<?php
$page_title = "請款申請";
include_once('template/base_head.php');
?>
			<!-- サイドバー -->
			<aside id="colLeft">
				<h1><a href="/tc/menu"><img src="../img/logo.png" alt="iWallet"></a></h1>
<?php include_once('template/base_sidebar.php'); ?>
			</aside>
			<!-- /サイドバー -->
			<!-- メインカラム -->
			<div id="colMain">
				<div class="mainIn">
<?php include_once('template/base_nav.php'); ?>
					<article>
						<div class="article-heading">
							<h2><?php echo $page_title; ?></h2>
						</div>
						<form id="acForm" action="" method="post">
							<?php $this -> echoMessage(); ?>
							<p class="pleft40 mb30 respM">請填寫對方的iWallet帳號或者電子信箱。<br>
							對方同意您的請款後，請款金額會即時從對方的帳戶內轉帳到您的帳戶內。</p>
							<div class="pleft40">
								<div class="respM pt10 transferTo"><span class="va9">對方帳號&nbsp：</span>
								<input type="text" id="account" name="account" value="" class="px240 ma100p"></div>
								<div class="respM pt10 transferTo"><span class="va9">或者&nbsp;</span>
								<select id="history" name="history" class="ma100p">
									<option value="">從歷史記錄中選擇</option>
									<?php $this -> dispHistory(); ?>
								</select>&nbsp;</div>
								<div class="respM pb20 transferTo "><span class="va9">&nbsp;</span><input type="button" id="btnBackInput" value="下一步" class="btn bg-grad px80 mt10"></div>
							</div>

							<input type="hidden" value="" id="type" name="type" />
						</form>
					</article>
				</div>
			</div>
			<!-- /メインカラム -->
		</div>
<?php include_once('template/base_foot.php'); ?>
	</div>
	<script src="../js/request.js"></script>
</body>
</html>
