@extends(env("CLIENT_PATH").".welcome")
@section("content")
<header>
<div class="container">
<img src="<?php echo site_url(); ?>pranjal/assets/images/office.jpg" alt="cover-image" class="img-fluid" />
</div>
</header>
<section class="main">
<div class="container">
<div class="form-box">
<form method="post" action="#" id="enquiry-form">
@csrf
<input type="hidden" name="sources_id" value="2" />
<input type="hidden" name="campaigns_id" value="2" />
<div class="titlebox">
<h2>
PERSONAL INFORMATION
</h2>
</div>
<div class="row">
<div class="col-lg-12 col-md-12">
<div class="form-row">
<div class="col-lg-2 col-md-3"><label for="from-name">Name:</label><span class="required-input">*</span></div>
<div class="col-lg-10 col-md-9">
<div class="form-group">
<input class="form-control" type="text" id="from-name" name="name" required="">
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-4 col-md-4">
<label for="from-dob">Date of Birth:<span class="required-input">*</span></label>
</div>
<div class="col-lg-8 col-md-8">
<div class="form-group">
<input class="form-control" type="text" id="from-dob" name="name" required="">
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-4"><label for="from-name">Gender:</label><span class="required-input">*</span></div>
<div class="col-lg-8">
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" id="inlineCheckbox1" name="gender" value="male">
<label class="form-check-label" for="inlineCheckbox1">Male</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" id="inlineCheckbox2" name="gender" value="female">
<label class="form-check-label" for="inlineCheckbox2">Female</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" id="inlineCheckbox3" name="gender" value="others">
<label class="form-check-label" for="inlineCheckbox3">Others</label>
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-4"><label for="from-name">Marital Status:</label><span class="required-input">*</span></div>
<div class="col-lg-8">
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" id="married" name="marital_status" value="married">
<label class="form-check-label" for="married">Married</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" id="unmarried" name="marital_status" value="unmarried">
<label class="form-check-label" for="unmarried">Unmarried</label>
</div>
<div class="form-check form-check-inline">
<input class="form-check-input" type="radio" id="divorced" name="marital_status" value="divorced">
<label class="form-check-label" for="divorced">Divorced</label>
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-4">
<label for="from-phone">Tel/Mob Number</label><span class="required-input">*</span>
</div>
<div class="col-lg-8">
<div class="form-group">
<div class="input-group">
<input class="form-control" type="text" id="from-phone" name="mobile" required="">
</div>
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-4"><label for="from-email">Email:</label><span class="required-input">*</span></div>
<div class="col-lg-8">
<div class="form-group">
<input class="form-control" type="email" id="from-email" name="email" required="">
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-4 col-md-4"> <label for="from-phone">Address</label><span class="required-input">*</span></div>
<div class="col-lg-8 col-md-8">
<div class="form-group">
<input class="form-control" type="text" id="from-address" name="address" required="">
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-4 col-md-4"> <label for="from-phone">Guardian's name</label><span class="required-input">*</span></div>
<div class="col-lg-8 col-md-8">
<div class="form-group">
<input class="form-control" type="text" id="from-address" name="guardian_name" required="">
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-4 col-md-4"> <label for="from-phone">Contact:</label><span class="required-input">*</span></div>
<div class="col-lg-8 col-md-8">
<div class="form-group">
<input class="form-control" type="text" id="from-address" name="address" required="">
