openfoodnetwork/app/assets/javascripts/templates/admin/edit_address_dialog.html.haml

#edit-address-dialog
  %h2 Edit Shipping Address
  %form{ name: 'edit_address_form', novalidate: true, ng: { submit: 'editAddress()'}}
    .row
      Required fields are denoted with an asterisk (
      %span.required *
      )
    %table.no-borders
      %tr
        %td
          Address1
          %span.required *
        %td
          %input{ type: 'text', name: 'address1', required: true, ng: { model: 'address1'} }
      %tr
        %td
          Address2:
        %td
          %input{ type: 'text', name: 'address2', ng: { model: 'address2'} }
      %tr
        %td
          Phone:
        %td
          %input{ type: 'text', name: 'phone', required: true, ng: { model: 'phone'} }
      %tr
        %td
          City:
        %td
          %input{ type: 'text', name: 'city', required: true, ng: { model: 'city'} }
      %tr
        %td
          Zipcode:
        %td
          %input{ type: 'text', name: 'zipcode', required: true, ng: { model: 'zipcode'} }
      %tr
        %td
          Country:
        %td
          %select{name: 'country', required: true, ng: {model: 'country', options: 'country as country.name for country in availableCountries track by country.id'}}
            %option{value: ''} Select Country
      %tr
        %td
          State:
        %td
          %select{name: 'state', required: true, ng: {model: 'state', options: 'state as state.name for state in states track by state.id'}}
            %option{value: ''} Select State

    .text-center
      %input.button.red.icon-plus{ type: 'submit', value: 'Update Address'}