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@@ -1 +1,52 @@
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-<p>order-form works!</p>
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+<form
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+ fxLayout="column"
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+ fxLayoutAlign="start stretch"
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+ class="gap-20"
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+ (submit)="onSubmit()"
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+>
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+ <h1 class="bold">Create Order</h1>
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+ <div class="form-input" fxLayout="column" fxLayoutAlign="start stretch">
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+ <label for="country">
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+ <span>Request Title <span class="red">*</span></span>
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+ </label>
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+ <input type="text" placeholder="Request Title" id="request_title" />
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+ </div>
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+ <div class="gap-20" fxLayout="wrap row" fxLayoutAlign="start start">
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+ <div
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+ class="form-input"
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+ fxLayout="column"
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+ fxLayoutAlign="start stretch"
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+ fxFlex.lt-md="100"
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+ fxFlex.gt-sm="48"
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+ >
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+ <label for="country">
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+ <span>Request Start Date <span class="red">*</span></span>
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+ </label>
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+ <input
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+ type="date"
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+ placeholder="Request Start Date"
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+ id="request_start_date"
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+ />
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+ </div>
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+ <div
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+ class="form-input"
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+ fxLayout="column"
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+ fxLayoutAlign="start stretch"
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+ fxFlex.lt-md="100"
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+ fxFlex.gt-sm="48"
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+ >
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+ <label for="country">
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+ <span>Request End Date <span class="red">*</span></span>
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+ </label>
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+ <input type="date" placeholder="Request End Date" id="request_end_date" />
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+ </div>
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+ </div>
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+ <div class="form-input" fxLayout="column" fxLayoutAlign="start stretch">
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+ <label for="country">
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+ <span>Request Description</span>
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+ </label>
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+ <!-- <input type="text" placeholder="Request Title" id="last_name" /> -->
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+ <textarea rows="8" cols="5"></textarea>
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+ </div>
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+ <button type="submit">Create</button>
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+</form>
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