</div>
</div>
</div>
</div>
<div class="col-lg-12 col-md-12">
<div class="row">
<div class="col-lg-3 col-md-3"> <label for="from-phone">Have you applied any country?</label></div>
<div class="col-lg-9 col-md-9">
<div class="form-group">
<input class="form-control" type="text" id="from-address" name="applied_before">
</div>
</div>
</div>
</div>
<div class="tabletitle">
<h2>
ACADEMIC DETAILS
</h2>
</div>
<table class="table table-bordered">
<thead>
<tr>
<th scope="col">Degree Obtained</th>
<th scope="col">Major</th>
<th scope="col">Institution</th>
<th scope="col">Score/GPA</th>
<th scope="col">Passed Year</th>
</tr>
</thead>
<tbody>
<tr>
<th scope="row">SLC / SEE</th>
<td> </td>
<td> <input class="form-control" type="text" id="from-address" name="see_school" ></td>
<td> <input class="form-control" type="text" id="from-address" name="see_grade" ></td>
<td> <input class="form-control" type="text" id="from-address" name="see_year" ></td>
</tr>
<tr>
<th scope="row">10+2/CTEVT/PCT</th>
<td> <input class="form-control" type="text" id="from-address" name="plus2_stream" ></td>
<td> <input class="form-control" type="text" id="from-address" name="plus2_college" ></td>
<td> <input class="form-control" type="text" id="from-address" name="plus2_grade" ></td>
<td> <input class="form-control" type="text" id="from-address" name="plus2_year" ></td>
</tr>
<tr>
<th scope="row">Bachelor</th>
<td> <input class="form-control" type="text" id="from-address" name="bachelors_stream" ></td>
<td> <input class="form-control" type="text" id="from-address" name="bachelors_college" ></td>
<td> <input class="form-control" type="text" id="from-address" name="bachelors_grade" ></td>
<td> <input class="form-control" type="text" id="from-address" name="bachelors_year" ></td>
</tr>
<tr>
<th scope="row">Master</th>
<td> <input class="form-control" type="text" id="from-address" name="highest_stream" ></td>
<td> <input class="form-control" type="text" id="from-address" name="highest_college" ></td>
<td> <input class="form-control" type="text" id="from-address" name="highest_grade" ></td>
<td> <input class="form-control" type="text" id="from-address" name="highest_year" ></td>
</tr>
</tbody>
</table>
<div class="col-lg-12 col-md-12">
<div class="row">
<div class="col-lg-3 col-md-4"> <label for="from-phone">Work Experience:</label></div>
<div class="col-lg-9 col-md-8">
<div class="form-group">
<input class="form-control" type="text" id="from-address" name="experience" >
</div>
</div>
</div>
</div>
<div class="col-lg-12 col-md-12 mb20">
<div class="row">
<div class="col-lg-3 col-md-4"> <label for="from-phone">Your Country of Interest:</label></div>
<div class="col-lg-9 col-md-8">
<div class="select-group">
<select name="preferred_destination" class="form-control field-info" >
<option value="" selected="" disabled="">Preferred Study Destination</option>
<option value="study-in-australia">Study in Australia</option>
<option value="study-in-usa">Study in USA</option>
<option value="study-in-canada">Study in Canada</option>
<option value="other">Others</option>
</select>
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-6 col-md-6"> <label for="from-test">Test Taken:</label></div>
<div class="col-lg-6 col-md-6">
<div class="form-group">
<input class="form-control" type="text" id="from-test" name="preparation_class" >
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-4 col-md-4"> <label for="from-score">Score:</label></div>
<div class="col-lg-8 col-md-8">
<div class="form-group">
<input class="form-control" type="text" id="from-score" name="preparation_score" >
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-6 col-md-6"> <label for="from-hdykau">How did you know about us?:</label></div>
<div class="col-lg-6 col-md-6">
<div class="form-group">
<input class="form-control" type="text" id="from-hdykau" name="how_you_know">
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-4 col-md-4"> <label for="from-ref">Reference:</label></div>
