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Server : Apache/2.4.41 (Ubuntu) System : Linux vmi1525618.contaboserver.net 5.4.0-105-generic #119-Ubuntu SMP Mon Mar 7 18:49:24 UTC 2022 x86_64 User : www-data ( 33) PHP Version : 8.2.12 Disable Function : NONE Directory : /var/www/leadai/leadai.co.in/resources/views/frontend/ |
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@extends('frontend.layout.app')
@section('main-section')
<section class="relative mt-24 pb-16">
<div class="container relative md:mt-24 mt-16">
<div class="grid md:grid-cols-12 grid-cols-1 items-center gap-[30px]">
<div class="lg:col-span-6 md:col-span-6">
<img src="{{asset('public/assets/images/contact.svg')}}" class="img-fluid d-block mx-auto" alt="">
</div>
<div class="lg:col-span-6 md:col-span-6">
<div class="lg:ms-5 create-account-form1">
<div class="bg-white dark:bg-slate-900 rounded-md shadow dark:shadow-gray-800 p-6">
<x-flashMessage />
<form id="create-course-form" method='post' action="{{asset('get-client-details')}}" >
@csrf
<div class="grid lg:grid-cols-12 lg:gap-6">
<div class="lg:col-span-6 mb-5">
<div class="text-start">
<label htmlFor="name" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">First Name:</label>
<div class="form-icon relative mt-2">
<Icon.User class="size-4 absolute top-3 start-4"></Icon.User>
<input name="first_name" value="{{ old('first_name') }}" id="first_name" type="text" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="Name :" />
</div>
@if ($errors->has('first_name'))
<div class=" text-danger">
{{ $errors->first('first_name') }}
</div>
@endif
</div>
</div>
<div class="lg:col-span-6 mb-5">
<div class="text-start">
<label htmlFor="email" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Last Name:</label>
<div class="form-icon relative mt-2">
<Icon.User class="size-4 absolute top-3 start-4"></Icon.User>
<input name="last_name" value="{{ old('last_name') }}" id="last_name" type="text" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="Name :" />
</div>
@if ($errors->has('last_name'))
<div class=" text-danger">
{{ $errors->first('last_name') }}
</div>
@endif
</div>
</div>
</div>
<div class="grid lg:grid-cols-12 lg:gap-6">
<div class="lg:col-span-6 mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Your Email:</label>
<div class="form-icon relative mt-2">
<input name="email" value="{{ old('email') }}" id="email" type="text" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="Email " />
</div>
@if ($errors->has('email'))
<div class=" text-danger">
{{ $errors->first('email') }}
</div>
@endif
</div>
</div>
<div class="lg:col-span-6 mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Your Number : </label>
<div class="form-icon relative mt-2">
<input name="phone" id="phone" value="{{ old('phone') }}" type="number" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="Number " />
</div>
@if ($errors->has('phone'))
<div class=" text-danger">
{{ $errors->first('phone') }}
</div>
@endif
</div>
</div>
</div>
<div class="grid grid-cols-1">
<div class="mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Company : </label>
<div class="form-icon relative mt-2">
<input name="company" value="{{ old('company') }}" id="company_name" type="text" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="Company " />
</div>
@if ($errors->has('company'))
<div class=" text-danger">
{{ $errors->first('company') }}
</div>
@endif
</div>
</div>
<div class="mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Select Plan </label>
<div class="form-icon relative mt-2">
<select name="plan_id" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" >
<option disabled selected>SELECT</option>
@foreach($plans as $plan)
<option value="{{$plan->id}}">{{$plan->plan_name}} ({{$plan->days}} Days)</option>
@endforeach
</select>
@if ($errors->has('plan_id'))
<div class=" text-danger">
{{ $errors->first('plan_id') }}
</div>
@endif
</div>
</div>
</div>
<div class="mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Coaching Institute : </label>
<div class="form-icon relative mt-2">
