@extends('master') @section('title') Innoxico Researched Report @stop @section('styles') @stop @section('content') @include('partials.nav')

Inoxico Researched Report


@if($errors->first('contactNumber')) {{ Form::text('contactNumber', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]) }} @else @endif
@if($errors->first('email')) {{ Form::email('email', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]) }} @else @endif
{{ Form::text('currency') }}
{{ Form::radio('consent1', 'YES', false) }} Yes {{ Form::radio('consent1', 'NO', false) }} No
{{ Form::radio('subject', 'YES', false) }} Yes {{ Form::radio('subject', 'NO', false) }} No
{{ Form::textarea('instructions') }}

Upload supporting files

{{ Form::file('file1') }}
{{ Form::file('file2') }}

Bank Account Information

@if($errors->first('accountHolder')) {{ Form::text('accountHolder', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]) }} @else @endif
{{ Form::radio('bankCodeRequest', 'YES', false) }} Yes {{ Form::radio('bankCodeRequest', 'NO', false) }} No
@if($errors->first('bank')) @else @endif
@if($errors->first('enquiryCurrency')) {{ Form::text('enquiryCurrency') }} @else {{ Form::text('enquiryCurrency') }} @endif
@if($errors->first('branch')) {{ Form::text('branch', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]) }} @else @endif
@if($errors->first('branchName')) {{ Form::text('branchName', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]) }} @else @endif
@if($errors->first('terms')) @else @endif
@if($errors->first('amount')) {{ Form::text('amount', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]) }} @else @endif
@if($errors->first('accountNumber')) {{ Form::text('accountNumber', '', ['class' => 'formFieldGrey', 'style'=>"border: 2px solid rgba(255, 0, 0, 0.3)"]) }} @else @endif
@if($errors->first('accountType')) @else @endif

@include('partials.footer') @stop @section('scripts') @stop