@extends($ajaxCall) @section("content")

Please Register


{!! Form::open(array('method' => 'GET', 'url' => 'register', 'class' => 'form-signup form-horizontal')) !!} {{-- Validation errors block --}} @if ($errors->count())

Validation Errors:

@endif {{-- Message block --}}
{!! Form::label('first_name', 'First Name', ['class'=>'col-sm-3 control-label', "required"=>"required"]) !!}
{!! Form::text('first_name', null, array('class'=>'input-block-level form-control', 'placeholder'=>'First Name', 'id' => 'first_name', "required"=>"required")) !!}
{!! Form::label('last_name', 'Last Name', ['class'=>'col-sm-3 control-label', "required"=>"required"]) !!}
{!! Form::text('last_name', null, array('class'=>'input-block-level form-control', 'placeholder'=>'Last Name', 'id' => 'last_name', "required"=>"required" )) !!}
{!! Form::select('department_id', $departments, \request()->old('department_id'), ['class' => 'form-control', 'id' => 'department_id', "required" => "required"]) !!}
{!! Form::select('subdepartment_id', [""=>"Select Subdivision"], \request()->old('subdepartment_id'), ['class' => 'form-control', 'id'=>'subdepartment_id']) !!}
{!! Form::select('position_id', [""=>"Select Position"], \request()->old('position_id'), ['class' => 'form-control', 'id'=>'position_id', "required"=>"required"])!!}
{!! Form::label('other_position_value', 'Other Position', ['class' => 'col-sm-3 control-label']) !!}
{!! Form::text('other_position', null, array('class'=>'input-block-level form-control', 'placeholder'=>'Position', 'autocomplete' => 'off', 'id' => 'other_position_value')) !!} Please specify your current position
{!! Form::label('email', 'Email Address', ['class' => 'col-sm-3 control-label']) !!}
{!! Form::email('email', null, array('class'=>'input-block-level form-control', 'placeholder'=>'Email Address', 'autocomplete' => 'off', 'id' => 'email', "required"=>"required")) !!}
{!! Form::select('staff', $staff, null, ['class' => 'form-control', 'id'=>'staff',"required"=>"required"])!!}
{!! Form::label('password', 'Password', ['class' => 'col-sm-3 control-label']) !!}
{!! Form::password('password', array('class'=>'input-block-level form-control', 'placeholder'=>'Password', 'id' => 'password', "required"=>"required")) !!}
{!! Form::label('password_confirmation', 'Password Confirmation', ['class' => 'col-sm-3 control-label']) !!}
{!! Form::password('password_confirmation', array('class'=>'input-block-level form-control', 'placeholder'=>'Confirm Password', 'id' => 'password_confirmation', "required"=>"required")) !!}
{!! Form::submit('Register', array('class'=>'btn btn-large btn-primary', 'id' => 'submit_button'))!!} Back
{!! Form::close() !!} @stop @section("js_scripts") @stop