@extends('layouts.default')
@section('content')

<!-- page content -->
<div class="right_col" role="main">
  	<div class="">
	    <div class="page-title">
	      	<div class="title_left">
	        	<h3>Submit To Vendor</h3>
	      	</div>
	    </div>
    	<div class="clearfix"></div>
	    <div class="row">
	      	<div class="col-md-12 col-sm-12 col-xs-12">
	      		{{ Userdefined::showMessage() }}
		        <div class="x_panel">
		          	<div class="x_content">
			            <form id="submit_vendor_form" class="form-horizontal form-label-left" method="post" action="{{ url('benchsalesSubmitVendorIndividual') }}" data-toggle="validator" role="form">
			            	<input type="hidden" name="student_id" value="{{ $employee->si_no }}">
			              	<div class="row">
		              			<fieldset>
		              				<legend>Candidate Details</legend>
		              				<div class="row">
		              					<div class="col-md-4 col-sm-4 col-xs-12 form-group">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Name</label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<label class="control-label" style="font-weight: 500">{{ $employee->name }}</label>
	    									</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Email</label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<label class="control-label" style="font-weight: 500">{{ $employee->email }}</label>
	    									</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Mobile</label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<label class="control-label" style="font-weight: 500">{{ $employee->mobile }}</label>
	    									</div>
						                </div>
		              				</div>
		              			</fieldset>
		              			<fieldset>
			              			<legend>Vendor Details</legend>
			              			<div class="row">
					              		<div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
					              			<input type="hidden" id="vendor_id" name="vendor_id">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Company Name<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="text" id="vendor_company_name" name="vendor_company_name" class="form-control" required maxlength="100">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Name<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="text" id="vendor_name" name="vendor_name" class="form-control" required maxlength="100">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Email<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="email" id="vendor_email" name="vendor_email" class="form-control" pattern="[a-z0-9._-]+@[a-z0-9.-]+\.[a-z.]{2,}$" data-pattern-error="Also, include a TLD. (Example: .com, .co.in, .co.us ...)" required maxlength="50">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
					               	</div>
					               	<div class="row">
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Mobile<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="text" id="vendor_mobile" name="vendor_mobile" class="form-control" data-inputmask="'mask' : '(999) 999-9999'" pattern="^[\+]?[(]?[0-9]{3}[)]?[-\s\.]?[0-9]{3}[-\s\.]?[0-9]{4,6}$" data-pattern-error="Valid Mobile Number Format. Example:(011) 123-4567" required maxlength="14">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Website<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="text" id="vendor_website" name="vendor_website" class="form-control" pattern="^[a-z]+\.[a-zA-Z0-9.-]+\.[a-zA-Z]{2,5}\.?" data-pattern-error="Valid URL. Example: www.website.com, .co.in, .co.us ..." required maxlength="100">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Country<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<select id="vendor_country" name="vendor_country" class="form-control" required>
						                    		<option value="">Select Country</option>
						                    		@foreach($countries as $country)
						                    		<option value="{{ $country->id }}">{{ $country->name }}</option>
						                    		@endforeach
						                    	</select>
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
					                </div>
					                <div class="row">
					                	<div class="col-md-4 col-sm-4 col-xs-12 form-group">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">State</label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<select id="vendor_state" name="vendor_state" class="form-control">
						                    		<option value="">Select State</option>
						                    	</select>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">City</label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<select id="vendor_city" name="vendor_city" class="form-control">city
						                    		<option value="">Select City</option>
						                    	</select>
						                  	</div>
						                </div>
				              			<div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Role<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<select id="vendor_role" name="vendor_role" class="form-control" required>
						                    		<option value="">Select Role</option>
						                    		@foreach($roles as $role)
						                    		<option value="{{ $role->id }}">{{ $role->display_name }}</option>
						                    		@endforeach
						                    	</select>
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
					                </div>
					                <div class="row">
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Address</label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<textarea id="vendor_address" name="vendor_address" class="form-control"></textarea>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Pay Rate<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="text" id="vendor_payrate" name="vendor_payrate" class="form-control" required>
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
				              		</div>
			              		</fieldset>
			              		<fieldset>
			              			<legend>Job Details</legend>
			              			<div class="row">
