@extends('themes.one.master')

@section('title', __('Online Admission'))

@section('content')
    <section class="space-ptb">
        <div class="container">
            <div class="row">
                <div class="col-lg-12">
                    <h4 class="mb-4">{{ __('Online Admission') . " " . __('Form') }} </h4>

                    @if ($errors->any())
                        <div class="alert alert-danger"><ul>@foreach($errors->all() as $e)<li>{{ $e }}</li>@endforeach</ul></div>
                    @endif
                    @if(session('success'))<div class="alert alert-success">{{ session('success') }}</div>@endif
                    @error('submission')<div class="alert alert-danger">{{ $message }}</div>@enderror

                    <form method="POST" action="{{ url('/online-admission') }}" enctype="multipart/form-data" class="shadow-sm p-4 bg-white border-radius">
                        @csrf

                        {{-- === Student Information === --}}
                        <h5 class="mb-3 text-primary fw-semibold">{{ __("Student Information") }}</h5>
                        <div class="form-row">
                            <div class="form-group col-md-4">
                                <label>{{ __('First Name') }} <span class="text-danger">*</span></label>
                                <input type="text" name="first_name" value="{{ old('first_name') }}" class="form-control bg-white border" required>
                                @error('first_name')<div class="invalid-feedback">{{ $message }}</div>@enderror
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __('Middle Name') }}</label>
                                <input type="text" name="middle_name" value="{{ old('middle_name') }}" class="form-control bg-white border">
                                @error('middle_name')<div class="invalid-feedback">{{ $message }}</div>@enderror
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __('Last Name') }} <span class="text-danger">*</span></label>
                                <input type="text" name="last_name" value="{{ old('last_name') }}" class="form-control bg-white border" required>
                                @error('last_name')<div class="invalid-feedback">{{ $message }}</div>@enderror
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __('Date of Birth') }} <span class="text-danger">*</span></label>
                                <input type="date" name="dob" value="{{ old('dob') }}" class="form-control bg-white border" required>
                                @error('dob')<div class="invalid-feedback">{{ $message }}</div>@enderror
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __('Gender') }} <span class="text-danger">*</span></label>
                                <select name="gender" class="form-control bg-white border" required>
                                    <option value="">-- {{ __('Select') . " " . __('Gender') }} --</option>
                                    <option value="Male" @selected(old('gender')==='Male')>{{ __('Male') }}</option>
                                    <option value="Female" @selected(old('gender')==='Female')>{{ __('Female') }}</option>
                                </select>
                                @error('gender')<div class="invalid-feedback">{{ $message }}</div>@enderror
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __('Class') }} <span class="text-danger">*</span></label>
                                <input type="text" name="class" value="{{ old('class') }}" class="form-control bg-white border" required placeholder="e.g. Nursery, Grade 1">
                                @error('class')<div class="invalid-feedback">{{ $message }}</div>@enderror
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __('Student') . " " . __('Email') }}</label>
                                <input type="email" name="email" value="{{ old('email') }}" class="form-control bg-white border" placeholder="{{ __('Enter email') . ' ' . '(' . __('optional') . ')'  }}">
                                @error('email')<div class="invalid-feedback">{{ $message }}</div>@enderror
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __('Contact Number') }} <span class="text-danger">*</span></label>
                                <input type="text" name="contact_no" value="{{ old('contact_no') }}" class="form-control bg-white border" required placeholder="{{ __('Enter contact number') }}">
                                @error('contact_no')<div class="invalid-feedback">{{ $message }}</div>@enderror
                            </div>

                            <div class="form-group col-md-8">
                                <label>{{ __('Address') }} <span class="text-danger">*</span></label>
                                <textarea name="address" rows="2" class="form-control bg-white border" required placeholder="{{ __('Enter full address') }}">{{ old('address') }}</textarea>
                                @error('address')<div class="invalid-feedback">{{ $message }}</div>@enderror
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __('Upload Photo') }}</label>
                                <input type="file" name="image" class="form-control bg-white border" accept="image/*">
                                @error('image')<div class="invalid-feedback">{{ $message }}</div>@enderror
                            </div>
                        </div>

                        <hr>

                        {{-- === Parent / Guardian Information === --}}
                        <h5 class="mb-3 text-primary fw-semibold">{{ __('Parents') }} / {{ __('Guardian') }}</h5>
                        <div class="form-row">
                            <div class="form-group col-md-4">
                                <label>{{ __("Father's") . " " . __('Name') }}</label>
                                <input type="text" name="father_name" value="{{ old('father_name') }}" class="form-control bg-white border">
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __("Father's") . " " . __('Phone')}} </label>
                                <input type="text" name="father_phone" value="{{ old('father_phone') }}" class="form-control bg-white border">
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __("Mother's") . " " . __('Name') }} </label>
                                <input type="text" name="mother_name" value="{{ old('mother_name') }}" class="form-control bg-white border">
                            </div>

                            <div class="form-group col-md-4">
                                <label>{{ __("Mother's") . " " . __('Phone') }} </label>
                                <input type="text" name="mother_phone" value="{{ old('mother_phone') }}" class="form-control bg-white border">
                            </div>
                        </div>

                        <div class="text-end mt-3">
                            <button type="reset" class="btn btn-outline-secondary">{{ __('Clear') }}</button>
                            <button type="submit" class="btn btn-primary">{{ __('Submit Admission') }}</button>
                        </div>
                    </form>

                    <p class="text-muted mt-3 mb-0" style="font-size:.9rem">
                        {{ __('Fields marked with') }} <span class="text-danger">*</span> {{ __('are required') }}
                    </p>
                </div>
            </div>
        </div>
    </section>
@endsection