@extends('reward.whitelabel.white-label-template')

@section('header')
<link rel="stylesheet" href="{{ URL::asset('site/css/custom.css')}}">

<script>
	var country_code = {!! $country_code !!};
</script>
@stop

@section('content')
	<!-- Page Header -->
	<header class="titlebar titlebar1">
		<div class="container">
			<div class="row">
				<div class="col-sm-12">
					<h1 class="page-title pull-left">Registration</h1>
					<ol class="breadcrumb pull-right">
						<li><a href="#">Home</a></li>
						<li class="active">Registration</li>
					</ol>
				</div>
			</div>
		</div>
	</header> <!-- END Page Header -->
	<section class="page-login section-4 mb40">
		<div class="container">
			<div class="row">
				<div class="col-sm-10 col-sm-offset-1 col-md-8 col-md-offset-2">
					<div class="well well-6 login-area mb0">
						<h2 class="section-title-2 st-2 mb20">Register</h2>
						{!! Form::open(['action' => 'MemberController@storeUob', 'class' => 'form-horizontal register-form', 'id' => 'member-profile']) !!}
					
						<div class="form-body">
							<div class="form-group {{ ($errors->first('email')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3">Email Address<span class="required">
								* </span>
								</label>
								<div class="col-md-8">
									{!! Form::text('email', null, ['class' => 'form-control', 'data-required' => 1, ($errors->first('email') ? 'aria-required="true" aria-invalid="false" aria-describedby="email-error"' : '')]) !!}
									@if ($errors->first('email') )
										<span id="email-error" class="help-block help-block-error">{{ $errors->first('email') }}</span>
									@endif
								</div>
							</div>

							<div class="form-group {{ ($errors->first('first_name')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3">First Name <span class="required">
								* </span>
								</label>
								<div class="col-md-8">
									{!! Form::text('first_name', null, ['class' => 'form-control', 'data-required' => 1, ($errors->first('first_name') ? 'aria-required="true" aria-invalid="false" aria-describedby="first_name-error"' : '')]) !!}
									@if ($errors->first('first_name') )
										<span id="first_name-error" class="help-block help-block-error">{{ $errors->first('first_name') }}</span>
									@endif
								</div>
							</div>

							<div class="form-group {{ ($errors->first('last_name')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3">Last Name <span class="required">
								* </span>
								</label>
								<div class="col-md-8">
									{!! Form::text('last_name', null, ['class' => 'form-control', 'data-required' => 1, ($errors->first('lastname') ? 'aria-required="true" aria-invalid="false" aria-describedby="last_name-error"' : '')]) !!}
									@if ($errors->first('last_name') )
										<span id="last_name-error" class="help-block help-block-error">{{ $errors->first('last_name') }}</span>
									@endif
								</div>
							</div>

							<div class="form-group {{ ($errors->first('prefer_name')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3">Prefer Name <span class="required">
								</span>
								</label>
								<div class="col-md-8">
									{!! Form::text('prefer_name', null, ['class' => 'form-control', 'data-required' => 1, ($errors->first('prefer_name') ? 'aria-required="true" aria-invalid="false" aria-describedby="prefer_name-error"' : '')]) !!}
									@if ($errors->first('prefer_name') )
										<span id="prefer_name-error" class="help-block help-block-error">{{ $errors->first('prefer_name') }}</span>
									@endif
								</div>
							</div>

							<div class="form-group {{ ($errors->first('country_residence')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3"> Country Of Residence <span class="required">
								* </span>
								</label>
								<div class="col-md-8">
									{!! Form::select('country_residence', $countries, 193, ['class' => 'chosen-select selectcategory form-control', 'id' => 'countryOfResidence', 'data-placeholder' => 'Choose a Country...']) !!}
									@if ($errors->first('c_country_code') )
										<span id="country_residence-error" class="help-block help-block-error">This field is mandatory</span>
									@endif 
								</div>
							</div>	

							<div class="form-group {{ ($errors->first('gender')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3"> Gender <span class="required">
								* </span>
								</label>
								<div class="col-md-8">
									<label>{!! Form::radio('gender', 'Male', true) !!} male </label>
									<label>{!! Form::radio('gender', 'Female') !!} female</label>
									@if ($errors->first('lastname') )
										<span id="gender-error" class="help-block help-block-error">{{ $errors->first('gender') }}</span>
									@endif
								</div>
							</div>															
							
							<div class="form-group {{ ($errors->first('date_of_birth')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3"> Birth Date<span class="required">
								* </span>
								</label>
								<div class="col-md-8">
                                    {!! Form::text('date_of_birth', null, ['class' => 'form-control date', 'id' => 'date-of-birth']) !!}
									@if ($errors->first('date_of_birth') )
									<span id="date_of_birth-error" class="help-block help-block-error">This field is mandatory</span>
									@endif
								</div>
							</div>

							<div class="form-group {{ ($errors->first('nric_passport')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3">NRIC/Passport No<span class="required">
								* </span>
								</label>
								<div class="col-md-8">
									{!! Form::text('nric_passport', null, ['class' => 'form-control', 'data-required' => 1, ($errors->first('nric_passport') ? 'aria-required="true" aria-invalid="false" aria-describedby="nric_passport-error"' : '')]) !!}
									@if ($errors->first('nric_passport') )
										<span id="nric_passport-error" class="help-block help-block-error">{{ $errors->first('nric_passport') }}</span>
									@endif
								</div>
							</div>

