<!-- edit categories brand -->
<div class="modal fade" id="editCategoriesModal" tabindex="-1" role="dialog">
  <div class="modal-dialog">
    <div class="modal-content">
    	
    	<form class="form-horizontal" id="editCategoriesForm" action="php_action/editClient.php" method="POST">
	      <div class="modal-header">
	        <button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
	        <h4 class="modal-title"><i class="fa fa-edit"></i> Edit Clients Details</h4>
	      </div>
	      <div class="modal-body">

	      	<div id="edit-categories-messages"></div>
			
			<div class="form-group">
			        	<label for="editProductName" class="col-sm-3 control-label">First Name: </label>
						    <div class="col-sm-9">
						      <input type="text" class="form-control" id="editFirstName" style="width:100%;margin-left:0%;" placeholder="First Name" name="editFirstName" autocomplete="off">
						    </div>
			        </div>
					
		    <div class="form-group">
			        	<label for="editProductName" class="col-sm-3 control-label">Middle Name: </label>
						    <div class="col-sm-9">
						      <input type="text" class="form-control" id="editMiddleName" style="width:100%;margin-left:0%;" placeholder="Middle Name" name="editMiddleName" autocomplete="off">
						    </div>
			        </div>
					
		 <div class="form-group">
			        	<label for="editProductName" class="col-sm-3 control-label">Last Name: </label>
						    <div class="col-sm-9">
						      <input type="text" class="form-control" id="editLastName" style="width:100%;margin-left:0%;" placeholder="Last Name" name="editLastName" autocomplete="off">
						    </div>
			        </div>
					
		 <div class="form-group">
			        	<label for="editProductName" class="col-sm-3 control-label">Email: </label>
						    <div class="col-sm-9">
						      <input type="text" class="form-control" id="editEmail" style="width:100%;margin-left:0%;" placeholder="Email" name="editEmail" autocomplete="off">
						    </div>
			        </div>
					
		 <div class="form-group">
			        	<label for="editProductName" class="col-sm-3 control-label">Phone Number: </label>
						    <div class="col-sm-9">
						      <input type="text" class="form-control" id="editPhoneNumber" style="width:100%;margin-left:0%;" placeholder="Phone Number" name="editPhoneNumber" autocomplete="off">
						    </div>
			        </div>
					
		<div class="form-group">
			        	<label for="editProductName" class="col-sm-3 control-label">TIN: </label>
						    <div class="col-sm-9">
						      <input type="text" class="form-control" id="editTIN" style="width:100%;margin-left:0%;" placeholder="TIN" name="editTIN" autocomplete="off">
						    </div>
			        </div>
					
					
		<div class="form-group">
			        	<label for="editProductName" class="col-sm-3 control-label"> Client Address: </label>
						    <div class="col-sm-9">
							  <textarea id="editAddress" rows="3" cols="50" name="editAddress" class="form-control" style="margin-left:0%;" autocomplete="off"></textarea>
						    </div>
			        </div>
					
					
		<div class="form-group">
	        	<label for="brandName" class="col-sm-3 control-label">Client Type: </label>
				    <div class="col-sm-9">
					
				       <select class="form-control" name="editclient_type" id="editclient_type" autocomplete="off">
			  						<option value="">~~SELECT~~</option>
			  						<option>Individual</option>
									<option>Company</option>
		  						</select>
					  
					  
				    </div>
	        </div> <!-- /form-group-->	
					
					
		<div class="form-group">
	        	<label for="brandName" class="col-sm-3 control-label">Client Source: </label>
				    <div class="col-sm-9">
				      
					 <select class="form-control" name="editclient_source" id="editclient_source" autocomplete="off">
			  						<option value="">~~SELECT~~</option>
									<option>Local</option>
									<option>International</option>
		  						</select>  
					  
					  
				    </div>
	        </div> <!-- /form-group-->
			
			
			
			
	      </div> <!-- /modal-body -->
	      
	      <div class="modal-footer editCategoriesFooter">
	        <button type="button" class="btn btn-default" data-dismiss="modal"> <i class="glyphicon glyphicon-remove-sign"></i> Close</button>
	        
	        <button type="submit" class="btn btn-success" id="editCategoriesBtn" data-loading-text="Loading..." autocomplete="off"> <i class="glyphicon glyphicon-ok-sign"></i> Save Changes</button>
	      </div>
	      <!-- /modal-footer -->
     	</form>
	     <!-- /.form -->
    </div>
    <!-- /modal-content -->
  </div>
  <!-- /modal-dailog -->
</div>
<!-- /categories brand -->