					              		<div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Client Name<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="text" id="client_name" name="client_name" class="form-control" required maxlength="100">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Job Title<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="text" id="job_title" name="job_title" class="form-control" required maxlength="100">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Location<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<select id="job_location" name="job_location" class="form-control" required>
						                    		<option value="">Select Location</option>
						                    		@foreach($countries as $country)
						                    		<option value="{{ $country->id }}">{{ $country->name }}</option>
						                    		@endforeach
						                    	</select>
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
					                </div>
					                <div class="row">
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Experience</label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                  		<div class="col-md-6 col-sm-6 col-xs-12 form-group has-feedback">
						                    		<input type="text" id="job_experience_min" name="job_experience_min" class="form-control" maxlength="2" placeholder="Min" pattern="[0-9]+$" data-pattern-error="Only Digits please.">
						                    		<div class="help-block with-errors"></div>
					                    		</div>
					                    		<div class="col-md-6 col-sm-6 col-xs-12 form-group has-feedback">
						                    		<input type="text" id="job_experience_max" name="job_experience_max" class="form-control" maxlength="2" placeholder="Max" pattern="[0-9]+$" data-pattern-error="Only Digits please.">
						                    		<div class="help-block with-errors"></div>
						                    	</div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Interview Mode<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<select id="job_interview_mode" name="job_interview_mode" class="form-control" required>
						                    		<option value="">Select Interview Mode</option>
						                    		<option value="telephonic">Telephonic</option>
						                    		<option value="face_to_face">Face to Face</option>
						                    	</select>
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Employment Type<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<select id="job_employment_type" name="job_employment_type" class="form-control" required>
						                    		<option value="">Select Employment Type</option>
						                    		<option value="c2c">C2C</option>
						                    		<option value="contract_to_hire">Contract to Hire</option>
						                    		<option value="full_time">Full Time</option>
						                    		<option value="1099">1099</option>
						                    	</select>
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
					                </div>
					                <div class="row">
					                	<div class="col-md-8 col-sm-8 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-2 col-sm-2 col-xs-12">Description<i class="mandatory">*</i></label>
						                  	<div class="col-md-10 col-sm-10 col-xs-12">
						                    	<textarea class="form-control" id="job_description" name="job_description" required></textarea>
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Internal Message</label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<textarea class="form-control" id="job_internal_message" name="job_internal_message"></textarea>
						                  	</div>
						                </div>
					                </div>
		              			</fieldset>
		              			<fieldset>
			              			<legend>Implementer Details</legend>
			              			<div class="row">
					              		<div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Company Name<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="text" id="implementer_company_name" name="implementer_company_name" class="form-control" required maxlength="100">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Name<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="text" id="implementer_name" name="implementer_name" class="form-control" required maxlength="100">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Email<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="email" id="implementer_email" name="implementer_email" class="form-control" pattern="[a-z0-9._-]+@[a-z0-9.-]+\.[a-z.]{2,}$" data-pattern-error="Also, include a TLD. (Example: .com, .co.in, .co.us ...)" required maxlength="50">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
					                </div>
					                <div class="row">
						                <div class="col-md-4 col-sm-4 col-xs-12 form-group has-feedback">
						                  	<label class="control-label col-md-5 col-sm-5 col-xs-12">Mobile<i class="mandatory">*</i></label>
						                  	<div class="col-md-7 col-sm-7 col-xs-12">
						                    	<input type="text" id="implementer_mobile" name="implementer_mobile" class="form-control" data-inputmask="'mask' : '(999) 999-9999'" pattern="^[\+]?[(]?[0-9]{3}[)]?[-\s\.]?[0-9]{3}[-\s\.]?[0-9]{4,6}$" data-pattern-error="Valid Mobile Number Format. Example:(011) 123-4567" required maxlength="14">
						                    	<div class="help-block with-errors"></div>
						                  	</div>
						                </div>
					                </div>
		              			</fieldset>
			              	</div>
			              	<div class="ln_solid"></div>
			              	<div class="form-group">
				                <div class="col-md-12 col-sm-12 col-xs-12 text-right">
				                  	<button class="btn btn-primary btn-sm" type="reset">Reset</button>
				                  	<button type="submit" class="btn btn-success btn-sm" name="submit_vendor" value="1">Submit</button>
				                </div>
			              	</div>
			              	{{ csrf_field() }}
			            </form>
		          	</div>
		        </div>
	      	</div>
	    </div>
  	</div>
</div>
<!-- /page content -->
<script type="text/javascript">
$(document).ready(function(){
	$("#vendor_country").change(function(){
		var country = $("#vendor_country").val();

		$("#vendor_state").empty();
		$("#vendor_city").empty();
		$.ajax({
			url: '