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pinkie.html
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<!DOCTYPE html>
<html lang="en-US">
<head>
<meta charset="UTF-8">
<link rel="stylesheet" href="styles.css">
<title>Electical and Computer Engineering Purchase Requisition Form</title>
</head>
<body>
<div class = "heading">
<p>Electrical and Computer Engineering</p>
<p>Purchase Requisition Request</p>
<p id = "date">DATE:</p>
</div>
<form id="pinkieForm" method="post" action="http://107.170.228.14/pinkies/cgi-bin/formHandler.py" target="_blank">
<div class='prelim'>
<span>
Requestor:
<select name = "requestor">
<option value="test1">Test1</option>
<option value="test2">Test2</option>
<option value="test3">Test3</option>
</select>
Extension:
<input type="text" name="extension">
</span>
<span class = "radials">
Action:
<input type="radio" name="action" value="purchase" checked>Purchase
<input type="radio" name="action" value="payment_request">Payment Request
<input type="radio" name="action" value="quote">Quote
<input type="radio" name="action" value="reimbursement">Reimbursement
</span>
</div>
<div class = "objects" id= 'objects_'>
<table>
<tr>
<td>QTY</td><td>STOCK No.</td><td>DESCRIPTION</td><td>PRICE EACH</td><td>TOTAL COST</td>
</tr>
</table>
<span><input type="text" name="qty"><input type="text" name="stock"><input type="text" name="desc"><input type="text" name="price"><input type="text" name="total" disabled="true"><br></span>
<span><input type="text" name="qty"><input type="text" name="stock"><input type="text" name="desc"><input type="text" name="price"><input type="text" name="total" disabled="true"><br></span>
<span><input type="text" name="qty"><input type="text" name="stock"><input type="text" name="desc"><input type="text" name="price"><input type="text" name="total" disabled="true"><br></span>
<span><input type="text" name="qty"><input type="text" name="stock"><input type="text" name="desc"><input type="text" name="price"><input type="text" name="total" disabled="true"><br></span>
<span><input type="text" name="qty"><input type="text" name="stock"><input type="text" name="desc"><input type="text" name="price"><input type="text" name="total" disabled="true"><br></span>
</div>
<input type="button" id="add_line_" value="Add Item" onclick="add_line(this)">
<div class = "totals">
<table>
<tr>
<td>Sub-total:</td><td><input type="text" name ="sub-total" disabled></td><td></td><td></td>
</tr>
<tr>
<td><input type="checkbox" name="tax" value="tax" checked>Tax:</td><td><input type="text" name ="tax" disabled></td><td>Delivery Location:</td><td><input type="text" name ="location"></td>
</tr>
<tr>
<td>Shipping Freight:</td><td><input type="text" name ="shipping"></td><td>Date Required:</td><td><input type="text" name ="date-required"></td>
</tr>
<tr>
<td>Total:</td><td><input type="text" name ="total-price" disabled></td><td></td><td></td>
</tr>
</table>
</div>
<div class = "vendors">
<table>
<tr>
<td>Vendor:</td><td colspan="5"><select name = "vendor"><option value="test1">Test1</option></select><a href=''>Edit Vendors</a></td>
</tr>
<tr>
<td>Name:</td><td colspan="5"><input type="text" name ="name">
</tr>
<tr>
<td>Address:</td><td colspan="5"><textarea name ="address"></textarea></td>
</tr>
<tr>
<td>City:</td><td><input type="text" name ="city"></td><td>State:</td><td><input type="text" name ="state"></td><td>Postal Code:</td><td><input type="text" name ="zip"></td>
</tr>
<tr>
<td>POC:</td><td><input type="text" name ="POC"></td><td>Phone No.:</td><td><input type="text" name ="phone"></td><td>Country:</td><td><input type="text" name ="country"></td>
</tr>
<tr>
<td>Internet:</td><td><input type="text" name ="internet"></td><td>Fax No.:</td><td><input type="text" name ="fax"></td><td>UCR Account:</td><td><input type="text" name ="account"></td>
</tr>
</table>
</div>
<div class = "questions">
<span>Justification for Purchase:
<input type="radio" name="justification" value="instruction" checked>Instruction
<input type="radio" name="justification" value="research">Research
<input type="radio" name="justification" value="fabrication">Fabrication
<input type="radio" name="justification" value="other">Other:
</span>
<span><textarea name = "jop-text"></textarea></span>
<span>Equiptment Location:</span>
<span><textarea name = "equip-loc"></textarea></span>
<span>UCR Property Number:</span>
<span><textarea name = "ucr-prop-num"></textarea></span>
<span>Class Instructed:
<input type='text' name="class">
Quote:
<input type='text' name='quote'>
</span>
<span>Is this computer software/hardware?
<input type="radio" name="computer" value="yes">Yes,
<input type="radio" name="computer" value="no" checked>No
</span>
<span>Is this Instructional Lab equipment?
<input type="radio" name="lab" value="yes">Yes,
<input type="radio" name="lab" value="no" checked>No
</span>
<span>Is this a chemical?
<input type="radio" name="chemical" value="yes">Yes,
<input type="radio" name="chemical" value="no" checked>No
</span>
</div>
<div class='funds'>
<span>Split cost in different funds?
<input type="radio" name="funds" value="yes">Yes,
<input type="radio" name="funds" value="no" checked>No
</span>
<div id="dynamic_funds">
<table id="funds_tbl">
<tr>
<td>Fund Name </td><td>Balance</td><td>Percentage</td><td>Amount</td><td></td>
</tr>
<tr>
<td>
<select name = "fname">
<option value="Test1">Test1</option>
</select>
</td>
<td><input type="text" name="balance" disabled></td><td><input type="text" name="percentage"></td><td><input type="text" name="amount[]"></td><td></td>
</tr>
</table>
<input type="button" id="add_fund_" value="Add Fund" onclick="add_fund(this)">
</div>
</div>
<div class="final_business">
<span>
Priority:
<select name = "priority">
<option value="Expedite">Expedite</option>
<option value="Urgent">Urgent</option>
<option value="Routine" selected>Routine</option>
<option value="Cancel">Cancel</option>
<option value="Hold">Hold</option>
</select>
</span>
<span>
Upload:
<input type="button" value="Choose File" id="upload">
</span>
<span>
<input type="submit" value="Submit" id="submitButton">
<input type="button" value="Reset" id="reset">
</span>
</div>
</form>
<script src="https://ajax.googleapis.com/ajax/libs/jquery/2.1.4/jquery.min.js"></script>
<script src="scripts.js"></script>
</body>
</html>