<?php $__env->startSection('title'); ?>
     Bank Code Report
<?php $__env->stopSection(); ?>

<?php $__env->startSection('styles'); ?>
<style>

</style>
<?php $__env->stopSection(); ?>

<?php $__env->startSection('content'); ?>

<?php echo $__env->make('partials.nav', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
<h1>Principal Bank Code (24 Hour Delivery)</h1>
<p>A direct enquiry at the corresponding bank, allowing us to understand the strength of the applicants banking account and cash flow based on set amounts (usually double the amount the application is made for i.e. 50,000 credit would justify 100,000 bank code. This way you know you are safe.
   Standard Bank Code (24 hour bank code)</p>
<hr style="margin-top: 10px;">

<form id="mainForm" method="POST" action="/individual-bank-code" accept-charset="UTF-8" enctype="multipart/form-data">

<div class="row">
    <div class="large-6 columns">
         <!-- required -->
        <?php if($errors->first('surname')): ?>
            <label class="red">Surname *</label>
            <?php echo Form::text('surname', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]); ?>

        <?php else: ?>
            <label>Surname *</label>
            <input type="text" id="surname" name="surname" class="formFieldGrey" onkeyup="checkFormsValidity();" required/>
        <?php endif; ?>
    </div>
    <div class="large-6 columns">
        <!-- required -->
        <?php if($errors->first('forename1')): ?>
            <label class="red">Forename 1 *</label>
            <?php echo Form::text('forename1', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]); ?>

        <?php else: ?>
            <label>Forename 1 *</label>
            <input type="text" id="forename1" name="forename1" class="formFieldGrey" onkeyup="checkFormsValidity();" required/>
        <?php endif; ?>
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <label>Forename2 - <em>(if applicable)</em></label>
        <?php echo Form::text('forename2'); ?>

    </div>
    <div class="large-6 columns">
        <label>Forename3 - <em>(if applicable)</em></label>
        <?php echo Form::text('forename3'); ?>

    </div>
</div>

<div class="row">
    <div class="large-6 columns">
         <!-- required -->
        <?php if($errors->first('accountHolder')): ?>
            <label class="red">Account Holder *</label>
            <?php echo Form::text('accountHolder', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]); ?>

        <?php else: ?>
            <label>Account Holder *</label>
            <input type="text" id="accountHolder" name="accountHolder" class="formFieldGrey" onkeyup="checkFormsValidity();" required/>
        <?php endif; ?>
    </div>
    <div class="large-6 columns">
        <!-- required -->
        <?php if($errors->first('idNumber')): ?>
            <label class="red">ID Number *</label>
            <?php echo Form::text('idNumber', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]); ?>

