_date_coverage.html.erb

<% @wmon = (1..12).to_a.unshift('--') %>
<% @wday = (1..31).to_a.unshift('--') %>

<div class="form-group <% if f.object.class.multiple? key %>multi_value<% end %>">

  <p class="text-bold">Date Coverage</p>
  <p class="help-block">The date range the work's data was created, as determined by the creator.</p>

  <% if f.object.class.multiple? key %>
  <ul class="listing">
    <li class="field-wrapper">
  <% end %> 

      <div class="row">
        <div class="col-md-6">
          <div class="row">

            <fieldset>
              <div class="col-md-12">
                <legend class="legend-label">Start Date</legend>
              </div>

              <div class="col-md-4">
                <label for="date_coverage_1_year" data-label="Date">Year</label>
                <input type="text" id="date_coverage_1_year" name="date_coverage_1_year[]" class="form-control"></input>
              </div>

              <div class="col-md-3">
                <label for="date_coverage_1_month">Month</label>
                <%= select_tag :date_coverage_1_month, options_for_select(@wmon), { class: 'form-control'} %>
              </div>

              <div class="col-md-3">
                <label for="date_coverage_1_day">Day</label>
                <%= select_tag :date_coverage_1_day, options_for_select(@wday), { class: 'form-control'} %>
              </div>
            </fieldset>

          </div>
        </div>

        <div class="col-md-6">
          <div class="row">

            <fieldset>
              <div class="col-md-12">
                <legend class="legend-label">End Date</legend>
              </div>

              <div class="col-md-4">
                <label for="date_coverage_2_year" data-label="Date">Year</label>
                <input type="text" id="date_coverage_2_year" name="date_coverage_2_year[]" class="form-control"></input>
              </div>

              <div class="col-md-3">
                <label for="date_coverage_2_month">Month</label>
                <%= select_tag :date_coverage_2_month, options_for_select(@wmon), { class: 'form-control'} %>
              </div>

              <div class="col-md-3">
                <label for="date_coverage_2_day">Day</label>
                <%= select_tag :date_coverage_2_day, options_for_select(@wday), { class: 'form-control'} %>
              </div>
            </fieldset>

          </div>
        </div>

      </div>

  <% if f.object.class.multiple? key %>
    </li>
  </ul>
  <% end %> 

</div>