modal

html nelsonsdrug.com collected 2026-10-02 16:03:03 UTC 2,019 bytes, 43 lines download raw bytes

1<!--=== Content Part ===-->   
2<div class="panel-body no-padding">
3    <div class="profile-event">
4    <div class="service-block service-block-default clearfix" style="margin-bottom:-10px;">
5        <div class="reg-block-header">
6            <button type="button" class="close" data-dismiss="modal" aria-hidden="true">&times;</button>
7            <h2>Sign In</h2>
8            <p>Don't Have an Account? <a class="color-green" href="/register">Click here to sign up!</a></p>            
9        </div>
10                        <form method="post" action="/login/auth/" autocomplete="off" class="sky-form" id="login-form">
11            <div class="input-group">
12                <span class="input-group-addon"><i class="fa fa-user"></i></span>
13                <input type="text" class="form-control" id="username" name="username" aria-label="Enter Username" placeholder="Username">
14            </div>
15            <div class="margin-bottom-20"></div>
16            <div class="input-group">
17                <span class="input-group-addon"><i class="fa fa-lock"></i></span>
18                <input type="password" class="form-control" id="password" name="password" name="password"  aria-label="Enter Password" placeholder="Password">
19            </div>
20            <div class="margin-bottom-20"></div>
21            <a class="color-green" href="/password" target="_self">Forgot username/password?</a>
22            <hr>                    
23            <div class="row">
24                <div class="col-xs-12">
25                    <button type="submit" class="btn-u btn-block">Login</button>
26                </div>
27            </div>
28        </form>
29    </div>
30    </div>
31</div>
32    <!--End Reg Block-->
33
34
35<!-- JS Implementing Plugins -->

36<script type="text/javascript" src="https://cdn.refillrxconnect.com/themes/1/assets/plugins/sky-forms-pro/skyforms/js/jquery.validate.min.js"></script>

36
37
38

39<script type="text/javascript">
40    jQuery(document).ready(function() {
41        Validation.initValidation();
42        });
43</script>

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