@extends('layouts.admin')
@section('pageTitle')
  <title>Best Insurance | Affiliates</title>
@stop
@section('content')
<section class="content ">
  <div class="box">
        <!-- <div class="box-header">
          <h3 class="box-title">Edit Affiliate</h3>
        </div> -->
        <!-- /.box-header -->

         <div class="box-body ">
        {{Form::open(array('url' => '/account/affiliates/update', 'method' => 'PUT', 'id' => 'formValidation'))}}
         
          <div class="form-group col-md-6 required">
          <span class=" control-label "></span>
            {{Form::label('UID',array())}}
            {{Form::number('uid',$request->uid,array('required' => true,'class' =>'form-control','required'))}}
            {{Form::hidden('id',$request->id,array('required' => true,'class' =>'form-control'))}}
            @if($errors->has('uid'))
            <label id="email-error" class="error" for="email">{{$errors->first('uid')}} </label>
            @endif
          </div>
          <!-- <div class="form-group  col-md-12"></div> -->
          <div class="form-group col-md-6 required">
          <span class=" control-label "></span>
            {{Form::label('Name Of The Organization',array())}}
            {{Form::text('name',$request->name,array('required' => true,'class' =>'form-control','required'))}}
            @if($errors->has('name'))
            <label id="email-error" class="error" for="name">{{$errors->first('name')}} </label>
            @endif
          </div>
          <!-- <div class="form-group  col-md-12"></div> -->
          <div class="form-group  col-md-6 required">
          <span class=" control-label "></span>
            {{Form::label('first name',array())}}
            {{Form::text('first_name',$request->first_name,array('required' => true,'class' =>'form-control'))}}

           
          </div>
          <!-- <div class="form-group  col-md-12"></div> -->
          <div class="form-group  col-md-6 required">
          <span class=" control-label "></span>
            {{Form::label('last name',array())}}
            {{Form::text('last_name',$request->last_name,array('required' => true,'class' =>'form-control'))}}
          </div>
          <!-- <div class="form-group  col-md-12"></div> -->
          <div class="form-group col-md-6 required">
          <span class=" control-label "></span>
            {{Form::label('Legal_Entity',array())}}
            {{Form::text('Legal_Entity',$request->Legal_Entity,array('required' => true,'class' =>'form-control','required'))}}
          </div>
          <!-- <div class="form-group  col-md-12"></div> -->
          <div class="form-group col-md-6 required">
          <span class=" control-label "></span>
            {{Form::label('Email',array())}}
            {{Form::text('email',$request->email,array('class' =>'form-control','required','readonly' => 'true'))}}
          </div>
          <div class="form-group  col-md-12"></div>
          <!-- <div class="form-group col-md-6">
            {{Form::label('new password',array())}}
            {{Form::text('Password',null,array('id' => 'password','class' =>'form-control'))}}
          </div>
          <div class="form-group  col-md-12"></div>
          <div class="form-group col-md-6">
            {{Form::label('confirm password',array())}}
            {{Form::text('confirm_password',null,array('class' =>'form-control'))}}
          </div>
          <div class="form-group  col-md-12"></div> -->
          <div class="form-group col-md-6">
            {{Form::label('source',array())}}
            {{Form::text('source',$request->source,array('class' =>'form-control'))}}
          </div>

          <!-- <div class="form-group  col-md-12"></div> -->

          <div class="form-group col-md-6">
            {{Form::label('Introducing Broker Firm',array())}}
            {{Form::text('broker_firm',$request->broker_firm,array('class' =>'form-control'))}}
          </div>

          <!-- <div class="form-group  col-md-12"></div> -->

          <div class="form-group col-md-6">
            {{Form::label('Introducing Broker Advisor',array())}}
            {{Form::text('broker_advisor',$request->broker_advisor,array('class' =>'form-control'))}}
          </div>


          <div class="form-group  col-md-12"></div>
          <hr/>

          <div class="form-group  col-md-6">
            <label class="checkbox-inline">
              @if(!empty($request->bai))
              <input type="checkbox" value="1" name="bai" checked>BAI
              @else
              <input type="checkbox" value="1" name="bai" >BAI
              @endif
            </label>
            <label class="checkbox-inline">
              @if(!empty($request->bi))
              <input type="checkbox" value="1" checked  name="bi">BI
              @else
              <input type="checkbox" value="1"  name="bi">BI
              @endif
            </label>
          </div>

          <!-- head office -->
          <div class="form-group  col-md-12">
            <h3>Head Office details</h3>
          </div>
          <div class="form-group  col-md-6">
            {{Form::label('HO Name',array())}}
            {{Form::text('ho_name',$request->ho_name,array('class' =>'form-control required'))}}
            @if($errors->has('ho_name'))
            <label id="email-error" class="error" for="ho_name">{{$errors->first('ho_name')}} </label>
            @endif
          </div>
          <div class="form-group  col-md-6">
            {{Form::label('HO Address',array())}}
            {{Form::text('ho_address',$request->ho_address,array('class' =>'form-control required'))}}
          </div>
          <!-- end of head office -->

          <div class="form-group  col-md-12"></div>
          <div class="form-group col-md-6">
            {{Form::label('Status',array())}}
            @if($request->status==1)
            {{Form::checkbox('status',null,$request->status)}}
            @else
            <input type="checkbox" value='1' name="status">
            @endif
          </div>
          <div class="form-group  col-md-12"></div>
           <div class="form-group col-md-6">
            {{Form::submit('Submit',array('class' => 'btn btn-success'))}}
          </div>
        {{Form::close()}}
        </div>
        <!-- /.box-body -->
        </div>
    <!-- </div> -->
   
</section>

@stop
@section('pageBottomJs')
<style type="text/css">
  
  .error{
    color :red;
  }
</style>
  
<script type="text/javascript">

   $(document).ready(function(){
    // trim blank spaces 
      $('#formValidation').submit( function(e){
          $(this).find('input:text').each(function(){
                $(this).val($.trim($(this).val()));
          });
      });
      $('#formValidation').validate({
          rules:{
            uid:{
              required:true,
              maxlength:11
            },
            name:{
              required:true,
              maxlength:100
            },
            Legal_Entity:{
              required:true,
              maxlength:255
            },
            user_name:{
              required:true,
              maxlength:50
            },
            first_name:{
              required:true,
              maxlength:50
            },
            last_name:{
              required:true,
              maxlength:50
            },
            password:{
              required:true,
              maxlength:8
            }
          },
          messages:{
            uid:'* Please enter UID and maximum length should be 11 characters.',
            name:'* Please enter name and maximum length should be 100 characters.',
            Legal_Entity:'* Please enter legal entity and maximum length should be 255 characters.',
            user_name:'* Please enter email and maximum length should be 50 characters.',
            password:'* Please enter password and maximum length should be 8 characters.',
            first_name: "* Please enter first name and length should be 50 characters",
            last_name: "* Please enter last name and length should be 50 characters",
            ho_name: "* Please enter Head office name",
            ho_address:"* Please enter Head office address"
          }
      });  
   });

  </script>
@stop