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Upload File : current_dir [ Writeable ] document_root [ Writeable ]

<?php $__env->startSection('title', ''); ?>
<?php $__env->startSection('meta_title',''); ?>
<?php $__env->startSection('meta_description',''); ?>

<?php $__env->startSection('content'); ?>
<div class="row">
    <!--  start free space-->
    <div class="col-xs-16 col-md-4"></div>
    <!--  end start free space-->

    <!--  start create account-->
    <div class="col-xs-16 col-sm-8 col-md-8">
        <!--start title form-->
        <div class="log-in-title">
            <b>Request</b> offer<br/>
            <span class="programm">We will respond to you within 24 hours (Mon - Fri)</span>
        </div>
        <!--start title form-->

        <!--start form create account-->
        <div class="log-in">

            <?php if(session()->has('flash_notification.message')): ?>
                <div class="log-in-title">
                    <span class="programm"><?php echo session('flash_notification.message'); ?></span>
                </div>
            <?php else: ?>

            <!--start form-->
            <?php echo Form::open(array('url' => URL::to('corporateform'), 'method' => 'post', 'id'=>'sendForm')); ?>

            <div class="form-group">
                <label for="first_name">First name</label>
                <?php echo Form::text('first_name',null,['class'=>'form-control','id'=>'first_name']); ?>

                <?php if($errors->has('first_name')): ?>
                    <span class="text-error"><i class="fa fa-exclamation-triangle"></i> <?php echo e($errors->first('first_name', ':message')); ?></span>
                <?php endif; ?>
            </div>
            <div class="form-group">
                <label for="last_name">Last name</label>
                <?php echo Form::text('last_name',null,['class'=>'form-control','id'=>'last_name']); ?>

                <?php if($errors->has('last_name')): ?>
                    <span class="text-error"><i class="fa fa-exclamation-triangle"></i> <?php echo e($errors->first('last_name', ':message')); ?></span>
                <?php endif; ?>
            </div>
            <div class="form-group">
                <label for="company">Company</label>
                <?php echo Form::text('company',null,['class'=>'form-control','id'=>'company']); ?>

                <?php if($errors->has('company')): ?>
                    <span class="text-error"><i class="fa fa-exclamation-triangle"></i> <?php echo e($errors->first('company', ':message')); ?></span>
                <?php endif; ?>
            </div>
            <div class="form-group">
                <label for="phone">Phone number</label>
                <?php echo Form::text('phone',null,['class'=>'form-control','id'=>'phone']); ?>

                <?php if($errors->has('phone')): ?>
                    <span class="text-error"><i class="fa fa-exclamation-triangle"></i> <?php echo e($errors->first('phone', ':message')); ?></span>
                <?php endif; ?>
            </div>

            <div class="form-group">
                <label for="email">Email</label>
                <?php echo Form::email('email',null,['class'=>'form-control','id'=>'email']); ?>

                <?php if($errors->has('email')): ?>
                    <span class="text-error"><i class="fa fa-exclamation-triangle"></i> <?php echo e($errors->first('email', ':message')); ?></span>
                <?php endif; ?>
            </div>

            <div class="form-group">
                <label for="no_of_employees">Number of employees</label>
                <?php echo Form::number('no_of_employees',null,['class'=>'form-control','id'=>'no_of_employees','min'=>1]); ?>

                <?php if($errors->has('no_of_employees')): ?>
                <span class="text-error"><i class="fa fa-exclamation-triangle"></i> <?php echo e($errors->first('no_of_employees', ':message')); ?></span>
                <?php endif; ?>
            </div>

            <div class="form-group">
                <label for="no_of_therapists">Number of therapists</label>
                <?php echo Form::number('no_of_therapists',null,['class'=>'form-control','id'=>'no_of_therapists','min'=>1]); ?>

                <?php if($errors->has('no_of_therapists')): ?>
                <span class="text-error"><i class="fa fa-exclamation-triangle"></i> <?php echo e($errors->first('no_of_therapists', ':message')); ?></span>
                <?php endif; ?>
            </div>

            <div class="form-group">
                <label for="no_of_hours">How many hours</label>
                <?php echo Form::number('no_of_hours',null,['class'=>'form-control','id'=>'no_of_hours','min'=>1]); ?>

                <?php if($errors->has('no_of_hours')): ?>
                    <span class="text-error"><i class="fa fa-exclamation-triangle"></i> <?php echo e($errors->first('no_of_hours', ':message')); ?></span>
                <?php endif; ?>
            </div>

            <button type="submit" id="send" class="btn update-btn">SUBMIT</button>
            <?php echo Form::close(); ?>

            <!--end login form-->
            <?php endif; ?>
        </div>
        <!--end form create account-->
    </div>
    <!--  end create account-->

    <!--  start free space-->
    <div class="col-xs-16 col-md-4"></div>
    <!--  end start free space-->
</div>
<?php $__env->stopSection(); ?>


<?php echo $__env->make("pages::frontend.layouts.layout_corporate_massage_form", array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>