<%= form_with(model: @member_address, local: true) do |phc_members_pro_member_address| %>
<%= render 'phcnotifi/validations', :object => @member_address %>
<%= phc_members_pro_member_address.label :mcaddressl1, "Address Line1" %>
<%= phc_members_pro_member_address.text_field :mcaddressl1, class: "form-control", placeholder: "Address Line 1 - Street Address" %>
<%= phc_members_pro_member_address.label :mcaddressl2, "Address Line2" %>
<%= phc_members_pro_member_address.text_field :mcaddressl2, class: "form-control", placeholder: "Address Line 2 - Box - Suite - Floor" %>
<%= phc_members_pro_member_address.label :mccity, "City" %>
<%= phc_members_pro_member_address.text_field :mccity, class: "form-control", placeholder: "City" %>
<%= phc_members_pro_member_address.label :mcprovince, "Province/State" %>
<%= phc_members_pro_member_address.text_field :mcprovince, class: "form-control", placeholder: "Province/State" %>
<%= phc_members_pro_member_address.label :mccountry, "Country" %>
<%= country_select("member_address", "mccountry", { priority_countries: ["CA", "GB", "FR", "US"], selected: "CA" }, { class: 'form-control', data: { attribute: "value" } }) %>
<%= phc_members_pro_member_address.label :mcpostalcode, "PostalCode" %>
<%= phc_members_pro_member_address.text_field :mcpostalcode, class: "form-control", placeholder: "PostalCode" %>
<%= phc_members_pro_member_address.label :mctype, "Address Type" %>
<%= phc_members_pro_member_address.select :mctype, [['Billing Address','Billing'],['Street Address','Street'],['Mailing Address','Mailing'],['Home Address','Home'],['Business Address','Business']], {}, class: "form-control" %>
<%= phc_members_pro_member_address.submit class: "btn btn-primary btn-gradient waves-effect waves-light btn-md" %>
<% end %>