@extends('admin.layout')

@section('content')

<div class="content-wrapper"> 

  <!-- Content Header (Page header) -->

  <section class="content-header">

    <h1> {{ trans('labels.AddCustomer') }} <small>{{ trans('labels.AddCustomer') }}...</small> </h1>

    <ol class="breadcrumb">

      <li><a href="{{ URL::to('admin/dashboard/this_month')}}"><i class="fa fa-dashboard"></i> {{ trans('labels.breadcrumb_dashboard') }}</a></li>

      <li><a href="listingmembers"><i class="fa fa-users"></i>{{ trans('labels.ListingAllCustomers') }}</a></li>

      <li class="active">{{ trans('labels.AddCustomer') }}</li>

    </ol>

  </section>

  

  <!-- Main content -->

  <section class="content"> 

    <!-- Info boxes --> 

    

    <!-- /.row -->



    <div class="row">

      <div class="col-md-12">

        

        <div class="box">

          <div class="box-header">

            <h3 class="box-title">{{ trans('labels.AddCustomer') }}</h3>

          </div>

          

          <!-- /.box-header -->

          <div class="box-body">

            <div class="row">

              <div class="col-xs-12">

              	  <div class="box box-info"><br>

						

						

                        <!--<div class="box-header with-border">

                          <h3 class="box-title">Edit category</h3>

                        </div>-->

                        <!-- /.box-header -->

                        <!-- form start -->                        

                         <div class="box-body">

                         

                            {!! Form::open(array('url' =>'admin/addNewMembers', 'method'=>'post', 'class' => 'form-horizontal form-validate', 'enctype'=>'multipart/form-data')) !!}

                            

                            <div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">First Name

                                <span class="help-block" style="font-weight: normal;font-size: 11px;margin-bottom: 0;margin-top: 0;">Enter customer first name.</span>

                                </label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('customers_firstname',  '', array('class'=>'form-control field-validate', 'id'=>'customers_firstname'))!!}

                                    <span class="help-block hidden">{{ trans('labels.textRequiredFieldMessage') }}</span>

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Last Name

                                <span class="help-block" style="font-weight: normal;font-size: 11px;margin-bottom: 0;margin-top: 0;">Enter customer last name.</span>

                                </label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('customers_lastname',  '', array('class'=>'form-control field-validate', 'id'=>'customers_lastname'))!!}

                                    <span class="help-block hidden">{{ trans('labels.textRequiredFieldMessage') }}</span>

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Date of Birth

                                <span class="help-block" style="font-weight: normal;font-size: 11px;margin-bottom: 0;margin-top: 0;">Enter customer date of birth.</span>

                                </label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('customers_dob',  '', array('class'=>'form-control', 'id'=>'customers_dob', 'disabled'=>'disabled'))!!}

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Email</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('customers_email_address',  '', array('class'=>'form-control field-validate', 'id'=>'customers_email_address'))!!}

                                    <span class="help-block hidden">{{ trans('labels.textRequiredFieldMessage') }}</span>

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Password</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('customers_password',  '', array('class'=>'form-control field-validate', 'id'=>'customers_password'))!!}

                                    <span class="help-block hidden">{{ trans('labels.textRequiredFieldMessage') }}</span>

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Telephone</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('customers_telephone',  '', array('class'=>'form-control', 'id'=>'customers_telephone'))!!}

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Fax Number</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('customers_fax',  '', array('class'=>'form-control', 'id'=>'customers_fax'))!!}

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Status</label>

								<div class="col-sm-10 col-md-4">

									<select name="old_option" class='form-control' id="old_option"> 

										<option value="1">Active</option>

										<option value="0">Inactive</option>

									</select>

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Company name</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('entry_company',  '', array('class'=>'form-control', 'id'=>'entry_company'))!!}

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">First Name</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('entry_firstname',  '', array('class'=>'form-control', 'id'=>'entry_firstname'))!!}

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Address</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('entry_street_address',  '', array('class'=>'form-control', 'id'=>'entry_street_address'))!!}

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Suburb</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('entry_suburb',  '', array('class'=>'form-control', 'id'=>'entry_suburb'))!!}

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Entry Postcode</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('entry_postcode',  '', array('class'=>'form-control', 'id'=>'entry_postcode'))!!}

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">City</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('entry_city',  '', array('class'=>'form-control', 'id'=>'entry_city'))!!}

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">State</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('entry_state',  '', array('class'=>'form-control', 'id'=>'entry_state'))!!}

								</div>

							</div>

							

							<div class="form-group">

								<label for="name" class="col-sm-2 col-md-3 control-label">Suburb</label>

								<div class="col-sm-10 col-md-4">

									{!! Form::text('entry_suburb',  '', array('class'=>'form-control', 'id'=>'entry_suburb'))!!}

								</div>

							</div>

							

							<!-- /.box-body -->

							<div class="box-footer text-center">

								<button type="submit" class="btn btn-primary">Add Member</button>

								<a href="listingMembers" type="button" class="btn btn-success">Completed</a>

							</div>

                              <!-- /.box-footer -->

                            {!! Form::close() !!}

                        </div>

                  </div>

              </div>

            </div>

            

          </div>

          

          

          <!-- /.box-body --> 

        </div>

        <!-- /.box --> 

      </div>

      <!-- /.col --> 

    </div>

    <!-- /.row --> 

    

    <!-- Main row --> 

    

    <!-- /.row --> 

  </section>

  <!-- /.content --> 

</div>

@endsection