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

    <main>
        <!-- Start section -->
        @include('web.layouts.header')
        <!-- Start section -->
        <section class="login_pg section">
            <div class="container">
                <div class="row justify-content-between">
                    <div class="col-lg-10 m-auto">
                        <div class="form_box">
                            <h2 class="sec_title bb fw-bold mb-4">  {{ __('reps.create_account_rep') }}  </h2>
                            <h6 class="small mb-5">{{ __('web.regist_desc') }}</h6>
                            <form method="post" action="{{ route('add.new.rep') }}" onsubmit="formAction(this)" enctype="multipart/form-data">
                                @CSRF
                                <div class="row">
                                    <div class="col-lg-12">
                                        <div class="profile-avatar mb-5" id="imagePreview"
                                             style="background-image: url('https://t3.ftcdn.net/jpg/00/64/67/80/360_F_64678017_zUpiZFjj04cnLri7oADnyMH0XBYyQghG.jpg');">
                                            <input type="file" name="photo" class="custom-file-input" id="imageUpload" required="">
                                            <button type="button"><i class="far fa-camera"></i></button>
                                        </div>
                                    </div>
                                    <div class="col-lg-4">
                                        <div class="form-group mb-4">
                                            <label class="inputLabel"> {{ __('reps.name') }} <span class="text-danger">*</span>
                                            </label>
                                            <input type="text" name="name" class="form-control" placeholder="" required>
                                        </div>
                                    </div>
                                    <div class="col-lg-4">
                                        <div class="form-group mb-4">
                                            <label class="inputLabel"> {{ __('reps.email') }} <span class="text-danger">*</span>
                                            </label>
                                            <input type="email" name="email" class="form-control" placeholder="" required>
                                        </div>
                                    </div>
                                    <div class="col-lg-4">
                                        <div class="form-group mb-4">
                                            <label class="inputLabel"> {{ __('reps.phone') }} <span class="text-danger">*</span>
                                            </label>
                                            <div class="phone_group">
                                                <select class="form-control form-select codeSelect">
                                                    <option>+966</option>
                                                </select>
                                                <input type="text" name="phone" class="form-control" placeholder="" required> <!-- numInput -->
                                            </div>
                                        </div>
                                    </div>
                                    <div class="col-lg-6">
                                        <div class="form-group mb-4">
                                            <label class="inputLabel"> {{ __('reps.id_number') }} </label>
                                            <input type="text" name="id_number" class="form-control" placeholder="" required>

                                        </div>
                                    </div>
                                    <div class="col-lg-6">
                                        <div class="form-group mb-4">
                                            <label class="inputLabel"> {{ __('reps.bank_acc') }} <span
                                                    class="text-danger">*</span> </label>
                                            <input type="text" name="bank_acc" class="form-control" placeholder="" required>
                                        </div>
                                    </div>
                                    <div class="col-lg-6">
                                        <div class="form-group mb-4">
                                            <label class="inputLabel"> {{ __('reps.password') }} <span
                                                    class="text-danger">*</span> </label>
                                            <input type="password" name="password" class="form-control" placeholder="" required>
                                        </div>
                                    </div>
                                    <div class="col-lg-6">
                                        <div class="form-group mb-4">
                                            <label class="inputLabel"> {{ __('reps.password_confirmation') }} <span
                                                    class="text-danger">*</span> </label>
                                            <input type="password" name="password_confirmation" class="form-control" placeholder="" required>
                                        </div>
                                    </div>
                                    <div class="col-lg-6">
                                        <div class="form-check mb-4">
                                            <input class="form-check-input" type="checkbox" name="terms" required id="flexCheckDefault">
                                            <label class="form-check-label" for="flexCheckDefault">
                                                 {{ __('reps.agreeing_to') }} <a href="{{ route('rep.terms') }}" target="_blank" class="underline"> {{ __('reps.terms_conditions') }} </a>
                                            </label>
                                        </div>
                                    </div>
                                    <div class="col-lg-6">
                                        <p class="p text-end color-primary">
                                            <small>
                                                <i class="fas fa-exclamation-circle color-primary me-1"></i> 
                                                {{ __('reps.note_rep_works_app') }}
                                            </small>
                                        </p>
                                    </div>
                                </div>
                                <div class="d-flex justify-content-center mt-5">
                                    <button type="submit" class="butn primary_butn px-5 py-3 me-2"> 
                                        {{ __('reps.register_new_account') }} 
                                    </button>
                                </div>
                            </form>
                        </div>
                    </div>
                </div>
            </div>
        </section>
    </main>
@endsection

@section('inject_js')

@endsection