201 lines
7.4 KiB
PHP
Executable File
201 lines
7.4 KiB
PHP
Executable File
@extends('merchbay_main')
|
|
@section('main-content')
|
|
{{-- <style>
|
|
.error {
|
|
color: red;
|
|
}
|
|
|
|
.g-recaptcha {
|
|
width: 100%;
|
|
}
|
|
</style>
|
|
|
|
<div class="wrapper bg-white pb-5">
|
|
<div class="main__content">
|
|
<div class="container">
|
|
<div class="row justify-content-center">
|
|
<div class="col col-lg-5 pt-5 text-center text-lg-start">
|
|
<h4>Register</h4>
|
|
<p> <strong>Please fill in registration form to complete purchase.</strong></p>
|
|
<hr class="custom-hr" />
|
|
</div>
|
|
</div>
|
|
<div class="row justify-content-center">
|
|
<div class="col col-lg-5">
|
|
<div id="register-response-msg"></div>
|
|
<form role="form" id="frm-register">
|
|
<input type="hidden" name="redirect" value="{{ Request::get('redirectUrl') }}">
|
|
<input type="hidden" name="_token" value="{{ csrf_token() }}">
|
|
|
|
<div class="text-center my-3 clearfix">
|
|
<strong>Personal Information</strong>
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">First name</label>
|
|
<input type="text" class="form-control" name="firstname" placeholder="First name">
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">Last name</label>
|
|
<input type="text" class="form-control" name="lastname" placeholder="Last name">
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">Email Address</label>
|
|
<input type="email" class="form-control" name="email" value="{{ old('email') }}" placeholder="Email Address">
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">Phone Number</label>
|
|
<input type="text" class="form-control" name="mobilenumber" placeholder="Phone Number">
|
|
</div>
|
|
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">Password</label>
|
|
<input type="password" class="form-control" name="password" id="password" required placeholder="Password">
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">Confirm Password</label>
|
|
<input type="password" class="form-control" name="password_confirmation" placeholder="Confirm Password" data-rule-equalTo="#password" required>
|
|
</div>
|
|
|
|
<!-- <div class="mb-3">
|
|
<label class="control-label">Username</label>
|
|
<input type="text" class="form-control" name="username" value="{{ old('username') }}" placeholder="Username">
|
|
</div> -->
|
|
|
|
<div class="text-center my-3 clearfix">
|
|
<strong>Address Information</strong>
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">Select Country</label>
|
|
<select name="countryCode" id="select_country" class="form-control" onchange="selectCountry(this)">
|
|
<option value="">Select Country</option>
|
|
<option value="US">United States</option>
|
|
<option value="CA">Canada</option>
|
|
</select>
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">State / Province</label>
|
|
<label></label>
|
|
<select class="form-control" name="state" id="lst-states">
|
|
<option value="">Select State</option>
|
|
</select>
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">City</label>
|
|
<select class="form-control" name="city" id="lst-cities">
|
|
<option value="">Select City</option>
|
|
</select>
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">Address 1</label>
|
|
<!-- <textarea type="text" class="form-control" name="address" placeholder="Please enter your House Number, Building and Street Name"></textarea> -->
|
|
<input type="text" class="form-control" name="address" placeholder="Address 1">
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">Address 2</label>
|
|
<!-- <textarea type="text" class="form-control" name="address" placeholder="Please enter your House Number, Building and Street Name"></textarea> -->
|
|
<input type="text" class="form-control" name="address2" placeholder="Address 2">
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<label class="control-label">Zip Code</label>
|
|
<input type="text" class="form-control" name="zipcode" placeholder="Please enter your zip code">
|
|
</div>
|
|
|
|
<div class="mb-3">
|
|
<div class="g-recaptcha text-center" data-sitekey="{{ env('CAPTCHA_SITE_KEY') }}"></div>
|
|
</div>
|
|
<button type="submit" class="btn btn-black btn-sm w-100 mt-3">
|
|
Register
|
|
</button>
|
|
</form>
|
|
<hr class="custom-hr" />
|
|
<div class="py-3 text-start">
|
|
Have already an account?
|
|
<a href="{{ url('./auth/login') }}" class="btn btn-green btn-sm w-100">Login here</a>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</div> --}}
|
|
<section class="login">
|
|
<div class="container-fluid">
|
|
<div class="row align-items-center">
|
|
<div class="col-lg-6">
|
|
<div class="row gx-5 justify-content-center align-items-center">
|
|
<div class="col-lg-8 text-start">
|
|
<h3>Create free account and start designing merch.</h3>
|
|
<!-- <div class="horizontal-divider bg-yellow"></div> -->
|
|
</div>
|
|
|
|
<div class="col-lg-8 mt-5">
|
|
<form action="">
|
|
<div class="mb-3">
|
|
<input
|
|
type="text"
|
|
class="form-control form-control-lg contact-input-custom"
|
|
placeholder="Email Address*"
|
|
required
|
|
/>
|
|
</div>
|
|
<div class="mb-3">
|
|
<input
|
|
type="password"
|
|
class="form-control form-control-lg contact-input-custom"
|
|
required
|
|
placeholder="Password*"
|
|
/>
|
|
</div>
|
|
<div class="mb-3">
|
|
<input
|
|
type="password"
|
|
class="form-control form-control-lg contact-input-custom"
|
|
required
|
|
placeholder="Confirm Password*"
|
|
/>
|
|
</div>
|
|
<!-- <div class="mb-3">
|
|
<input
|
|
type="text"
|
|
class="form-control form-control-lg contact-input-custom"
|
|
id="exampleFormControlInput1"
|
|
placeholder="Phone Number*"
|
|
/>
|
|
</div>
|
|
<div class="mb-3">
|
|
<textarea
|
|
class="form-control form-control-lg contact-input-custom"
|
|
required
|
|
rows="5"
|
|
placeholder="What can we help you with?"
|
|
></textarea>
|
|
</div> -->
|
|
|
|
<div class="mb-3">
|
|
<button class="btn btn-lg btn-contact w-100">Submit</button>
|
|
</div>
|
|
|
|
<p class="text-start">
|
|
Already have an account?
|
|
<a href="{{ url('./auth/login') }}">Login</a>
|
|
</p>
|
|
</form>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<div class="col login-page-right"></div>
|
|
</div>
|
|
</div>
|
|
</section>
|
|
@endsection |