@extends('frontend.layouts.index')

@section('content')
    <div class="row mt3">
        <div class="col-lg-9 col-md-9 overflow-fix">
            <div class="o-fix">
                <div class="col-md-12 col-lg-12 col-xs-12">
                    <h2 class="title">{{ 'Submission Form' }}</h2>

                        <form id="survey-form" action="{{ url('/make-a-submission') }}" method="post"
                            enctype="multipart/form-data">
                            @csrf
                            <div class="row">
                                <div class="col-md-12 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="title-label" for="title">Research Title*</label>
                                        <input type="text" name="title" id="title"
                                            placeholder="Enter your research title" class="form-control"
                                            value="{{ old('title') }}" required>
                                        @error('title')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-6 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="email-label" for="email">Email*</label>
                                        <input type="email" name="email" id="email" placeholder="Enter your email"
                                            class="form-control" value="{{ old('email') }}" required>
                                        @error('email')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                                <div class="col-md-6 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="alternative_email-label" for="alternative_email">Alternative
                                            Email*</label>
                                        <input type="email" name="alternative_email" id="alternative_email"
                                            placeholder="Enter your alternative email" class="form-control"
                                            value="{{ old('alternative_email') }}" required>
                                        @error('alternative_email')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>

                            <div class="row">
                                <div class="col-md-12 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="authors-label" for="authors">Research Authors*</label>
                                        <span style="font-size:12px;">(For multiple authors, separate their names with commas.)</span>
                                        <input type="text" name="authors" id="authors"
                                            placeholder="Enter your research authors name" class="form-control"
                                            value="{{ old('authors') }}" required>
                                        @error('authors')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-6 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="contact_number-label" for="contact_number">Contact Number*</label>
                                        <input type="text" name="contact_number" id="contact_number"
                                            placeholder="Enter your contact number" class="form-control"
                                            value="{{ old('contact_number') }}" required>
                                        @error('contact_number')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>

                                <div class="col-md-6 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="data-collection-label" for="tool">Data Collection Tool*</label>
                                        <input type="text" name="tool" id="tool"
                                            placeholder="Enter your data collection tool" class="form-control"
                                            value="{{ old('tool') }}" required>
                                        @error('tool')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-12 col-xs-12 ">
                                    <div class="form-group">
                                        <label>Summary*</label>
                                        <span style="font-size:12px;">(Summary of the Proposal Maximum 500 words)</span>
                                        <textarea id="description" class="form-control" name="description" placeholder="Enter your Summary here..."
                                            rows="10" required>{{ old('description') }}</textarea>
                                        @error('description')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-12 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="file-label" for="file">Upload Proposal File*</label>
                                        <input type="file" name="file" id="file" class="form-control" required>
                                        @error('file')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-12 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="file-label" for="file">Meta Files*</label>
                                        <span style="font-size:12px;">(Flow chart*, Informed Consent Form, Assent Form and other meta files)</span>
                                        <input type="file" name="multifiles[]" id="files" class="form-control"
                                            multiple required>
                                        @error('multifiles')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-4 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="file-label" for="cv">Curriculum Vitae*</label>
                                        <span style="font-size:12px;">(Updated Curriculum Vitae with photo of Principal Investigator and co-investigators)*</span>
                                        <input type="file" name="cv" id="cv" class="form-control" required>
                                        @error('cv')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                                <div class="col-md-4 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="file-label" for="coverletter">Cover Letter*</label><br>
                                        <span style="font-size:12px;">Cover letter by Principal Investigator*</span><br>
                                        <input type="file" name="coverletter" id="coverletter" class="form-control" required>
                                        @error('coverletter')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                                <div class="col-md-4 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="file-label" for="coi">COI Declaration*</label><br>
                                        <span style="font-size:12px;">COI Declaration by each investigator*</span><br>
                                        <input type="file" name="coi" id="coi" class="form-control" required>
                                        @error('coi')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                            <div class="row">
                                <div class="col-md-4 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="file-label" for="al">Approval letter*</label><br>
                                        <span style="font-size:12px;">Approval letter from concern authority*</span><br>
                                        <input type="file" name="al" id="al" class="form-control" required>
                                        @error('al')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                                <div class="col-md-4 col-xs-12 ">
                                    <div class="form-group">
                                        <label id="file-label" for="wp">Work Plan*</label><br>
                                        <input type="file" name="wp" id="wp" class="form-control" required>
                                        @error('wp')
                                            <div class="text-danger">{{ $message }}</div>
                                        @enderror
                                    </div>
                                </div>
                            </div>
                
                            
                            <div class="row " style="margin-bottom: 14px;">
                                <div class="col-md-4">
                                    <button type="submit" id="submit" class="btn btn-primary btn-block">Submit
                                        </button>
                                </div>
                            </div>
                            <div class="row" style="margin:6px;">
                                <div class="form-group">
                                    {!! NoCaptcha::renderJs() !!}
                                    {!! NoCaptcha::display() !!}
                                    @if ($errors->has('g-recaptcha-response'))
                                        <span class="help-block">
                                            <strong>{{ $errors->first('g-recaptcha-response') }}</strong>
                                        </span>
                                    @endif
                                </div>
                            </div> 
                        </form>
                    </div>
                </div>
            </div>
        <div style="margin-top:60px">
            @include('frontend.includes.aside')
        </div>
    </div>
@endsection