<!DOCTYPE html>
<html lang="zh-CN">
<head>
	<meta name="viewport" content="width=device-width, initial-scale=1">
	<title>获奖用户资料</title>
	<link rel="stylesheet" type="text/css" href="<?php echo __PUBLIC__;?>/bootstrap/css/bootstrap.min.css" />
	<script src="<?php echo __PUBLIC__;?>/js/jquery.min.js"></script>
	<script src="<?php echo __PUBLIC__;?>/bootstrap/js/bootstrap.min.js"></script>
	<script src="<?php echo __PUBLIC__;?>/js/validform.js"></script>
</head>
<body>
<div class="container-fluid">
	<div class="row">
	<div class="col-sm-12 col-md-12">
		<div class="panel panel-default">
			<div class="panel-heading">获奖用户资料填写</div>
			<div class="panel-body">
			<form action="<?php echo url('wechat/plugin_action', array('name'=>$this->plugin_name));?>" method="post" class="form-horizontal validforms" role="form">
				<div class="form-group">
				    <label class="col-sm-2 control-label">姓名</label>
				    <div class="col-sm-10">
				      <input type="text" class="form-control" placeholder="姓名" name="data[name]" datatype="*" />
				    </div>
			  	</div>
			  	<div class="form-group">
				    <label class="col-sm-2 control-label">手机号</label>
				    <div class="col-sm-10">
				      <input type="text" class="form-control" placeholder="手机号" name="data[phone]" datatype="m" />
				    </div>
			  	</div>
			  	<div class="form-group">
				    <label class="col-sm-2 control-label">收货地址</label>
				    <div class="col-sm-10">
				      <input type="text" class="form-control" placeholder="详细收货地址" name="data[address]" datatype="*" />
				    </div>
			  	</div>
			  	<div class="form-group">
				    <div class="col-sm-offset-2 col-sm-10">
				    	<input type="hidden" name="id" value="<?php echo $id;?>" />
						<input type="submit" class="btn btn-primary" value="确认" />
						<input type="reset" class="btn btn-default" value="重置" />
				    </div>
				 </div>
			</form>
			</div>
		</div>
	</div>
	</div>
</div>
</body>
</html>