@extends('layouts.master_pre')

@section('css')
{!! Html::style('css/datepicker.css')!!}

@stop

@section('content')
    @if(Session::has('message_error'))
    <div class="row">
      <div class="col-lg-8 col-lg-offset-2 col-md-8 col-md-offset-2 col-sm-12 col-xs-12">
        <div class="alert alert-danger error-msg centrado"><strong>{!! Session::get('message_error') !!}</strong></div>
      </div>
    </div>
    @endif
    @if(Session::has('message_success'))
    <div class="row">
      <div class="col-lg-8 col-lg-offset-2 col-md-8 col-md-offset-2 col-sm-12 col-xs-12">
        <div class="alert alert-success success-msg centrado"><strong>{!! Session::get('message_success') !!}</strong></div>
      </div>
    </div>
    @else
    <div class="col-lg-10 col-lg-offset12 col-md-10 col-md-offset-1 col-sm-12 col-xs-12">
        <div class="panel panel-primary">
            <div class="panel-heading">
                Formulario de Inscripci&oacute;n: Proped&eacute;utico
            </div>
            <div class="panel-body">
                <label>Informaci&oacute;n:</label>
                <p style="text-align: justify;">Por favor rellene todos los campos indicados a continuaci&oacute;n:</p>
                {!!Form::open(array('url' => 'solicitud/guardarencuesta'))!!}{!! csrf_field() !!}                
                <div class="form-group col-lg-4 col-md-6 col-sm-12 col-xs-12 @if($errors->has('nro de identificaci&oacute;n')){!!'has-error'!!} @endif">
                    <label for="estudiante_id">Nro. de Identificaci&oacute;n <span class="glyphicon glyphicon-asterisk text-danger"></span></label> 
                    {!! Form::text('estudiante_id',  NULL , $attributes = array('class' => 'form-control mayuscula', 'id'=>'estudiante_id','placeholder' => '123456')) !!}
                    <div class="text-danger">
                        @if($errors->has('nro de identificaci&oacute;n'))   {!! $errors->first('nro de identificaci&oacute;n') !!}    @else {!! "&nbsp;" !!} @endif
                    </div>
                </div>
                <div class="form-group col-lg-4 col-md-6 col-sm-12 col-xs-12 @if($errors->has('primer y segundo nombre')){!!'has-error'!!} @endif">
                    <label for="nombres">Primer y Segundo Nombre <span class="glyphicon glyphicon-asterisk text-danger"></span></label> 
                    {!! Form::text('nombres',  NULL , $attributes = array('class' => 'form-control', 'id'=>'nombres')) !!}
                    <div class="text-danger">
                        @if($errors->has('primer y segundo nombre'))   {!! $errors->first('primer y segundo nombre') !!}    @else {!! "&nbsp;" !!} @endif
                    </div>
                </div>
                <div class="form-group col-lg-4 col-md-6 col-sm-12 col-xs-12 @if($errors->has('primer y segundo apellido')){!!'has-error'!!} @endif">
                    <label for="apellidos">Primer y Segundo Apellido <span class="glyphicon glyphicon-asterisk text-danger" ></span></label> 
                    {!! Form::text('apellidos',  NULL , $attributes = array('class' => 'form-control', 'id'=>'apellidos')) !!}
                    <div class="text-danger">
                        @if($errors->has('primer y segundo apellido'))   {!! $errors->first('primer y segundo apellido') !!}    @else {!! "&nbsp;" !!} @endif
                    </div> 
                </div>
                <div class="form-group col-lg-4 col-md-6 col-sm-12 col-xs-12 @if($errors->has('tel&eacute;fono')){!!'has-error'!!} @endif">
                    <label for="telefono">Tel&eacute;fono <span class="glyphicon glyphicon-asterisk text-danger"></span></label> 
                    {!! Form::text('telefono', NULL, $attributes = array('class' => 'form-control', 'id'=>'telefono')) !!}
                    <div class="text-danger">
                        @if($errors->has('tel&eacute;fono'))   {!! $errors->first('tel&eacute;fono') !!}    @else {!! "&nbsp;" !!} @endif
                    </div>
                </div>
                <div class="form-group col-lg-4 col-md-6 col-sm-12 col-xs-12 @if($errors->has('correo')){!!'has-error'!!} @endif">
                    <label for="correo_alt">Correo <span class="glyphicon glyphicon-asterisk text-danger"></span></label> 
                    {!! Form::email('correo', NULL, $attributes = array('class' => 'form-control', 'id'=>'correo','placeholder'=>'correo@iutar.com')) !!}
                    <div class="text-danger">
                        @if($errors->has('correo'))   {!! $errors->first('correo') !!}    @else {!! "&nbsp;" !!} @endif
                    </div> 
                </div>
                <div class="form-group col-lg-4 col-md-6 col-sm-12 col-xs-12 @if($errors->has('fecha de nacimiento')){!!'has-error'!!} @endif" >
                    <label for="fecha_nacimiento">Fecha de Nacimiento <span class="glyphicon glyphicon-asterisk text-danger" ></span></label>
                    <div class="input-group">
                        {!! Form::text('fecha_nacimiento', NULL , $attributes = array('class' => 'form-control', 'id'=>'fecha_nacimiento', 'readonly'=>'readonly'))!!}

                        <span class="input-group-addon"><i class="glyphicon glyphicon-calendar"></i></span>
                    </div>
                    <div class="text-danger">

                        @if($errors->has('fecha de nacimiento')) {!! $errors->first('fecha de nacimiento') !!} @else {!! "&nbsp;" !!} @endif
                    </div>
                </div>
                <div class="form-group col-lg-12 col-md-12 col-sm-12 col-xs-12 text-center">
                    <input type="submit" value="Enviar Datos" class="btn btn-primary">
                </div>
                {!!Form::close()!!}
            </div>
        </div>
    </div>
    @endif
@stop
@section('postscript')
{!! Html::script('js/jquery_ui.js') !!}
{!! Html::script('js/datepicker/bootstrap-datepicker.js') !!}
{!! Html::script('js/datepicker/locales/bootstrap-datepicker.es.js') !!}
<script type="text/javascript">
    $(document).ready(function(){

        $('#fecha_nacimiento').datepicker({

            language: "es",

            autoclose: true,

            maxDate:  "+0d",

            format: "dd-mm-yyyy"

        });
    });
</script>
@stop