@extends('layouts.agent')
@section('content')

<div class="container-fluid">
    <div class="row justify-content-center">
        <div class="col-md-6">

            <div class="card mx-4">
                <div class="card-body p-4">

                    <form method="POST" action="{{ route('register') }}" enctype="multipart/form-data">
                        {{ csrf_field() }}

                        <h1>{{ trans('panel.site_title') }}</h1>
                        <p class="text-muted">{{ trans('global.register') }}</p>

                        <div class="input-group mb-3">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fa fa-user fa-fw"></i>
                                </span>
                            </div>
                            <input type="text" name="name" class="form-control{{ $errors->has('name') ? ' is-invalid' : '' }}" required autofocus placeholder="{{ trans('global.user_name') }}" value="{{ old('name', null) }}">
                            @if($errors->has('name'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('name') }}
                                </div>
                            @endif
                        </div>

                        <div class="input-group mb-3">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fas fa-id-card fa-fw"></i>
                                </span>
                            </div>
                            <input type="text" name="ic_number" class="form-control{{ $errors->has('ic_number') ? ' is-invalid' : '' }}" required autofocus placeholder="{{ trans('cruds.agent.fields.ic_number') }}" value="{{ old('ic_number', null) }}">
                            @if($errors->has('ic_number'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('ic_number') }}
                                </div>
                            @endif
                        </div>

                        <div class="input-group mb-3">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fa fa-address-book fa-fw"></i>
                                </span>
                            </div>
                            <input type="text" name="address" class="form-control{{ $errors->has('address') ? ' is-invalid' : '' }}" required autofocus placeholder="{{ trans('cruds.agent.fields.address') }}" value="{{ old('address', null) }}">
                            @if($errors->has('address'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('address') }}
                                </div>
                            @endif
                        </div>

                        <div class="input-group mb-3">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fas fa-mars-double fa-fw"></i>
                                </span>
                            </div>
                            <select class="form-control {{ $errors->has('gender') ? 'is-invalid' : '' }}" name="gender" id="gender" required>
                                <option value disabled {{ old('gender', null) === null ? 'selected' : '' }}>{{ trans('global.pleaseSelect') }}</option>
                                @foreach(App\Models\Agent::GENDER_SELECT as $key => $label)
                                    <option value="{{ $key }}" {{ old('gender', '0') === (string) $key ? 'selected' : '' }}>{{ $label }}</option>
                                @endforeach
                            </select>
                            @if($errors->has('gender'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('gender') }}
                                </div>
                            @endif
                        </div>

                        <div class="input-group mb-3">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fas fa-ring fa-fw"></i>
                                </span>
                            </div>
                            <select class="form-control {{ $errors->has('civil_status') ? 'is-invalid' : '' }}" name="civil_status" id="civil_status" required>
                                <option value disabled {{ old('civil_status', null) === null ? 'selected' : '' }}>{{ trans('global.pleaseSelect') }}</option>
                                @foreach(App\Models\Employee::CIVIL_STATUS_SELECT as $key => $label)
                                    <option value="{{ $key }}" {{ old('civil_status', '0') === (string) $key ? 'selected' : '' }}>{{ $label }}</option>
                                @endforeach
                            </select>
                            @if($errors->has('civil_status'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('civil_status') }}
                                </div>
                            @endif
                        </div>

                        <div class="input-group mb-3">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fa fa-phone fa-fw"></i>
                                </span>
                            </div>
                            <input type="text" name="contact_number" class="form-control{{ $errors->has('contact_number') ? ' is-invalid' : '' }}" required autofocus placeholder="{{ trans('cruds.agent.fields.contact_number') }}" value="{{ old('contact_number', null) }}">
                            @if($errors->has('contact_number'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('contact_number') }}
                                </div>
                            @endif
                        </div>

                        <div class="input-group mb-3">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fa fa-envelope fa-fw"></i>
                                </span>
                            </div>
                            <input type="email" name="email" class="form-control{{ $errors->has('email') ? ' is-invalid' : '' }}" required placeholder="{{ trans('global.login_email') }}" value="{{ old('email', null) }}">
                            @if($errors->has('email'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('email') }}
                                </div>
                            @endif
                        </div>