							<div class="form-group {{ ($errors->first('nationality')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3"> Nationality <span class="required">
								* </span>
								</label>
								<div class="col-md-8">
									{!! Form::select('nationality', $countries, 193, ['class' => 'chosen-select selectcategory form-control', 'id' => 'nationality', 'data-placeholder' => 'Choose a Country...']) !!}
									@if ($errors->first('c_country_code') )
										<span id="nationality-error" class="help-block help-block-error">This field is mandatory</span>
									@endif 
								</div>
							</div>	

							<div class="form-group {{ ($errors->first('password')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3">Password<span class="required">
									* </span>
								</label>
								<div class="col-md-8">
									{!! Form::password('password', ['class' => 'form-control', 'data-required' => 1, 'id' => 'password' ]) !!}
									@if ($errors->first('password') )
									<span id="password-error" class="help-block help-block-error">{{ $errors->first('password') }}</span>
									@endif
								</div>
							</div>

							<div class="form-group {{ ($errors->first('password_confirmation')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3">Confirm Password<span class="required">
									* </span>
								</label>
								<div class="col-md-8">
									{!! Form::password('password_confirmation', ['class' => 'form-control', 'data-required' => 1 ]) !!}
									@if ($errors->first('password_confirmation') )
									<span id="password_confirmation-error" class="help-block help-block-error">This field is mandatory</span>
									@endif
								</div>
							</div>

							<div class="form-group {{ ($errors->first('contact_no')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3">Mobile Number<span class="required">
									* </span>
								</label>
								<div class="col-md-3">
									{!! Form::select('c_country_code', $countries, 193, ['class' => 'chosen-select selectcategory form-control', 'id' => 'country', 'data-placeholder' => 'Choose a Country...']) !!}
									@if ($errors->first('c_country_code') )
										<span id="email-error" class="help-block help-block-error">This field is mandatory</span>
									@endif 
								</div>
								<div class="col-md-5">
									<div class="row">
										<div class="col-md-2" style="padding-left:0px;padding-right:0px;">
											<span class="input-group-addon" style="padding-top:10px;padding-bottom:10px;border-top-left-radius: 5px;border-bottom-left-radius: 5px;border:none">
												<span class="addon-country-code">
													+65
												</span>
											</span>
										</div>
										<div class="col-md-10" style="padding-left:0px;">
										{!! Form::text('contact_no', null, ['class' => 'form-control', 'data-required' => 1]) !!}
										</div>
									</div>
									@if ($errors->first('contact_no') )
										<span id="contact_no-error" class="help-block help-block-error">{{$errors->first('contact_no')}}</span>
									@endif
								</div>
							</div>

							<div class="form-group {{ ($errors->first('receive_exclusive')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3">Receive exclusive<span class="required">
								</span>
								</label>
								<div class="col-md-8">
									<label>
										{!! Form::checkbox('receive_exclusive', 1, true) !!}
										Receive exclusive, members-only offers and promotions from United Points.
									</label>
									@if ($errors->first('receive_exclusive') )
									<span id="receive_exclusive-error" class="help-block help-block-error">This field is mandatory</span>
									@endif
								</div>
							</div>

							<div class="form-group {{ ($errors->first('terms_conditions')) ? 'has-error' : '' }}">
								<label class="control-label col-md-3">Terms and Conditions<span class="required">*
								</span>
								</label>
								<div class="col-md-8">
									<label>
										{!! Form::checkbox('terms_conditions', 1) !!}
 										By registering as a UP Member, I have read, understood and agreed 
 										to UP	<a href="{{ url('terms') }}">Membership T&Cs  </a> and 
 												<a href="{{ url('privacy') }}">Privacy Policy</a>.
									</label>
									@if ($errors->first('terms_conditions') )
									<span id="terms_conditions-error" class="help-block help-block-error">You Should have to agree Terms and Conditions to register the account.</span>
									@endif
								</div>
								<div class="col-md-8 col-md-offset-3">
									<label>
										{!! Form::checkbox('uob_signup', 1) !!}
 										Sign up for <strong>{{ $marketplace->name }}</strong> and agreed to 
 										<a href='{{ url("partner/$marketplace->name/terms-and-conditions") }}'>
 											Terms & Conditions
 										</a>.
									</label>
								</div>
							</div>

							<div class="form-actions" style="margin-top: 40px;">
								<div class="row">
									<div class="col-md-offset-3 col-md-9">
										<button type="submit" class="btn btn-default">Register</button>
										<a href="{{ URL::to('/') }}" class="btn btn-new-o">Cancel</a>
									</div>
								</div>
							</div>
						</div>
						{!! Form::close() !!}
					</div>
				</div>
			</div>
		</div>
	</section>
	
   
@stop

@section('footer')
<script src="{{ asset('metronic/global/plugins/jquery-validation/js/jquery.validate.min.js') }}" type="text/javascript"></script>
<script type="text/javascript" src="{{ asset('metronic/global/plugins/select2/select2.min.js') }}"></script>
<script src="{{ asset('metronic/admin/pages/scripts/login.js') }}" type="text/javascript"></script>
<script type="text/javascript">

  	$(document).ready(function() {
  		$('#country, #countryOfResidence, #nationality').select2();
	 	Login.init();

		$('#country').on('change', function() {
	 		$('.addon-country-code').html( "+" + country_code[$(this).val()] );
	 	});

 	    $('#date-of-birth').datepicker({
      		changeMonth: true,
	        changeYear: true,
	        yearRange: '1920:2016',
	        dateFormat : 'yy-mm-dd',
	        defaultDate: new Date(1990, 00, 01)
	    });
	});
</script>

@stop