@extends('users.layout.app')

@section('content')
@include('users.partials.sidebar')

<div id="content" class="vheight" >
    <div class="row">
        <div class="col-md-6 ">
            <div class="panel panel-default">
                <div class="panel-heading">Contact Us</div>

                <div class="panel-body">
                    <form class="form-horizontal" method="POST" action="{{ url('details/store') }}" novalidate data-parsley-validate = "">
                        {{ csrf_field() }}

                        <div class="form-group{{ $errors->has('name') ? ' has-error' : '' }}">
                            <label for="name" class="col-md-12 control-label">Name <span class="required">*</span></label>

                            <div class="col-md-12">
                                <input id="name" type="text" class="form-control" name="name" value="{{ old('name') }}" required autofocus data-parsley-trigger="keyup" data-parsley-validate = "">

                                @if ($errors->has('name'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('name') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('email') ? ' has-error' : '' }}">
                            <label for="email" class="col-md-12 control-label">E-Mail Address <span class="required">*</span></label>

                            <div class="col-md-12">
                                <input id="email" type="email" class="form-control" name="email" value="{{ old('email') }}" required data-parsley-trigger="keyup" data-parsley-validate = "">

                                @if ($errors->has('email'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('email') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('contact_no') ? ' has-error' : '' }}">
                            <label for="contact_no" class="col-md-6 control-label">Contact Number <span class="required">*</span></label>

                            <div class="col-md-12">
                                <input id="contact_no" type="text" class="form-control" name="contact_no" value="{{ old('contact_no') }}" required autofocus data-parsley-trigger="keyup" data-parsley-validate = "" data-parsley-type="digits">

                                @if ($errors->has('contact_no'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('contact_no') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>

                        <div class="form-group{{ $errors->has('message') ? ' has-error' : '' }}">
                            <label for="message" class="col-md-12 control-label">Message <span class="required">*</span></label>

                            <div class="col-md-12">
                                <textarea class="form-control" name="message" required=""></textarea>

                                @if ($errors->has('message'))
                                    <span class="help-block">
                                        <strong>{{ $errors->first('message') }}</strong>
                                    </span>
                                @endif
                            </div>
                        </div>
                        <input name="client_email" type="hidden" value="{{ $client_email }}">
                        <div class="form-group">
                            <div class="col-md-12">
                                <button type="submit" class="btn btn-green">
                                    Submit
                                </button>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
@endsection


<!-- <script src="https://ajax.googleapis.com/ajax/libs/jquery/3.2.1/jquery.min.js"></script> -->

@section('scripts')

<script type="text/javascript">

</script>
@endsection