@extends('master')

@section('title')
     Bank Code Report
@stop

@section('styles')
<style>

</style>
@stop

@section('content')

<img style="max-width: 30%;display: block; margin-top: -3rem; margin-left: auto; margin-right: auto;" src="/img/Prestige_Logo.jpg" />
<a  href="/bank-code-options"><button style="    margin-left: 32rem;
                                         padding-bottom: 0.01rem;
                                         margin-top: 2rem;
                                         padding-left: 0rem;
                                         padding-right: 3rem;
                                         background-color: #093c68;
                                         padding-top: 1rem;"><i style="font-size: 1rem;" class="fa fa-arrow-circle-left" aria-hidden="true"></i>Back</button></a>

<h1>Request Commercial/Business Bank Code Report</h1>
<p style="text-align: center;">Bank Code (24hrs) - Including bank code history</p>

{{ Form::open() }}
<div class="row">
    <div class="large-6 columns">
        <label>Account Holder <small class="red">{{ $errors->first('accountHolder') }}</small></label>
        {{ Form::text('accountHolder') }}
    </div>
    <div class="large-6 columns">
        <label>Registration or ID Number <small class="red">{{ $errors->first('idNumber') }}</small></label>
        {{ Form::text('idNumber') }}
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <label>Bank Name <small class="red">{{ $errors->first('bank') }}</small></label>
        {{ Form::select('bank', [
                 '' => 'Please Select',
                 'ASBA' => 'ASBA',
                 'NEDBANK' => 'NEDBANK',
                 'STANDARD' => 'STANDARD BANK',
                 'FNB' => 'FNB',
                 'MERCANTILE' => 'MERCANTILE',
                 'BANK OF ATHENS' => 'BANK OF ATHENS',
                 'CITI BANK' => 'CITI BANK',
                 'HSBC' => 'HSBC',
                 'HBZ' => 'HBZ',
                 'HABIB BANK' => 'HABIB BANK',
                 'INVESTEC' => 'INVESTEC']
                                    ) }}
    </div>
    <!--
    <div class="large-6 columns">
        <label>Bank Country <small class="red">{{ $errors->first('country') }}</small></label>
            <select id="country" 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>
    </div> -->
</div>

<div class="row">
    <div class="large-6 columns">
        <label>Branch Code <small class="red">{{ $errors->first('branch') }}</small></label>
        {{ Form::text('branch') }}
    </div>
    <div class="large-6 columns">
         <label>Branch Name <small class="red">{{ $errors->first('branchName') }}</small></label>
         {{ Form::text('branchName') }}
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
        <label>Terms <small class="red">{{ $errors->first('terms') }}</small></label>
        <select id="terms" 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>
    </div>
    <div class="large-6 columns">
        <label>Amount <small class="red">{{ $errors->first('amount') }}</small></label>
        {{ Form::text('amount') }}
    </div>
</div>

<div class="row">
    <div class="large-6 columns">
         <label>Account Number <small class="red">{{ $errors->first('accountNumber') }}</small></label>
         {{ Form::text('accountNumber') }}
    </div>
    <div class="large-6 columns">
        <label>Account Type <small class="red">{{ $errors->first('accountType') }}</small></label>
         <select id="accountType" name="accountType" >
            <option value ="CUR" >Savings</option>
            <option value ="CUR" >Check</option>
            <option value ="CUR" >Transmission</option>
            <option value ="BON" >Bond</option>
            <option value ="SUB" >Subscription Share acc</option>
         </select>
    </div>
</div>

<button class="myButton" type="submit">Submit</button>

{{ Form::close() }}

@stop