@extends('admin.layouts.mainlayout')
@section('content')
<div class="container my-5">
    <div class="row justify-content-center">
        <div class="col-md-8">
            <div class="card shadow-sm">
                <div class="card-header bg-primary text-white">
                    <h4>Undergraduate Admission Form</h4>
                </div>
                <div class="card-body"> 
                    <form method="POST" action="{{ route('undergradadmission') }}" enctype="multipart/form-data">
                        @csrf

                        <!-- Full Name -->
                        <div class="mb-3">
                            <label for="full_name" class="form-label">Full Name<span class="text-danger">*</span></label>
                            <input type="text" name="full_name" id="full_name" class="form-control @error('full_name') is-invalid @enderror" value="{{ old('full_name') }}" required>
                            @error('full_name')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <!-- Email -->
                        <div class="mb-3">
                            <label for="email" class="form-label">Email Address<span class="text-danger">*</span></label>
                            <input type="email" name="email" id="email" class="form-control @error('email') is-invalid @enderror" value="{{ old('email') }}" required>
                            @error('email')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <!-- Phone Number -->
                        <div class="mb-3">
                            <label for="phone" class="form-label">Phone Number<span class="text-danger">*</span></label>
                            <input type="text" name="phone" id="phone" class="form-control @error('phone') is-invalid @enderror" value="{{ old('phone') }}" required>
                            @error('phone')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <!-- Date of Birth -->
                        <div class="mb-3">
                            <label for="dob" class="form-label">Date of Birth<span class="text-danger">*</span></label>
                            <input type="date" name="dob" id="dob" class="form-control @error('dob') is-invalid @enderror" value="{{ old('dob') }}" required>
                            @error('dob')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <!-- Gender -->
                        <div class="mb-3">
                            <label class="form-label">Gender<span class="text-danger">*</span></label><br>
                            <div class="form-check form-check-inline">
                                <input class="form-check-input" type="radio" name="gender" id="gender_male" value="Male" {{ old('gender') == 'Male' ? 'checked' : '' }} required>
                                <label class="form-check-label" for="gender_male">Male</label>
                            </div>
                            <div class="form-check form-check-inline">
                                <input class="form-check-input" type="radio" name="gender" id="gender_female" value="Female" {{ old('gender') == 'Female' ? 'checked' : '' }}>
                                <label class="form-check-label" for="gender_female">Female</label>
                            </div>
                            <div class="form-check form-check-inline">
                                <input class="form-check-input" type="radio" name="gender" id="gender_other" value="Other" {{ old('gender') == 'Other' ? 'checked' : '' }}>
                                <label class="form-check-label" for="gender_other">Other</label>
                            </div>
                            @error('gender')
                                <div class="text-danger">{{ $message }}</div>
                            @enderror
                        </div>

                        <!-- Address -->
                        <div class="mb-3">
                            <label for="address" class="form-label">Address<span class="text-danger">*</span></label>
                            <textarea name="address" id="address" class="form-control @error('address') is-invalid @enderror" rows="2" required>{{ old('address') }}</textarea>
                            @error('address')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <!-- High School Name -->
                        <div class="mb-3">
                            <label for="high_school" class="form-label">High School Name<span class="text-danger">*</span></label>
                            <input type="text" name="high_school" id="high_school" class="form-control @error('high_school') is-invalid @enderror" value="{{ old('high_school') }}" required>
                            @error('high_school')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <!-- Graduation Year -->
                        <div class="mb-3">
                            <label for="graduation_year" class="form-label">High School Graduation Year<span class="text-danger">*</span></label>
                            <input type="number" min="1900" max="{{ date('Y') }}" name="graduation_year" id="graduation_year" class="form-control @error('graduation_year') is-invalid @enderror" value="{{ old('graduation_year') }}" required>
                            @error('graduation_year')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <!-- Program Applied For -->
                        <div class="mb-3">
                            <label for="program" class="form-label">Program Applied For<span class="text-danger">*</span></label>
                            <select name="program" id="program" class="form-select @error('program') is-invalid @enderror" required>
                                <option value="">Select Program</option>
                                <option value="BSc Computer Science" {{ old('program') == 'BSc Computer Science' ? 'selected' : '' }}>BSc Computer Science</option>
                                <option value="BA Economics" {{ old('program') == 'BA Economics' ? 'selected' : '' }}>BA Economics</option>
                                <option value="BBA" {{ old('program') == 'BBA' ? 'selected' : '' }}>BBA</option>
                                <option value="BSc Mathematics" {{ old('program') == 'BSc Mathematics' ? 'selected' : '' }}>BSc Mathematics</option>
                                <!-- Add more programs as needed -->
                            </select>
                            @error('program')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <!-- Passport Photo Upload -->
                        <div class="mb-3">
                            <label for="photo" class="form-label">Passport Photo (JPG, PNG - Max 2MB)<span class="text-danger">*</span></label>
                            <input class="form-control @error('photo') is-invalid @enderror" type="file" name="photo" id="photo" accept="image/*" required>
                            @error('photo')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <!-- Submit button -->
                        <div class="d-grid">
                            <button type="submit" class="btn btn-primary btn-block">Submit Application</button>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
@endsection