{{--

Name: package.partials.customPackageForm
Author: AL
Created: 2015-11-02

--}}

@extends('partials.box')

@section($content_id)

    {!! Form::open(['method' => 'POST', 'class' => 'form-horizontal', 'action' => 'PackageController@contact']) !!}

        <div class="form-group {{ $errors->has('receivers') ? 'has-error' : '' }}">
            {!! Form::label('receivers', Lang::get('package.customForm.receivers'), ['class' => 'col-md-4 control-label']) !!}
            <div class="col-md-2">
                {!! Form::input('number', 'receivers', old('receivers'), ['class' => 'form-control', 'min' => '50000', 'placeholder' => '50000']) !!}
                {!! $errors->first('receivers', '<span class="help-block">:message</span>') !!}
            </div>
        </div>

        <div class="form-group {{ $errors->has('sendouts') ? 'has-error' : '' }}">
            {!! Form::label('sendouts', Lang::get('package.customForm.sendouts'), ['class' => 'col-md-4 control-label']) !!}
            <div class="col-md-2">
                {!! Form::input('number', 'sendouts', old('sendouts'), ['class' => 'form-control']) !!}
                {!! $errors->first('sendouts', '<span class="help-block">:message</span>') !!}
            </div>
        </div>

        <div class="form-group {{ $errors->has('name') ? 'has-error' : '' }}">
            {!! Form::label('name', Lang::get('package.customForm.name'), ['class' => 'col-md-4 control-label']) !!}
            <div class="col-md-2">
                {!! Form::input('text', 'name', old('name'), ['class' => 'form-control']) !!}
                {!! $errors->first('name', '<span class="help-block">:message</span>') !!}
            </div>
        </div>
        <div class="form-group {{ $errors->has('phone') ? 'has-error' : '' }}">
            {!! Form::label('phone', Lang::get('package.customForm.phone'), ['class' => 'col-md-4 control-label']) !!}
            <div class="col-md-2">
                {!! Form::input('text', 'phone', old('phone'), ['class' => 'form-control']) !!}
                {!! $errors->first('phone', '<span class="help-block">:message</span>') !!}
            </div>
        </div>

        <div class="form-group {{ $errors->has('message') ? 'has-error' : '' }}">
            {!! Form::label('message', Lang::get('package.customForm.message'), ['class' => 'col-md-4 control-label']) !!}
            <div class="col-md-5">
                {!! Form::textarea('message', old('message'), ['class' => 'form-control', 'rows' => '4']) !!}
                {!! $errors->first('message', '<span class="help-block">:message</span>') !!}
            </div>
        </div>
<hr>
        <div class="form-group col-xs-12">
            <a href="{{ route('account.edit') }}" class="btn btn-default pull-left">{{ Lang::get('package.form.cancel') }}</a>

            {!! Form::submit(Lang::get('package.customForm.contactSend'), ['class' => 'btn btn-primary pull-right']) !!}

        </div>
        <div class="clearfix">

        </div>
    {!! Form::close() !!}

@stop