HEX
Server: Microsoft-IIS/8.5
System: Windows NT YDAWBH120 6.3 build 9600 (Windows Server 2012 R2 Standard Edition) AMD64
User: tentjecom_web (0)
PHP: 7.4.14
Disabled: NONE
Upload Files
File: D:/HostingSpaces/SBogers27/dndin.nl/resources/views/site/auth/register.blade.php
@extends('site.master')

@section('content')
    <div class="container">
        <div class="row">
            <div class="grid-col col-md-12">
                <div class="panel panel-default">
                    <div class="panel-heading">Register</div>

                    <div class="panel-body">
                        <form class="form-horizontal" method="POST" action="{{ route('register') }}">
                            {{ csrf_field() }}

                            <div class="form-group{{ $errors->has('first_name') || $errors->has('last_name') ? ' has-error' : '' }}">
                                <label for="first_name" class="grid-col grid-col col-md-4 control-label">@lang('auth.first_name')</label>
                                <div class="grid-col grid-col col-md-6">
                                    <input id="first_name" type="text" class="form-control" name="first_name" value="{{ old('first_name') }}" required autofocus>
                                    @if ($errors->has('first_name'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('first_name') }}</strong>
                                    </span>
                                    @endif
                                </div>
                                <label for="last_name" class="grid-col grid-col col-md-4 control-label">@lang('auth.last_name')</label>
                                <div class="grid-col grid-col col-md-6">
                                    <input id="last_name" type="text" class="form-control" name="last_name" value="{{ old('last_name') }}" required autofocus>
                                    @if ($errors->has('last_name'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('last_name') }}</strong>
                                    </span>
                                    @endif
                                </div>
                            </div>
                            <div class="grid-col col-md-12"></div>
                            {{-- Company info --}}
                            <div class="form-group{{ $errors->has('company_name') || $errors->has('chamber_of_commerce') ? ' has-error' : '' }}">
                                <label for="company_name" class="grid-col col-md-4 control-label">@lang('auth.company_name')</label>
                                <div class="grid-col col-md-6">
                                    <input id="company_name" type="text" class="form-control" name="company_name" value="{{ old('company_name') }}" required autofocus>
                                    @if ($errors->has('company_name'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('company_name') }}</strong>
                                    </span>
                                    @endif
                                </div>
                                <label for="chamber_of_commerce" class="grid-col col-md-4 control-label">@lang('company.chamber_of_commerce')</label>
                                <div class="grid-col col-md-6">
                                    <input id="chamber_of_commerce" type="text" class="form-control" name="chamber_of_commerce" value="{{ old('chamber_of_commerce') }}" required autofocus>
                                    @if ($errors->has('chamber_of_commerce'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('chamber_of_commerce') }}</strong>
                                    </span>
                                    @endif
                                </div>
                            </div>

                            <div class="form-group{{ $errors->has('company_street') || $errors->has('company_house_number') ? ' has-error' : '' }}">
                                <label for="company_street" class="grid-col col-md-4 control-label">@lang('auth.company_street')</label>
                                <div class="grid-col col-md-6">
                                    <input id="company_street" type="text" class="form-control" name="company_street" value="{{ old('company_street') }}" required autofocus>
                                    @if ($errors->has('company_street'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('company_street') }}</strong>
                                    </span>
                                    @endif
                                </div>
                                <label for="company_house_number" class="grid-col col-md-4 control-label">@lang('auth.company_house_number')</label>
                                <div class="grid-col col-md-6">
                                    <input id="company_house_number" type="text" class="form-control" name="company_house_number" value="{{ old('company_house_number') }}" required autofocus>
                                    @if ($errors->has('company_house_number'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('company_house_number') }}</strong>
                                    </span>
                                    @endif
                                </div>
                            </div>

                            <div class="form-group{{ $errors->has('company_zip_code') || $errors->has('company_city') ? ' has-error' : '' }}">
                                <label for="company_zip_code" class="grid-col col-md-4 control-label">@lang('auth.company_zip_code')</label>
                                <div class="grid-col col-md-6">
                                    <input id="company_zip_code" type="text" class="form-control" name="company_zip_code" value="{{ old('company_zip_code') }}" required autofocus>
                                    @if ($errors->has('company_zip_code'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('company_zip_code') }}</strong>
                                    </span>
                                    @endif
                                </div>
                                <label for="company_city" class="grid-col col-md-4 control-label">@lang('auth.company_city')</label>
                                <div class="grid-col col-md-6">
                                    <input id="company_city" type="text" class="form-control" name="company_city" value="{{ old('company_city') }}" required autofocus>
                                    @if ($errors->has('company_city'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('company_city') }}</strong>
                                    </span>
                                    @endif
                                </div>
                            </div>

