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

<main>

    <!-- ---------- breadcrumb ----------- -->
    <div class="breadcrumb_links">
        <div class="container">
            <div class="links">
                <a href="<?php echo e(route('home')); ?>"> <i class="fas fa-home"></i> </a>
                <a href="<?php echo e(route('courses.index')); ?>"> <?php echo e(__('web.courses')); ?> </a>
                <a href="<?php echo e(route('courses.show',$course->id)); ?>"> <?php echo e($course->name); ?> </a>
                <a href="#"> <?php echo e($title); ?> </a>
            </div>
        </div>
    </div>

    <!-- ---------- pg_course_details ----------- -->
    <section class="pg_course_details">
        <div class="bg_title">
            <div class="container">
                <div class="row">
                    <div class="col-lg-8">
                        <div class="title_cont pb-5 mb-3">
                            <h1> <?php echo e(__('web.please_fill')); ?> </h1>
                        </div>
                    </div>
                </div>
            </div>
            <img src="<?php echo e($course->image_url); ?>" alt="" class="bg">
        </div>
        <div class="container">
            <div class="application_form section_padding">
                <form action="<?php echo e($action); ?>" method="POST" onsubmit="formAction(this)" class="form">
                    <?php echo csrf_field(); ?>
                    <div class="form_box">
                        <div class="proccess_line">
                            <span class="active"></span>
                            <span></span>
                        </div>
                        <h4 class="box_title pb-3 mb-4 border-bottom text-capitalize"> <?php echo e(__('web.personal_info')); ?> </h4>
                        <div class="row">
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.name')); ?> </h6>
                                    <input type="text" name="name" class="form-control" placeholder=" <?php echo e(__('web.write_here')); ?>... ">
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.phone')); ?> </h6>
                                    <input type="number" name="phone" class="form-control" placeholder=" <?php echo e(__('web.write_here')); ?>... ">
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.email')); ?> </h6>
                                    <input type="email" name="email" class="form-control" placeholder=" <?php echo e(__('web.write_here')); ?>... ">
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.gender')); ?> </h6>
                                    <div class="check_group">
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" name="gender" id="gender1" value="male">
                                            <label class="form-check-label" for="gender1"> <?php echo e(__('web.male')); ?> </label>
                                        </div>
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" name="gender" id="gender2" value="female">
                                            <label class="form-check-label" for="gender2"> <?php echo e(__('web.female')); ?> </label>
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.age')); ?> </h6>
                                    <input type="number" name="age" class="form-control" placeholder=" <?php echo e(__('web.write_here')); ?>... ">
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.date_of_birth')); ?> </h6>
                                    <input type="text" name="date_of_birth" class="form-control" placeholder=" <?php echo e(__('web.write_here')); ?>... " id="datepicker">
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.national_id')); ?> </h6>
                                    <input type="text" name="national_id" class="form-control" placeholder=" <?php echo e(__('web.write_here')); ?>... ">
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.nationality')); ?> </h6>
                                    <input type="text" name="nationality" class="form-control" placeholder=" <?php echo e(__('web.write_here')); ?>... ">
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.marital_status')); ?> </h6>
                                    <div class="check_group">
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" name="marital" id="marital1" value="married">
                                            <label class="form-check-label" for="marital1"> <?php echo e(__('web.married')); ?> </label>
                                        </div>
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" name="marital" id="marital2" value="single">
                                            <label class="form-check-label" for="marital2"> <?php echo e(__('web.single')); ?> </label>
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.district')); ?>  </h6>
                                    <input type="text" name="district" class="form-control" placeholder=" <?php echo e(__('web.write_here')); ?>... ">
                                </div>
                            </div>
                            <div class="col-lg-6">
                                <div class="form-group mb-3">
                                    <h6 class="mb-2"> <?php echo e(__('web.process_status')); ?> </h6>
                                    <div class="check_group flex-wrap">
                                        <?php $__currentLoopData = $processes; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $row): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
                                        <div class="form-check form-check-inline">
                                            <input class="form-check-input" type="radio" name="process_id[]" id="status<?php echo e($row->id); ?>" value="<?php echo e($row->id); ?>">
                                            <label class="form-check-label" for="status<?php echo e($row->id); ?>"> <?php echo e($row->name); ?> </label>
                                        </div>
                                        <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
                                    </div>
                                </div>
                            </div>
                        </div>
                        <div class="form-group mt-5 text-center">
                            <button type="submit" class="butn px-5 py-3"> <span> <?php echo e(__('web.next')); ?> <i class="fad fa-sign-in ms-2"></i> </span> </button>
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </section>


</main>


<?php $__env->startSection('inject_js'); ?>
    <script>
        $(document).on("change", ".file", function() {
            $(this)
                .parent()
                .find(".input_ques")
                .val(
                    $(this)
                        .val()
                        .replace(/C:\\fakepath\\/i, "")
                );
        });
    </script>

    <script>
        $(function() {
            $("#datepicker").datepicker({
                changeMonth: true,
                changeYear: true,
                // showButtonPanel: true,
                dateFormat: 'yy-mm-dd',
                yearRange: '1950:2013',
            });
        });
    </script>
<?php $__env->stopSection(); ?>


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

<?php echo $__env->make('web.layouts.layout', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH /home/omaralyomhost/public_html/ntc/resources/views/web/pages/courses/apply_course.blade.php ENDPATH**/ ?>