<input name="institute_name" value="{{ old('institute_name') }}" id="institute_name" type="text" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="Coaching Institute " />
</div>
@if ($errors->has('institute_name'))
<div class=" text-danger">
{{ $errors->first('institute_name') }}
</div>
@endif
</div>
</div>
<div class="mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">No of User : </label>
<div class="form-icon relative mt-2">
<img src="{{asset('public/assets/images/down.png')}}" alt="" style="position:absolute;width:20px;right:20px;top:10px;">
{{--<i class="fa fa-caret-down size-4 absolute top-3 end-4" aria-hidden="true" style="position: absolute;"></i>--}}
<input type="number" value="{{ old('no_of_user') }}" name="no_of_user" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" >
</div>
</div>
</div>
</div>
<div class="py-2 px-5 inline-block font-semibold tracking-wide border align-middle duration-500 text-base text-center bg-indigo-600 hover:bg-indigo-700 border-indigo-600 hover:border-indigo-700 text-white rounded-md w-full create-account-btn">Create Account</div>
</div>
</div>
<div class="bg-white create-account-form dark:bg-slate-900 rounded-md shadow dark:shadow-gray-800 p-6" style="height: 600px;overflow: auto;">
<div class="grid lg:grid-cols-12 lg:gap-6">
<div class="lg:col-span-12 mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Address:</label>
<div class="form-icon relative mt-2">
<textarea name="address" class='form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0'></textarea>
</div>
@if ($errors->has('address'))
<div class=" text-danger">
{{ $errors->first('address') }}
</div>
@endif
</div>
</div>
</div>
<div class="grid lg:grid-cols-12 lg:gap-6">
<div class="lg:col-span-6 mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">City:</label>
<div class="form-icon relative mt-2">
<input name="city" value="{{ old('city') }}" class='form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0'>
</div>
@if ($errors->has('city'))
<div class=" text-danger">
{{ $errors->first('city') }}
</div>
@endif
</div>
</div>
<div class="lg:col-span-6 mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Your State : </label>
<div class="form-icon relative mt-2">
<select name="state" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0'">
@if(isset($states))
@foreach($states as $state)
<option value="{{$state->state_name}}">{{$state->state_name}}</option>
@endforeach
@endif
</select>
@if ($errors->has('state'))
<div class=" text-danger">
{{ $errors->first('state') }}
</div>
@endif
</div>
</div>
</div>
</div>
<div class="grid lg:grid-cols-12 lg:gap-6">
<div class="lg:col-span-6 mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Country:</label>
<div class="form-icon relative mt-2">
<div class="form-icon relative mt-2">
<select name="country" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0'">
<option value="India">India</option>
</select>
</div>
</div>
</div>
</div>
<div class="lg:col-span-6 mb-5">
<div class="text-start mt-2">
<label htmlFor="zipcode" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Zip Code : </label>
<input value="{{ old('zipcode') }}" name="zipcode" id="zipcode" type="text" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="Zip Code" />
</div>
@if ($errors->has('zipcode'))
<div class=" text-danger">
{{ $errors->first('zipcode') }}
</div>
@endif
</div>
</div>
<div class="grid lg:grid-cols-12 lg:gap-6">
<div class="lg:col-span-8 mb-5">
<div class="text-start d-flex">
<div class="form-icon relative mt-2">
If india GST :
</div>
<div class="text-start mt-2 d-flex">
<input type="radio" id="html" name="gst_type" value="yes" value="HTML" style="margin-left:20px;">
<p style="margin-left:10px;">Yes</p>
<input type="radio" id="html" name="gst_type" value="no" value="HTML" style="margin-left:20px;">
<p style="margin-left: 10px;">No</p>
</div>
</div>
</div>
</div>
<div class="grid grid-cols-1">
<div class="mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">GST No : </label>
<div class="form-icon relative mt-2">
<input name="gstin" value="{{ old('gstin') }}" type="text" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="GST No " />