<div class="col-lg-8 col-md-8">
<div class="form-group">
<input class="form-control" type="text" id="from-ref" name="reference" >
</div>
</div>
</div>
</div>
<div class="col-lg-6 col-md-6">
<div class="row">
<div class="col-lg-6 col-md-6"> <label for="from-other">Other:</label></div>
<div class="col-lg-6 col-md-6">
<div class="form-group">
<input class="form-control" type="text" id="from-other" name="other" >
</div>
</div>
</div>
</div>
</div>
<div class="form-row">
<div class="col-12 col-sm-12 col-md-12 col-lg-12">
<div class="form-group"><label for="from-calltime">FOR OFFICIAL USE</label><span class="required-input">*</span>
<textarea name="message" class="form-control" rows="5" ></textarea>
</div>
</div>
</div>
<div class="form-group ">
<div class="form-row">
<input type="hidden" name="g-recaptcha-response" value="">
<div class="col-3"><button class="btn btn-primary btn-block" type="submit" id="submitButton">Submit </button></div>
</div>
</div>
</div>
</form>
<?php //pre(SITEVARS->Campaigns[0]);
?>
<div class="modal fade" id="success-modal" tabindex="-1" role="dialog" aria-labelledby="success-modal-label" aria-hidden="true">
<div class="modal-dialog" role="document">
<div class="modal-content">
<div class="modal-header" style="display: none;">
<h5 class="modal-title" id="success-modal-label">Success</h5>
<button type="button" class="close" data-dismiss="modal" aria-label="Close">
<span aria-hidden="true">×</span>
</button>
</div>
<div class="modal-body">
<div id="modal-text-area">
</div>
<div id="success-modal-qr">
</div>
<div id="canvas-area">
</div>
</div>
<div class="modal-footer">
<button type="button" id="downloadButton" class="btn btn-success full-width" style="width: 100%;">Download QR</button>
<button type="button" id="downloadFormButton" class="btn btn-success full-width" style="width: 100%;">Download Form</button>
</div>
</div>
</div>
</div>
<div class="modal fade" id="error-modal" tabindex="-1" role="dialog" aria-labelledby="error-modal-label" aria-hidden="true">
<div class="modal-dialog" role="document">
<div class="modal-content">
<div class="modal-header">
<h5 class="modal-title" id="error-modal-label">Form Validation Errors</h5>
<button type="button" class="close" data-dismiss="modal" aria-label="Close">
<span aria-hidden="true">×</span>
</button>
</div>
<div class="modal-body">
<!-- Error messages will be displayed here -->
</div>
<div class="modal-footer">
<button type="button" class="btn btn-secondary" data-dismiss="modal">Close</button>
</div>
</div>
</div>
</div>
</div>
</div>
</section>
@endsection
@push("js")
<script>
$.registration_id=0;
$(document).ready(function() {
$('#enquiry-form').submit(function(e) {
e.preventDefault();
var formData = $(this).serialize();
var response = "";
$.ajax({
type: 'POST',
url: '<?php echo route("registration.submit"); ?>',
data: formData,
success: function(response) {
// fbq('trackCustom', 'EventRegistration', {promotion: 'astro_solutions'});
//alert(response.registration_id);
fbq('track', 'PageView');
if (response.status) {
$('#registration-id').text(response.registration_id);
$.registration_id=response.registration_id;
$('#success-modal-label').text("Registration is successful");
$('#success-modal-qr').html("<p class='text-center' style='text-align: center!important;background-color: #830404;color: white;padding: 10px;font-weight: 600;'>Please download/save this PASS. </p><img src='" + response.qr_code + "' class='img-fluid' />");
var downloadLink = document.createElement('a');
downloadLink.href = response.qr_code;
downloadLink.download = 'pranjal_inquiry_form.png'; // Set the desired file name
// downloadLink.click();
$('#success-modal').modal('show');
$form[0].reset();
} else if (response.message == 'Mobile number already exists. Returning existing data.') {
var existingRegistrationData = response.registration;
$.registration_id=response.registration_id;
//$('#modal-text-area').html(JSON.stringify(existingRegistrationData));
var downloadLink = document.createElement('a');
