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@joeydsmith

joeydsmith/gist:f99a6381c67fac65071f

Created March 8, 2016 20:48
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  1. Joey D. Smith created this gist Mar 8, 2016.
    349 changes: 349 additions & 0 deletions gistfile1.txt
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    <div class="loanApplication">

    <!-- Nav tabs -->
    <ul class="nav nav-tabs" role="tablist">
    <li role="presentation" class="active"><a href="#personalInfo" aria-controls="home" role="tab" data-toggle="tab">Personal Info</a></li>
    <li role="presentation"><a href="#propertyInfo" aria-controls="profile" role="tab" data-toggle="tab">Property Info</a></li>
    </ul>

    <!-- Tab panes -->
    <div class="tab-content">
    <div role="tabpanel" class="tab-pane active" id="personalInfo">
    <ul class="list-group">
    <li class="list-group-item focus">
    <div class="loanApplication__label">
    <label>Full Name</label>
    </div>
    <div class="loanApplication__input">
    <input name="fullName" type="text" class="form-control" />
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Date of Birth</label>
    </div>
    <div class="loanApplication__input">
    <input name="dateOfBith" class="form-control inputDate" type="text"></input>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Education</label>
    </div>
    <div class="loanApplication__input">
    <select name="education" class="form-control">
    <option value="" selected disabled>Please select</option>
    <option>Some high school, no diploma</option>
    <option>High school graduate, diploma or the equivalent </option>
    <option>Some college credit, no degree</option>
    <option>Trade/technical/vocational training</option>
    <option>Associate degree</option>
    <option>Bachelor’s degree</option>
    <option>Master’s degree</option>
    <option>Professional degree</option>
    <option>Doctorate degree</option>
    </select>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Current Address</label>
    </div>
    <div class="loanApplication__input">
    <input name="currentAddress" type="text" class="form-control" />
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Years at above address</label>
    </div>
    <div class="loanApplication__input">
    <input name="yearsAtAddress" type="text" class="form-control" />
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Mailing Address (if different from above)</label>
    </div>
    <div class="loanApplication__input">
    <div class="loanApplication__input">
    <input name="mailingAddress" type="text" class="form-control" />
    </div>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Marital Status</label>
    </div>
    <div class="loanApplication__input">
    <select name="MaritalStatus" class="form-control">
    <option value="" selected disabled>Please select</option>
    <option>Single, never married</option>
    <option>Married or domestic partnership</option>
    <option>Widowed</option>
    <option>Divorced</option>
    <option>Separated</option>
    </select>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Number of Dependents</label>
    </div>
    <div class="loanApplication__input">
    <input name="numOfDependents" type="text" class="form-control" />
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Employment Status</label>
    </div>
    <div class="loanApplication__input">
    <select name="employmentStatus" class="form-control">
    <option value="" selected disabled>Please select</option>
    <option>Employed for wages</option>
    <option>Self-employed</option>
    <option>Out of work and looking for work</option>
    <option>Out of work but not currently looking for work</option>
    <option>A homemaker</option>
    <option>A student</option>
    <option>Military</option>
    <option>Retired</option>
    <option>Unable to work</option>
    </select>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Years at Current Employer</label>
    </div>
    <div class="loanApplication__input">
    <input name="yearsAtEmployer" type="text" class="form-control" />
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Monthly employment income</label>
    </div>
    <div class="loanApplication__input">
    <div class="loanApplication__input">
    <form class="form-inline">
    <div class="form-group">
    <label class="sr-only" for="exampleInputAmount">Amount (in dollars)</label>
    <div class="input-group">
    <div class="input-group-addon">$</div>
    <input name="monthlyIncome" type="text" class="form-control" />
    </div>
    </div>
    </form>
    </div>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Annual self-employment income</label>
    </div>
    <div class="loanApplication__input">
    <form class="form-inline">
    <div class="form-group">
    <label class="sr-only" for="exampleInputAmount">Amount (in dollars)</label>
    <div class="input-group">
    <div class="input-group-addon">$</div>
    <input name="annualIncome" type="text" class="form-control" />
    </div>
    </div>
    </form>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Total value of asset</label>
    </div>
    <div class="loanApplication__input">
    <form class="form-inline">
    <div class="form-group">
    <label class="sr-only" for="exampleInputAmount">Amount (in dollars)</label>
    <div class="input-group">
    <div class="input-group-addon">$</div>
    <input name="valueOfAssets" type="text" class="form-control" />
    </div>
    </div>
    </form>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Total value of liabilites</label>
    </div>
    <div class="loanApplication__input">
    <form class="form-inline">
    <div class="form-group">
    <label class="sr-only" for="exampleInputAmount">Amount (in dollars)</label>
    <div class="input-group">
    <div class="input-group-addon">$</div>
    <input name="valueOfLiabilities" type="text" class="form-control" />
    </div>
    </div>
    </form>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Are you a U.S citizen?</label>
    </div>
    <div class="loanApplication__input">
    <select name="citizen" class="form-control">
    <option value="" selected disabled>Please select</option>
    <option>Yes</option>
    <option>No </option>
    </select>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Social Security Number</label>
    </div>
    <div class="loanApplication__input">
    <input name="socialSecurityNumber" class="form-control inputSSN" type="text"></input>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    </ul>
    </div>
    <div role="tabpanel" class="tab-pane" id="propertyInfo">
    <ul class="list-group">
    <li class="list-group-item focus">
    <div class="loanApplication__label">
    <label>Property Address</label>
    </div>
    <div class="loanApplication__input">
    <input name="propertyAddress" type="text" class="form-control" />
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>How Much do you want to buy it for?</label>
    </div>
    <div class="loanApplication__input">
    <div class="loanApplication__input">
    <form class="form-inline">
    <div class="form-group">
    <label class="sr-only" for="exampleInputAmount">Amount (in dollars)</label>
    <div class="input-group">
    <div class="input-group-addon">$</div>
    <input name="buyingAmount"type="text" class="form-control" />
    </div>
    </div>
    </form>
    </div>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Down Payment Amount</label>
    </div>
    <div class="loanApplication__input">
    <div class="loanApplication__input">
    <form class="form-inline">
    <div class="form-group">
    <label class="sr-only" for="exampleInputAmount">Amount (in dollars)</label>
    <div class="input-group">
    <div class="input-group-addon">$</div>
    <input name="downPaymentAmount" type="text" class="form-control" />
    </div>
    </div>
    </form>
    </div>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Property Type</label>
    </div>
    <div class="loanApplication__input">
    <select name="propertyType" class="form-control">
    <option value="" selected disabled>Please select</option>
    <option>Single Family Home</option>
    <option>Property Type Here</option>
    <option>Property Type Here</option>
    </select>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    <li class="list-group-item">
    <div class="loanApplication__label">
    <label>Purpose of Loan</label>
    </div>
    <div class="loanApplication__input">
    <select name="purposeOfLoan" class="form-control">
    <option value="" selected disabled>Please select</option>
    <option>Purchase</option>
    <option>Purpose of loan here</option>
    <option>Purpose of loan here</option>
    </select>
    </div>
    <div class="loanApplication__info">
    <i class="fa fa-info-circle"></i>
    </div>
    </li>
    </ul>
    </div>
    </div>
    </div>