</div>
@if ($errors->has('gstin'))
<div class=" text-danger">
{{ $errors->first('gstin') }}
</div>
@endif
</div>
</div>
</div>
<div class="lg:col-span-12 mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Amount : </label>
<div class="form-icon relative mt-2">
<input name="amount" value="{{ old('amount') }}" id="email" type="text" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="Amount " />
</div>
@if ($errors->has('amount'))
<div class=" text-danger">
{{ $errors->first('amount') }}
</div>
@endif
</div>
</div>
<div class="mb-5">
<div class="text-start d-flex " style="align-items: center;">
<label htmlFor="subject" class="font-semibold" style="margin-top:10px;">Payment Mode : </label>
<div class="form-icon relative mt-2">
<i class="fa fa-caret-down size-4 absolute top-3 end-4" aria-hidden="true"></i>
<div class=" w-full" style="margin-left:30px;">
<select name="payment_mode" class="form-input w-full">
<option value="net_banking">Net Banking</option>
<option value="upi">UPI</option>
</select>
@if ($errors->has('payment_mode'))
<div class=" text-danger">
{{ $errors->first('payment_mode') }}
</div>
@endif
</div>
</div>
</div>
</div>
<div class="lg:col-span-12 mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Bank Details : </label>
<div class="form-icon relative mt-2">
<div class="form-input w-full h-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="Ucr Details ">
Bank : IndusInd Bank Ltd.<br>
Branch : Golf Course, Gurgaon<br>
Name : Edukrypt Corporation Private Limited<br>
Account Number : 252518082023 <br>
IFSC : INDB0000401<br>
</div>
</div>
</div>
</div>
<div class="lg:col-span-12 mb-5">
<div class="text-start">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Transfer Details : </label>
<div class="form-icon relative mt-2">
<input name="transfer_details" value="{{ old('transfer_details') }}" type="text" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" placeholder="Ucr Details " />
</div>
@if ($errors->has('transfer_details'))
<div class=" text-danger">
{{ $errors->first('transfer_details') }}
</div>
@endif
</div>
</div>
<div class="row mb-5">
<div class="text-start col-md-6">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Date : </label>
<div class="form-icon relative mt-2">
<input name="date" value="{{ old('date') }}" type="date" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" />
</div>
@if ($errors->has('date'))
<div class=" text-danger">
{{ $errors->first('date') }}
</div>
@endif
</div>
<div class="text-start col-md-6">
<label htmlFor="subject" class="font-semibold title h5 text-lg font-medium hover:text-indigo-600">Time : </label>
<div class="form-icon relative mt-2">
<input name="time" id="time" value="{{ old('time') }}" type="time" class="form-input w-full py-2 px-3 h-10 bg-transparent dark:bg-slate-900 dark:text-slate-200 rounded outline-none border border-gray-200 focus:border-indigo-600 dark:border-gray-800 dark:focus:border-indigo-600 focus:ring-0" />
</div>
@if ($errors->has('time'))
<div class=" text-danger">
{{ $errors->first('time') }}
</div>
@endif
</div>
</div>
<button type='submit' class="py-2 px-5 inline-block font-semibold tracking-wide border align-middle duration-500 text-base text-center bg-indigo-600 hover:bg-indigo-700 border-indigo-600 hover:border-indigo-700 text-white rounded-md w-full">Submit</button>
</form>
</div>
</div>
</div>
</div>
</section>
@include('frontend.layout.footer')
<!-- Back to top -->
<a href="#" onclick="topFunction()" id="back-to-top" class="back-to-top fs-5"><i data-feather="arrow-up" class="fea icon-sm icons align-middle"></i></a>
<!-- Back to top -->
@endsection
@push('custom-js')
<script src="https://www.google.com/recaptcha/api.js" async defer></script>
<script>
document.querySelector('.create-account-form').style.display='none'
document.querySelector('.create-account-btn').addEventListener('click',()=>{
document.querySelector('.create-account-form').style.display='block'
document.querySelector('.create-account-form1').style.display='none'
})
</script>
@endpush