@extends('layout.mainlayout')

@section('content')
  <main class="page-main">
    <!-- Start Breadcrubms Section -->
    <section class="new-sec breadcrumbs-sec">
      <div class="container">
        <h3 class="page-title">{{trans('web.become_a_partner')}}</h3>
        <i class="ri-arrow-down-s-line icon"></i>
      </div>
    </section>
    <!-- End Breadcrubms Section -->
    <!-- Start Form  -->
    <form class="form" method="post" action="/become-partner">
      {{-- Honeypot anti-spam field: hidden from real users, bots fill it and get rejected --}}
      <div style="position:absolute;left:-9999px;top:-9999px;height:0;width:0;overflow:hidden" aria-hidden="true">
        <input type="text" name="company_registration" tabindex="-1" autocomplete="off" value="">
      </div>
      <!-- Start Step Section -->
      <section class="new-sec step-sec first-step">
        <div class="container">
          <div class="step-content">
            <h5 class="name">{{trans('web.step_one')}}</h5>
            <div class="group">
              <h3 class="group-title">{{trans('web.select_business_type')}}</h3>
              <div class="inputs radios">
                <input type="radio" id="type1" name="partner_type" value="lab" />
                <label for="type1" class="btn" id="type1">{{trans('web.partner_lab')}}</label>
                <input type="radio" id="type2" name="partner_type" value="pharmacy" />
                <label for="type2" class="btn" id="type2">{{trans('web.partner_pharmacy')}}</label>
                <input type="radio" id="type3" name="partner_type" value="clinic" />
                <label for="type3" class="btn" id="type3">{{trans('web.partner_clinic')}}</label>
                <input type="radio" id="type4" name="partner_type" value="Others" />
                <label for="type4" class="btn" id="type4">{{trans('web.partner_home_care_provider')}}</label>
              </div>
            </div>
            <div class="group">
              <h3 class="group-title">{{trans('web.partner_contact_details')}}</h3>
              <div class="inputs">
                <div class="row">
                  <div class="col-md-6">
                    <div class="form-group">
                      <input type="text" class="form-control" id="nameAr" required name="commercial_name_ar" placeholder="{{trans('web.partner_commercial_arabic')}}">
                    </div>
                  </div>
                  <div class="col-md-6">
                    <div class="form-group">
                      <input type="text" class="form-control" id="nameEn" required name="commercial_name_en" placeholder="{{trans('web.partner_commercial_english')}}">
                    </div>
                  </div>
                  <div class="col-md-6">
                    <div class="form-group">
                      <input type="text" class="form-control" id="city" required name="city" placeholder="{{trans('web.partner_city')}}">
                    </div>
                  </div>
                  <div class="col-md-6">
                    <div class="form-group">
                      <input type="number" class="form-control" id="branches" required name="branches" placeholder="{{trans('web.partner_number_of_branches')}}">
                    </div>
                  </div>
                  <div class="col-md-12">
                    <div class="form-group">
                      <input type="url" class="form-control" id="link" name="link" placeholder="{{trans('web.partner_link_website')}}">
                    </div>
                  </div>
                </div>
              </div>
            </div>
            <div class="group">
              <h3 class="group-title">{{trans('web.partner_do_you_care_service')}}</h3>
              <div class="inputs radios">
                <input type="radio" id="yes" value="yes" name="agreement" />
                <label for="yes" class="btn" id="yes">{{trans('web.yes')}}</label>
                <input type="radio" id="no" value="no" name="agreement" />
                <label for="no" class="btn" id="no">{{trans('web.no')}}</label>
              </div>
            </div>
          </div>
        </div>
      </section>
      <!-- End Step Section -->
      <!-- Start Step Section -->
      <section class="new-sec step-sec second-step">
        <div class="container">
          <div class="step-content">
            <h5 class="name">{{trans('web.step_two')}}</h5>
            <div class="group">
              <h3 class="group-title">{{trans('web.personal_info')}}</h3>
              <div class="inputs">
                <div class="row">
                  <div class="col-md-6">
                    <div class="form-group">
                      <input type="text" class="form-control" required id="name" name="name" placeholder="{{trans('web.name')}}*">
                    </div>
                  </div>
                  <div class="col-md-6">
                    <div class="form-group">
                      <input type="email" class="form-control" required id="email" name="email" placeholder="{{trans('web.email')}}*">
                    </div>
                  </div>
                  <div class="col-md-12">
                    <div class="form-group">
                      <input type="text" class="form-control" id="phone" required name="phone" placeholder="{{trans('web.contact_number')}}* ">
                    </div>
                  </div>
                </div>
                <div class="form-group">
                  <button class="btn send-contact-btn">
                    {{trans('web.send')}}
                    <span class="icon">&#10230;</span>
                  </button>
                </div>
              </div>
            </div>
          </div>
        </div>
      </section>
      <!-- End Step Section -->
    </form>
    <!-- End Form -->
    <!-- Start CTA Contacts Section -->
    <section class="new-sec cta-contact-sec">
      <div class="container">
        <div class="sec-content">
          <h2 class="sec-title">{{trans('web.dont_like_forms')}}</h2>
          <p class="subtitle">{!! trans('web.dont_like_forms_desc') !!}</p>
        </div>
      </div>
    </section>
    <!-- Start CTA Contacts Section -->
  </main>
@endsection