@extends('web.layouts.main')
@section('content')

  <div class="page-heading">
                <div class="bread">
                    <h4>{{__('web.formdesc')}}</h4>
                    <nav aria-label="breadcrumb">
                        <ol class="breadcrumb">
                        <li class="breadcrumb-item"><a href="{{url(getCurrentLocale().'/')}}">{{__('web.home')}}</a></li>
                        <li class="breadcrumb-item active" aria-current="page">{{__('web.form')}} </li>
                        </ol>
                    </nav>
                </div>
            </div>  
        <main>
            <!--start diet-form-->
            <section class="diet-form">
                <div class="container">
                    <div class="row">
                        <div class="col-md-8 m-auto">
                            <div class="inner">
                                <div class="text mb-5">
                                    <h3>{{__('web.fromdesc')}}</h3>
                                </div>
                                
                                <form  id="formcontacts" onsubmit="contacts()"  method="post" action="{{url(getCurrentLocale().'/forming')}}">
                                    @CSRF
                                   
                                        <div class="col-md-12">
                                            <label>First name</label>
                                            <div class="form-group">
                                                <input name="first_name" class="form-control">
                                            </div>
                                        </div>
                                        <div class="col-md-12">
                                            <label>Last name</label>
                                            <div class="form-group">
                                                <input name="last_name" class="form-control">
                                            </div>
                                        </div>
                                        <div class="col-md-12">
                                            <label>Workplace Name</label>
                                            <div class="form-group">
                                                <input name="workplace" class="form-control">
                                            </div>
                                        </div>
                                        <div class="col-md-12">
                                            <label>Specialty</label>
                                            <div class="form-group">
                                                <input name="specialty" class="form-control">
                                            </div>
                                        </div>
                                        <div class="col-md-12">
                                            <label>SCFHS ID number</label>
                                            <div class="form-group">
                                                <input type="number" name="scfhs_id" class="form-control">
                                            </div>
                                        </div>
                                        
                                        <div class="col-md-12">
                                            <label>{{__('web.Sector')}}</label>
                                            <div class="form-group">
                                                <select  name="sector" class="form-control" >
                                                    <option value="private">{{__('web.private')}}</option>
                                                    <option value="governmental">{{__('web.governmental')}}</option>
                                                </select>
                                            </div>
                                        </div>
                                        <div class="col-md-12">
                                            <label>Phone</label>
                                            <div class="form-group">
                                                <input type="number" name="phone" class="form-control">
                                            </div>
                                        </div>

                                        
                                         <div class="row">
                                        <div id="success" style="display : none" class="col-12 alert alert-success">
                           
                        </div>
                         <div id="error" style="display : none" class="col-12 alert alert-danger">
                           
                        </div>
                                        <div class="col-md-12">
                                            <button class="bg-butn"><span>{{__('web.send')}}</span></button>
                                        </div>
                                    </div>
                                </form>
                            </div>
                        </div>
                    </div>
                </div>
            </section>
        </main>

 @push('js')
   <script>
        function contacts(){
        event.preventDefault(); 
       var action = $('#formcontacts').attr('action');
       var urls = action;
       var dataform = $('#formcontacts').serialize();
     
      $.ajax({
          url : urls,
          type: 'POST',              
          data: dataform,
          success:function(data)
          {
           
              $('#error').css("display", "none");
              $('#success').css("display", "block");
            $('#success').html('تم ارسال رسالتك بنجاح');
             location.reload();
             
          }
          ,error:function(data) {
             
              $('#success').css("display", "none");
              $('#error').html('');
    $('#error').css("display", "block");
   
   $.each(data.responseJSON.errors, function(value) {
     $('#error').append('<div class="col-12">'+value+'</div');
     
     
 }); 
 
}
        })
        }
    </script>
   @endpush
@stop