@extends('templates.'. $template_name .'.layouts.default')

@section('title', trans('message.sign_up'))

@section('content')

<!-- crumb-area-start -->
<div class="crumb-area">
    <div class="container">
        <div class="row">
            <div class="col-xs-12">
                <div class="crumb">
                    <ul class="crumb-list">
                        <li><a href="{!! url('/')!!}">{{trans('message.home')}}</a></li>
                        <li class="active"><a href="#">{{trans('message.sign_up')}}</a></li>
                    </ul>
                </div>
            </div>
        </div>
    </div>
</div>
<!-- crumb-area-end -->

<!-- my-account-area-start -->
<div class="my-account-area">
    <div class="container">
        <!-- session flash message -->
        {!! getFlashMessage() !!}
        <div class="row">
            <div class="col-md-12">
                <div class="personal-information">
                    <h4 class="my-account-title">{{trans('message.fill_out_information')}}</h4>
                    <div class="personal-information-box">
                        {!! Form::open(['url' => url('/api-sign-up'), 'method' => 'POST']) !!}
                            <div class="row">
                                <div class="col-md-6 col-xs-12">
                                    <div class="pib-item">
                                        <label>{{trans('message.name')}}</label>
                                        <input type="text" name="name" required>
                                    </div>
                                    <div class="pib-item">
                                        <label>{{trans('message.email')}}</label>
                                        <input type="email" name="email" required>
                                    </div>
                                </div>
                                <div class="col-md-6 col-xs-12">
                                    <div class="pib-item">
                                        <label>{{trans('message.phone_number')}}</label>
                                        <input type="number" name="phone" required>
                                    </div>
                                    <div class="pib-item">
                                        <label>{{trans('message.gender')}}</label>
                                        <select name="gender">
                                            <option>{{ucfirst(trans('male'))}}</option>
                                            <option>{{ucfirst(trans('female'))}}</option>
                                        </select>
                                    </div>
                                </div>
                                <div class="col-xs-12">
                                    <div class="pib-save-change">
                                        <button class="btn-sign-up">{{trans('message.sign_up')}}</button>
                                    </div>
                                </div>
                            </div>
                        {!! Form::close() !!}
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
<!-- my-account-area-end -->

@endsection

@section('script')
<script type="text/javascript">
$(function(){
    // code here
});
</script>
@endsection