@extends('front.layout.app')
@section('content')



<section class="custom_step_fom">
    <div class="container">
        <div class="row justify-content-center">
            <div class="col-12 col-sm-12 col-md-12 col-lg-8">
                <div class="kcustm_fom_main">
                    <h2>Your Organization Details</h2>
                    <form class="form-get-quote" action="{{ route('register.post') }}" id="banform" method="POST">
                        @csrf
                        <div class="row">
                            <div class="col-sm-12 col-md-6 col-lg-6">
                                <div class="inner_box">
                                <label for="nme21">SERVICES PROVIDER NAME</label>
                                <input id="nme21" type="text" name="name" placeholder=" Services Provider Name" class="@error('name') is-invalid @enderror" autocomplete="name" value="{{ old('name') }}">
                                <input type="hidden" name="role_id" value="{{ $data['role_id'] }}">
                                <input type="hidden" name="email" value="{{ $data['email'] }}">
                                <input type="hidden" name="password" value="{{ $data['password'] }}">
                                @if($errors->has('name'))
                                    <div class="error">{{ $errors->first('name') }}</div>
                                @endif
                                </div>
                            </div>
                            <div class="col-sm-12 col-md-6 col-lg-6">
                                <div class="inner_box">
                                <label for="phone-order">PHONE</label>
                                <input id="phone-order" name="number" type="number" placeholder="Enter Phone Number" class="@error('number') is-invalid @enderror" autocomplete="number" value="{{ old('number') }}">
                                </div>
                                @if($errors->has('number'))
                                    <div class="error">{{ $errors->first('number') }}</div>
                                @endif
                            </div>
                            <div class="col-sm-12 col-md-6 col-lg-6">
                                <div class="inner_box">
                                <label for="nme2123">ADDRESS</label>
                                <input id="nme2123" type="text" name="address" placeholder=" Enter Your Address" class="@error('address') is-invalid @enderror" autocomplete="address" value="{{ old('address') }}">
                                </div>
                                @if($errors->has('address'))
                                    <div class="error">{{ $errors->first('address') }}</div>
                                @endif
                            </div>
                            <div class="col-sm-12 col-md-6 col-lg-6">
                                <div class="inner_box">
                                <label for="nme21765">WEBSITE</label>
                                <input id="nme21765" type="text" name="website" placeholder=" Enter Your Website" class="@error('website') is-invalid @enderror" autocomplete="website" value="{{ old('website') }}">
                                </div>
                                @if($errors->has('website'))
                                    <div class="error">{{ $errors->first('website') }}</div>
                                @endif
                            </div>
                            <div class="col-sm-12 col-md-12 col-lg-12">
                                <div class="innr_btn_main">
                                   <input type="submit" class="form-control" value="GO">
                                </div>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</section>


@endsection