB
HTML
198 lines
6.4 KiB
HTML
{{ define "content" }}
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<div class="flex-1 flex flex-col overflow-hidden">
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<!-- Top Navigation -->
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<div class="bg-white border-b border-gray-200 px-6 py-3">
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<div class="flex items-center justify-between">
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<div class="flex items-center gap-4">
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<div class="flex items-center gap-2">
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<i
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class="{{if .PageIcon}}{{.PageIcon}}{{else}}fas fa-poll{{end}} text-green-600"
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></i>
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<span class="text-sm font-medium">Poll Questions</span>
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</div>
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</div>
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<div class="flex items-center gap-2">
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<a
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href="/appointments"
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class="px-3 py-1 bg-gray-500 text-white text-sm hover:bg-gray-600 rounded"
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>
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Back to Appointments
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</a>
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</div>
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</div>
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</div>
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<!-- Form Content -->
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<div class="flex-1 overflow-y-auto bg-gray-50 p-6">
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<div class="max-w-2xl mx-auto">
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<div class="bg-white rounded-lg shadow-sm border border-gray-200 p-6">
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<div class="mb-6">
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<h2 class="text-lg font-semibold text-gray-900">
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Campaign Poll Questions
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</h2>
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<p class="text-sm text-gray-600 mt-1">Address: {{ .Address }}</p>
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</div>
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<form method="POST" class="space-y-6">
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<input type="hidden" name="poll_id" value="{{ .PollID }}" />
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<!-- Postal Code -->
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<div>
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<label class="block text-sm font-medium text-gray-700 mb-2">
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Respondent's Postal Code
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</label>
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<input
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type="text"
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name="postal_code"
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placeholder="Enter postal code (e.g., T2P 1J9)"
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class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-blue-500"
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required
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/>
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</div>
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<!-- Question 1 -->
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<div>
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<label class="block text-sm font-medium text-gray-700 mb-3">
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1. Have you voted before?
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</label>
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<div class="space-y-2">
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<label class="flex items-center">
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<input
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type="radio"
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name="question1_voted_before"
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value="true"
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class="mr-2"
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/>
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<span class="text-sm">Yes</span>
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</label>
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<label class="flex items-center">
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<input
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type="radio"
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name="question1_voted_before"
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value="false"
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class="mr-2"
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/>
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<span class="text-sm">No</span>
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</label>
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</div>
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</div>
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<!-- Question 2 -->
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<div>
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<label class="block text-sm font-medium text-gray-700 mb-3">
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2. Will you vote again for this candidate?
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</label>
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<div class="space-y-2">
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<label class="flex items-center">
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<input
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type="radio"
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name="question2_vote_again"
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value="true"
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class="mr-2"
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/>
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<span class="text-sm">Yes</span>
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</label>
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<label class="flex items-center">
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<input
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type="radio"
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name="question2_vote_again"
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value="false"
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class="mr-2"
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/>
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<span class="text-sm">No</span>
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</label>
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</div>
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</div>
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<!-- Question 3 -->
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<div>
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<label class="block text-sm font-medium text-gray-700 mb-2">
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3. How many lawn signs do you need?
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</label>
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<input
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type="number"
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name="question3_lawn_signs"
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min="0"
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max="10"
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value="0"
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class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-blue-500"
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/>
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</div>
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<!-- Question 4 -->
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<div>
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<label class="block text-sm font-medium text-gray-700 mb-2">
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4. How many banner signs do you need?
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</label>
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<input
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type="number"
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name="question4_banner_signs"
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min="0"
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max="5"
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value="0"
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class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-blue-500"
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/>
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</div>
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<!-- Question 5 -->
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<div>
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<label class="block text-sm font-medium text-gray-700 mb-2">
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5. Write your thoughts (optional)
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</label>
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<textarea
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name="question5_thoughts"
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rows="4"
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placeholder="Any additional comments or feedback..."
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class="w-full px-3 py-2 border border-gray-300 rounded-md focus:outline-none focus:ring-2 focus:ring-blue-500"
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></textarea>
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</div>
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<!-- Submit Button -->
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<div class="flex justify-end gap-3 pt-6">
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<a
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href="/appointments"
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class="px-4 py-2 border border-gray-300 rounded-md text-sm font-medium text-gray-700 hover:bg-gray-50"
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>
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Cancel
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</a>
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<button
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type="submit"
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class="px-4 py-2 bg-blue-600 text-white text-sm font-medium rounded-md hover:bg-blue-700"
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>
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Submit Poll Response
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</button>
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</div>
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</form>
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</div>
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</div>
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</div>
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</div>
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<script>
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// Show delivery address section if user needs signs
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document.addEventListener("DOMContentLoaded", function () {
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const lawnSignsInput = document.querySelector(
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'input[name="question3_lawn_signs"]'
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);
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const bannerSignsInput = document.querySelector(
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'input[name="question4_banner_signs"]'
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);
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const deliverySection = document.getElementById("delivery-section");
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function toggleDeliverySection() {
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const lawnSigns = parseInt(lawnSignsInput.value) || 0;
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const bannerSigns = parseInt(bannerSignsInput.value) || 0;
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if (lawnSigns > 0 || bannerSigns > 0) {
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deliverySection.style.display = "block";
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} else {
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deliverySection.style.display = "none";
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}
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}
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lawnSignsInput.addEventListener("input", toggleDeliverySection);
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bannerSignsInput.addEventListener("input", toggleDeliverySection);
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});
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</script>
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{{ end }}
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