                        <div class="input-group mb-3">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fas fa-university fa-fw"></i>
                                </span>
                            </div>
                            <select class="form-control {{ $errors->has('education_level') ? 'is-invalid' : '' }}" name="education_level" id="education_level" required>
                                <option value disabled {{ old('education_level', null) === null ? 'selected' : '' }}>{{ trans('global.pleaseSelect') }}</option>
                                @foreach(App\Models\Employee::EDUCATION_LEVEL_SELECT as $key => $label)
                                    <option value="{{ $key }}" {{ old('education_level', '0') === (string) $key ? 'selected' : '' }}>{{ $label }}</option>
                                @endforeach
                            </select>
                            @if($errors->has('education_level'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('education_level') }}
                                </div>
                            @endif
                        </div>

                        {{-- <div class="input-group mb-3 education_level_answer">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fa fa-envelope fa-fw"></i>
                                </span>
                            </div>
                            <input type="text" name="education_level_answer" id="education_level_answer" class="form-control{{ $errors->has('education_level_answer') ? ' is-invalid' : '' }}" required placeholder="{{ trans('global.education_level_answer') }}" value="{{ old('education_level_answer', null) }}">
                            @if($errors->has('education_level_answer'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('education_level_answer') }}
                                </div>
                            @endif
                        </div> --}}

                        <div class="form-group">
                            <label for="AreaCitiesCover">Name the regional area / cities which you cover:</label>
                            <textarea class="form-control{{ $errors->has('area_cities_cover') ? ' is-invalid' : '' }}" id="AreaCitiesCover" rows="3" placeholder="{{ trans('cruds.agent.fields.area_cities_cover') }}" value="{{ old('area_cities_cover', null) }}"></textarea>
                             @if($errors->has('area_cities_cover'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('area_cities_cover') }}
                                </div>
                            @endif
                        </div>

                        <div class="form-group">
                            <label for="AnswerQuestion1">Do you have any relatives / family members connected with Happy Grains (whether as employees or sales agents?</label>
                            <textarea class="form-control{{ $errors->has('answer_question_1') ? ' is-invalid' : '' }}" id="AnswerQuestion1" rows="3" placeholder="{{ trans('cruds.agent.fields.answer_question_1') }}" value="{{ old('answer_question_1', null) }}"></textarea>
                             @if($errors->has('answer_question_1'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('answer_question_1') }}
                                </div>
                            @endif
                        </div>

                        <div class="form-group row">
                            <label for="UploadIC" class="col-sm-3 col-form-label col-form-label-sm">Upload IC</label>
                            <div class="col-sm-9">
                                <input type="file" class="form-control-file {{ $errors->has('upload_ic') ? ' is-invalid' : '' }}" name="upload_ic" id="UploadIC" required>
                            </div>
                            @if($errors->has('upload_ic'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('upload_ic') }}
                                </div>
                            @endif
                        </div>

                        <div class="input-group mb-3">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fa fa-lock fa-fw"></i>
                                </span>
                            </div>
                            <input type="password" name="password" class="form-control{{ $errors->has('password') ? ' is-invalid' : '' }}" required placeholder="{{ trans('global.login_password') }}">
                            @if($errors->has('password'))
                                <div class="invalid-feedback">
                                    {{ $errors->first('password') }}
                                </div>
                            @endif
                        </div>

                        <div class="input-group mb-4">
                            <div class="input-group-prepend">
                                <span class="input-group-text">
                                    <i class="fa fa-lock fa-fw"></i>
                                </span>
                            </div>
                            <input type="password" name="password_confirmation" class="form-control" required placeholder="{{ trans('global.login_password_confirmation') }}">
                        </div>

                        <div class="row">
                            <div class="col-6 text-center">
                                <button class="btn btn-block btn-primary text-white" type="submit">{{ trans('global.register') }}</button>
                            </div>
                            <div class="col-6 text-center">
                                <a href="{{ url()->previous() }}" class="btn btn-block btn-danger text-white">
                                    {{ trans('global.back') }}
                                </a>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
@endsection