        <?php else: ?>
            <label>ID Number *</label>
            <input type="text" id="idNumber" name="idNumber" class="formFieldGrey" onkeyup="checkFormsValidity();" required/>
        <?php endif; ?>
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <!-- required -->
        <?php if($errors->first('bank')): ?>
            <label class="red">Bank *</label>
            <select style="border: 2px solid rgba(255, 0, 0, 0.3);" name="bank">
              <option value="">Please Select</option>
              <option value ="ASBA" >ASBA</option>
              <option value ="NEDBANK" >NEDBANK</option>
              <option value ="STANDARD" >STANDARD BANK</option>
              <option value ="FNB" >FNB</option>
              <option value ="MERCANTILE" >MERCANTILE</option>
              <option value ="BANK OF ATHENS" >BANK OF ATHENS</option>
              <option value ="CITI BANK" >CITI BANK</option>
              <option value ="HSBC" >HSBC</option>
              <option value ="HBZ" >HBZ</option>
              <option value ="HABIB BANK" >HABIB BANK</option>
              <option value ="INVESTEC" >INVESTEC</option>
            </select>
        <?php else: ?>
            <label>Bank *</label>
            <select name="bank" onchange="checkFormsValidity();" required>
            <option value="">Please Select</option>
            <option value ="ASBA" >ASBA</option>
            <option value ="NEDBANK" >NEDBANK</option>
            <option value ="STANDARD" >STANDARD BANK</option>
            <option value ="FNB" >FNB</option>
            <option value ="MERCANTILE" >MERCANTILE</option>
            <option value ="BANK OF ATHENS" >BANK OF ATHENS</option>
            <option value ="CITI BANK" >CITI BANK</option>
            <option value ="HSBC" >HSBC</option>
            <option value ="HBZ" >HBZ</option>
            <option value ="HABIB BANK" >HABIB BANK</option>
            <option value ="INVESTEC" >INVESTEC</option>
            </select>
        <?php endif; ?>
    </div>
    <div class="large-6 columns">
        <!-- required -->
        <?php if($errors->first('country')): ?>
            <label class="red">Bank Country *</label>
            <select style="border: 2px solid rgba(255, 0, 0, 0.3);" name="country">
              <option value ="ZAF" >South Africa</option>
              <option value ="BWA" >Botswana</option>
              <option value ="LSO" >Lesotho</option>
              <option value ="MWI" >Malawi</option>
              <option value ="NAM" >Namibia</option>
              <option value ="SWZ" >Swaziland</option>
              <option value ="ZWE" >Zimbabwe</option>
            </select>
        <?php else: ?>
            <label>Bank Country *</label>
            <select name="country" onchange="checkFormsValidity();" required>
            <option value="">Please Select</option>
              <option value ="ZAF" >South Africa</option>
              <option value ="BWA" >Botswana</option>
              <option value ="LSO" >Lesotho</option>
              <option value ="MWI" >Malawi</option>
              <option value ="NAM" >Namibia</option>
              <option value ="SWZ" >Swaziland</option>
              <option value ="ZWE" >Zimbabwe</option>
            </select>
        <?php endif; ?>
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <!-- required -->
        <?php if($errors->first('branchName')): ?>
            <label class="red">Branch Name *</label>
            <?php echo Form::text('branchName', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]); ?>

        <?php else: ?>
            <label>Branch Name *</label>
            <input type="text" id="branchName" name="branchName" class="formFieldGrey" onkeyup="checkFormsValidity();" required/>
        <?php endif; ?>
    </div>
    <div class="large-6 columns">
        <!-- required -->
        <?php if($errors->first('branchCode')): ?>
            <label class="red">Branch Code *</label>
            <?php echo Form::text('branchCode', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]); ?>

        <?php else: ?>
            <label>Branch Code *</label>
            <input type="text" id="branchCode" name="branchCode" class="formFieldGrey" onkeyup="checkFormsValidity();" required/>
        <?php endif; ?>
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <!-- required -->
        <?php if($errors->first('accountNumber')): ?>
            <label class="red">Account Number *</label>
            <?php echo Form::text('accountNumber', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]); ?>

        <?php else: ?>
            <label>Account Number *</label>
            <input type="text" id="accountNumber" name="accountNumber" class="formFieldGrey" onkeyup="checkFormsValidity();" required/>
        <?php endif; ?>
    </div>
    <div class="large-6 columns">
        <!-- required -->
        <?php if($errors->first('accountType')): ?>
            <label class="red">Account Type *</label>
            <select style="border: 2px solid rgba(255, 0, 0, 0.3);" name="accountType">
              <option value="">Please Select</option>
              <option value ="CUR" >Savings</option>
              <option value ="CUR" >Cheque</option>
              <option value ="CUR" >Transmission</option>
              <option value ="BON" >Bond</option>
              <option value ="SUB" >Subscription Share acc</option>
            </select>
        <?php else: ?>
            <label>Account Type *</label>
            <select name="accountType" onchange="checkFormsValidity();" required>
            <option value="">Please Select</option>
                <option value ="CUR" >Savings</option>
                <option value ="CUR" >Cheque</option>
                <option value ="CUR" >Transmission</option>
                <option value ="BON" >Bond</option>
                <option value ="SUB" >Subscription Share acc</option>
            </select>
        <?php endif; ?>
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <!-- required -->
        <?php if($errors->first('amount')): ?>
            <label class="red">Amount *</label>
            <?php echo Form::text('amount', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]); ?>

