<%= label_tag :card_type, "Card Type", :class => "control-label" %>

<%= text_field_tag :card_type, @card_type, :class => 'input-small' %>

<%= label_tag :card_holder_name, "Name of card holder", :class => "control-label" %>

<%= text_field_tag :card_holder_name, @card_holder_name, :class => "input-xlarge" %>

Expiration date

<%= text_field_tag :expiration_year, @expiration_year, :class => "input-small", :placeholder => "Year" %> <%= text_field_tag :expiration_month, @expiration_month, :class => "input-small", :placeholder => "Month" %>

<%= label_tag :credit_card_number, "Credit card number", :class => "control-label" %>

<%= text_field_tag :credit_card_number, @credit_card_number, :class => "input-xlarge" %>

<%= label_tag :address1, "Adress 1", :class => "control-label" %>

<%= text_field_tag :address1, @address1, :class => "input-xlarge" %>

<%= label_tag :address2, "Adress 2", :class => "control-label" %>

<%= text_field_tag :address2, @address2, :class => "input-xlarge" %>

<%= label_tag :city, "City", :class => "control-label" %>

<%= text_field_tag :city, @city, :class => "input-xlarge" %>

<%= label_tag :postal_code, "ZIP code", :class => "control-label" %>

<%= text_field_tag :postal_code, @postal_code, :class => "input-xlarge" %>

<%= label_tag :state, "State", :class => "control-label" %>

<%= text_field_tag :state, @state, :class => "input-xlarge" %>

<%= label_tag :country, "Country", :class => "control-label" %>

<%= text_field_tag :country, @country, :class => "input-xlarge" %>