                            <div class="form-group{{ $errors->has('company_country') || $errors->has('company_vat_number') ? ' has-error' : '' }}">
                                <label for="company_country" class="grid-col col-md-4 control-label">@lang('auth.company_country')</label>
                                <div class="grid-col col-md-6">
                                    <input id="company_country" type="text" class="form-control" name="company_country" value="{{ old('company_country') }}" required autofocus>
                                    @if ($errors->has('company_country'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('company_country') }}</strong>
                                    </span>
                                    @endif
                                </div>
                                <label for="company_vat_number" class="grid-col col-md-4 control-label">@lang('company.vat_number')</label>
                                <div class="grid-col col-md-6">
                                    <input id="company_vat_number" type="text" class="form-control" name="company_vat_number" value="{{ old('company_vat_number') }}" required autofocus>
                                    @if ($errors->has('company_vat_number'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('company_vat_number') }}</strong>
                                    </span>
                                    @endif
                                </div>
                            </div>
                            <div class="grid-col col-md-12"></div>
                            {{-- Shipping info --}}
                            <div class="form-group{{ $errors->has('shipping_street') || $errors->has('shipping_house_number') ? ' has-error' : '' }}">
                                <label for="shipping_street" class="grid-col col-md-4 control-label">@lang('auth.company_street')</label>
                                <div class="grid-col col-md-6">
                                    <input id="shipping_street" type="text" class="form-control" name="shipping_street" value="{{ old('shipping_street') }}" required autofocus>
                                    @if ($errors->has('shipping_street'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('shipping_street') }}</strong>
                                    </span>
                                    @endif
                                </div>
                                <label for="shipping_house_number" class="grid-col col-md-4 control-label">@lang('auth.company_house_number')</label>
                                <div class="grid-col col-md-6">
                                    <input id="shipping_house_number" type="text" class="form-control" name="shipping_house_number" value="{{ old('shipping_house_number') }}" required autofocus>
                                    @if ($errors->has('shipping_house_number'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('shipping_house_number') }}</strong>
                                    </span>
                                    @endif
                                </div>
                            </div>

                            <div class="form-group{{ $errors->has('shipping_zip_code') || $errors->has('shipping_city') ? ' has-error' : '' }}">
                                <label for="shipping_zip_code" class="grid-col col-md-4 control-label">@lang('auth.company_zip_code')</label>
                                <div class="grid-col col-md-6">
                                    <input id="shipping_zip_code" type="text" class="form-control" name="shipping_zip_code" value="{{ old('shipping_zip_code') }}" required autofocus>
                                    @if ($errors->has('shipping_zip_code'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('shipping_zip_code') }}</strong>
                                    </span>
                                    @endif
                                </div>
                                <label for="shipping_city" class="grid-col col-md-4 control-label">@lang('auth.company_city')</label>
                                <div class="grid-col col-md-6">
                                    <input id="shipping_city" type="text" class="form-control" name="shipping_city" value="{{ old('shipping_city') }}" required autofocus>
                                    @if ($errors->has('shipping_city'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('shipping_city') }}</strong>
                                    </span>
                                    @endif
                                </div>
                            </div>

                            <div class="form-group{{ $errors->has('shipping_country') ? ' has-error' : '' }}">
                                <label for="shipping_country" class="grid-col col-md-4 control-label">@lang('auth.company_country')</label>
                                <div class="grid-col col-md-6">
                                    <input id="shipping_country" type="text" class="form-control" name="shipping_country" value="{{ old('shipping_country') }}" required autofocus>
                                    @if ($errors->has('shipping_country'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('shipping_country') }}</strong>
                                    </span>
                                    @endif
                                </div>
                            </div>

                            <div class="form-group{{ $errors->has('email') || $errors->has('telephone') ? ' has-error' : '' }}">
                                <label for="email" class="grid-col col-md-4 control-label">@lang('auth.email_address')</label>
                                <div class="grid-col col-md-6">
                                    <input id="email" type="email" class="form-control" name="email" value="{{ old('email') }}" required>

                                    @if ($errors->has('email'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('email') }}</strong>
                                    </span>
                                    @endif
                                </div>
                                <label for="telephone" class="grid-col col-md-4 control-label">@lang('auth.telephone')</label>
                                <div class="grid-col col-md-6">
                                    <input id="telephone" type="text" class="form-control" name="telephone" value="{{ old('telephone') }}" required autofocus>
                                    @if ($errors->has('telephone'))
                                        <span class="help-block">
                                        <strong>{{ $errors->first('telephone') }}</strong>
                                    </span>
                                    @endif
                                </div>
                            </div>

                            {{--<div class="form-group{{ $errors->has('password') ? ' has-error' : '' }}">--}}
                                {{--<label for="password" class="grid-col col-md-4 control-label">Password</label>--}}

                                {{--<div class="grid-col col-md-6">--}}
                                    {{--<input id="password" type="password" class="form-control" name="password" required>--}}

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

                            {{--<div class="form-group">--}}
                                {{--<label for="password-confirm" class="grid-col col-md-4 control-label">Confirm Password</label>--}}

                                {{--<div class="grid-col col-md-6">--}}
                                    {{--<input id="password-confirm" type="password" class="form-control" name="password_confirmation" required>--}}
                                {{--</div>--}}
                            {{--</div>--}}

                            <div class="form-group">
                                <div class="grid-col col-md-6 col-md-offset-4">
                                    <button type="submit" class="btn btn-primary">
                                        Register
                                    </button>
                                </div>
                            </div>
                        </form>
                    </div>
                </div>
            </div>
        </div>
    </div>
@endsection