{{define "roModal"}}
<div class="modal fade" id="roModal" tabindex="-1" role="dialog" aria-labelledby="roModalLabel" aria-hidden="true">
    <div class="modal-dialog modal-lg" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <h5 class="modal-title" id="roModalLabel">Create Referral Credit</h5>
                <button type="button" class="close" data-dismiss="modal" aria-label="Close">
                <span aria-hidden="true">&times;</span>
                </button>
            </div>
            <div class="modal-body">
                <form>
                    <div class="form-row">
                        <div class="form-group col-md-4">
                            <label for="offer-name">Offer Name</label>
                            <input type="text" class="form-control" id="offer-name" placeholder="May Referral">
                        </div>
                        <div class="form-group col-md-4">
                            <label for="description">Description</label>
                            <input type="text" class="form-control" id="description" placeholder="Our test with $50 for May">
                        </div>
                        <div class="form-group col-md-4">
                            <label for="expiration">Credit Exp Date</label>
                            <input type="date" class="form-control" id="expiration" placeholder="06/01/19">
                        </div>
                    </div>
                    <div class="form-row">
                        <div class="form-group col-md-2">
                            <label for="give-credit">Give Credit</label>
                            <input type="number" class="form-control" id="give-credit" value="$50">                        </div>
                        <div class="form-group col-md-2">
                            <label for="give-credit-exp">Give Credit Exp.</label>
                            <input type="date" class="form-control" id="give-credit-exp">
                        </div>
                        <div class="form-group col-md-2">
                            <label for="get-credit">Get Credit</label>
                            <input type="number" class="form-control" id="get-credit" value="$50">                        </div>
                        <div class="form-group col-md-3">
                            <label for="get-credit-exp">Get Credit Exp.</label>
                            <input type="date" class="form-control" id="get-credit-exp">
                        </div>
                        <div class="form-group col-md-3">
                            <label for="redeemable-capacity">Redeemable Capacity</label>
                            <input type="text" class="form-control" id="redeemable-capacity">
                        </div>
                    </div>
                    <div class="m-1 text-left">
                        <button type="submit" class="btn btn-secondary">Create Offer</button>
                        <a class="ml-3" href="/">Cancel</a>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>
{{end}}