        <?php else: ?>
            <label>Amount *</label>
            <input type="text" id="amount" name="amount" class="formFieldGrey" onkeyup="checkFormsValidity();" required/>
        <?php endif; ?>
    </div>
    <div class="large-6 columns">
        <!-- required -->
        <?php if($errors->first('terms')): ?>
            <label class="red">Terms *</label>
            <select style="border: 2px solid rgba(255, 0, 0, 0.3);" name="terms">
              <option value ="30" >30 Days</option>
              <option value ="60" >60 Days</option>
              <option value ="90" >90 Days</option>
              <option value ="120" >120 Days</option>
              <option value ="COD" >Cash On Delivery</option>
              <option value ="12" >12 Months</option>
              <option value ="24" >24 Months</option>
              <option value ="36" >36 Months</option>
            </select>
        <?php else: ?>
            <label>Terms *</label>
            <select name="terms" onchange="checkFormsValidity();" required>
            <option value="">Please Select</option>
                <option value ="30" >30 Days</option>
                <option value ="60" >60 Days</option>
                <option value ="90" >90 Days</option>
                <option value ="120" >120 Days</option>
                <option value ="COD" >Cash On Delivery</option>
                <option value ="12" >12 Months</option>
                <option value ="24" >24 Months</option>
                <option value ="36" >36 Months</option>
            </select>
        <?php endif; ?>
    </div>
</div>

<p style="text-align:center;">Supplier:</p>
<img style="margin-left:auto;margin-right: auto;display: block" width="10%" src="/img/compuscan_logo.jpg" />
<p style="text-align:center;">R<?php echo $compuscanBankCodePrincipal; ?></p>

<a href="#" data-reveal-id="offer11"><button class="myButton" id="submitBtn">Request</button></a>

        <div id="offer11" class="reveal-modal small" data-reveal aria-labelledby="modalTitle" aria-hidden="true" role="dialog">
		    <h1>Confirm Order</h1>
		    <p><strong>Service Provider: </strong> Compuscan</p>
		    <p><strong>Report type: </strong> Principal Bank Code</p>
		    <p><strong>Turnaround Time: </strong> 24 hours</p>
		    <p><strong>Amount Ex VAT: </strong> R<?php echo $compuscanBankCodePrincipal; ?></p>
		    <hr>
		    <span style="color:#daab2b;">By selecting “confirm Order” you agree to the terms and conditions provided to you in terms of your agreement with Prestige.</span>
            <hr>
           <button id="submit" class="myButton" type="submit">Confirm</button>
            <a class="close-reveal-modal" aria-label="Close">&#215;</a>
        </div>

</form>
<hr>
<?php echo $__env->make('partials.footer', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>
<?php $__env->stopSection(); ?>

<?php $__env->startSection('scripts'); ?>
<script src=<?php echo asset('https://ajax.googleapis.com/ajax/libs/jquery/3.1.1/jquery.min.js'); ?>></script>
<script>
var sbmtBtn = document.getElementById("submitBtn");
sbmtBtn.disabled = true;

checkFormsValidity = function(){
var myforms = document.forms["mainForm"];
    if (myforms.checkValidity()) {
        sbmtBtn.disabled = false;
    } else {
        sbmtBtn.disabled = true;
    }
}
</script>
<script>
    $('#submitBtn').click(function() {
         $('#lname').text($('#lastname').val());
         $('#fname').text($('#firstname').val());
    });

    $('#submit').click(function(){
        $('#mainForm').submit();
    });
</script>
<script>
document.getElementById("submit").onclick = function() {
    //disable
    this.disabled = true;
}
</script>
<?php $__env->stopSection(); ?>
<?php echo $__env->make('master', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>