downloadLink.href = response.qr_code;
downloadLink.download = 'pranjal_inquiry_form.png'; // Set the desired file name
//downloadLink.click();
$('#success-modal-label').text(response.message);
$('#success-modal-qr').html("<img src='" + response.qr_code + "' class='img-fluid' />");
$('#success-modal').modal('show');
} else {
var errorMessages = '';
$.each(response.errors, function(field, errors) {
errorMessages += errors.join('<br>');
});
$('#error-modal .modal-body').html(errorMessages);
$('#error-modal').modal('show');
}
}
});
});
$('#success-modal').on('hidden.bs.modal', function() {
$('#enquiry-form')[0].reset(); // Reset the form
});
$('#downloadButton').on('click', function() {
// Trigger the download when the button is clicked
var downloadLink = document.createElement('a');
downloadLink.href = $('#success-modal-qr img').attr('src');
downloadLink.download = 'pranjal_inquiry_form.png';
downloadLink.click();
});
$('#downloadFormButton').on('click', function() {
// Trigger the download when the button is clicked
var downloadLink = document.createElement('a');
downloadLink.href = '{{route("pdf.generate")}}?id='+$.registration_id;
downloadLink.download = 'pranjal_inquiry_form.pdf';
downloadLink.click();
});
});
</script>
@endpush
@push("css")
<style>
* {
box-sizing: border-box;
}
.mb10{ margin-bottom: 10px;}
.mb20{ margin-bottom: 20px;}
body {
background: #d5cdce;
}
header {
background-color: #FFFFFF;
width: 100%;
padding-bottom: 40px;
}
.main {
background-color: #d5cdce;
margin: 0;
padding: 0;
}
.table {
background-color: #FFFFFF;
}
.table thead {
background: rgb(2, 0, 36);
background: linear-gradient(90deg, rgba(2, 0, 36, 1) 0%, rgba(139, 23, 26, 1) 0%, rgba(236, 31, 40, 1) 100%);
color: #fff;
}
.titlebox h2 {
background: rgb(2, 0, 36);
background: linear-gradient(90deg, rgba(2, 0, 36, 1) 0%, rgba(139, 23, 26, 1) 0%, rgba(236, 31, 40, 1) 100%);
color: #fff;
text-align: left;
margin: 10px 0px 20px 0;
text-transform: capitalize;
padding: 10px 20px;
font-size: 24px;
font-weight: 600;
}
.tabletitle h2 {
background: rgb(2, 0, 36);
background: linear-gradient(90deg, rgba(2, 0, 36, 1) 0%, rgba(139, 23, 26, 1) 0%, rgba(236, 31, 40, 1) 100%);
color: #fff;
text-align: left;
margin: 10px 0px 0px 0;
text-transform: capitalize;
padding: 10px 20px;
font-size: 20px;
font-weight: 600;
}
.form-box {
display: block;
margin: 0 auto;
/* margin-top: 5%; */
/* margin-bottom: 5%; */
background-color: #d5cdce;
width: 98%;
/* border-radius: 5px;
box-shadow: 10px 10px 0 0 #9c1e5b; */
}
.boximage {
width: 100%;
height: auto;
background-size: cover;
border-radius: 5px 5px 0 0;
}
.infotext {
width: 100%;
padding: 3%;
text-align: center;
color: #162c38;
font-family: sans-serif;
}
h1 {
font-family: 'Roboto Slab', serif;
font-size: 1.1em;
color: #162c38;
text-transform: uppercase;
}
.infotext p {
line-height: 1.5em;
letter-spacing: 0.05em;
}
form {
width: 100%;
padding: 5%;
}
.required-input {
color: #f00;
}
input {
display: block;
width: 100%;
border: solid 1px #ec1f28;
border-radius: 5px;
/* margin-bottom: 15px; */
padding: 2%;
font-size: 0.8em;
font-family: sans-serif;
letter-spacing: 0.1em;
color: #888;
text-align: left;
}
input[type=submit] {
border: none;
border-radius: 5px;
background-color: #a82d2d;
color: #fff;
text-align: center;
}
input[type=submit]:hover {
background-color: #711616;
cursor: pointer;
}
.form-control {
height: 30px;
background: #fff;
border: 1px #ef373e solid;
padding: 0 15px;
font-size: 16px;
-webkit-transition: all 0.3s ease-in-out;
-moz-transition: all 0.3s ease-in-out;
-o-transition: all 0.3s ease-in-out;
transition: all 0.3s ease-in-out;
}
.form-control:focus {
border-color: #00bcd9;
-webkit-box-shadow: 0px 0px 20px rgba(0, 0, 0, .1);
-moz-box-shadow: 0px 0px 20px rgba(0, 0, 0, .1);
box-shadow: 0px 0px 20px rgba(0, 0, 0, .1);
}
textarea.form-control {
height: 160px;
padding-top: 15px;
resize: none;
}
.content-column ul li {
list-style-type: disc;
margin-left: 20px;
}
</style>
@endpush