@extends('layouts.adminLayout')

@section('title')
	Settings
@stop

@section('styles')
@stop

@section('scripts')
@stop

@section('content')
<form action="{{$url}}" method="POST">
	<?php /*@foreach($fields as $id => $field)
		<?php
			$name = preg_replace('/([A-Z])/', ' $1', $id);// Add apace before any capialized letter
			$name = ucwords( trim($name) );// Make all words capitalized
		?>
		<div class="form-group">
			<label for="exampleInputEmail1">{{$name}}</label>
			<input id="{{$id}}" class="form-control" name="{{$id}}" value="{{$field}}" type="text" placeholder="{{$name}}">
		</div>
	@endforeach*/?>
	<fieldset>
		<legend>Advertising Manufacturer/Company Info</legend>

		<div class="row">
			<div class="form-group col-sm-6">
				<label for="companyName">Name</label>
				<input id="companyName" class="form-control" name="companyName" value="{{$fields['companyName']}}" type="text" placeholder="Company Name">
			</div>

			<div class="form-group col-sm-6">
				<label for="companyAddress">Address</label>
				<input id="companyAddress" class="form-control" name="companyAddress" value="{{$fields['companyAddress']}}" type="text" placeholder="Company Address">
			</div>

			<div class="form-group col-sm-6">
				<label for="companyActivityCode">Activity Code</label>
				<input id="companyActivityCode" class="form-control" name="companyActivityCode" value="{{$fields['companyActivityCode']}}" type="text" placeholder="Registration Number">
			</div>

			<div class="form-group col-sm-6">
				<label for="companyActivity">Activity Description</label>
				<input id="companyActivity" class="form-control" name="companyActivity" value="{{$fields['companyActivity']}}" type="text" placeholder="Description of activities">
			</div>

			<div class="form-group col-sm-6">
				<label for="companyEIN">EIN</label>
				<input id="companyEIN" class="form-control" name="companyEIN" value="{{$fields['companyEIN']}}" type="text" placeholder="EIN">
			</div>
		</div>

		<fieldset class="row">
			<legend>Authorized Person</legend>

			<div class="form-group col-sm-6">
				<label for="companyAuthorizedPersonName">Name</label>
				<input id="companyAuthorizedPersonName" class="form-control" name="companyAuthorizedPersonName" value="{{$fields['companyAuthorizedPersonName']}}" type="text" placeholder="Name">
			</div>

			<div class="form-group col-sm-6">
				<label for="companyAuthorizedPersonAddress">Address</label>
				<input id="companyAuthorizedPersonAddress" class="form-control" name="companyAuthorizedPersonAddress" value="{{$fields['companyAuthorizedPersonAddress']}}" type="text" placeholder="Address">
			</div>

			<div class="form-group col-sm-3">
				<label for="companyAuthorizedPersonPIN">PIN Number</label>
				<input id="companyAuthorizedPersonPIN" class="form-control" name="companyAuthorizedPersonPIN" value="{{$fields['companyAuthorizedPersonPIN']}}" type="text" placeholder="ID">
			</div>

			<div class="form-group col-sm-3">
				<label for="companyAuthorizedPersonID">ID Number</label>
				<input id="companyAuthorizedPersonID" class="form-control" name="companyAuthorizedPersonID" value="{{$fields['companyAuthorizedPersonID']}}" type="text" placeholder="ID">
			</div>

			<div class="form-group col-sm-6">
				<label for="companyAuthorizedPersonPlaceOfIssuance">Place Of Issuance</label>
				<input id="companyAuthorizedPersonPlaceOfIssuance" class="form-control" name="companyAuthorizedPersonPlaceOfIssuance" value="{{$fields['companyAuthorizedPersonPlaceOfIssuance']}}" type="text" placeholder="ID">
			</div>
		</fieldset>
	</fieldset>

	<div><br><br><br></div>

	<fieldset>
		<legend>Advertiser Info</legend>

		<div class="row">
			<div class="form-group col-sm-6">
				<label for="advertiserCompanyName">Name</label>
				<input id="advertiserCompanyName" class="form-control" name="advertiserCompanyName" value="{{$fields['advertiserCompanyName']}}" type="text" placeholder="Company Name">
			</div>

			<div class="form-group col-sm-6">
				<label for="advertiserCompanyAddress">Address</label>
				<input id="advertiserCompanyAddress" class="form-control" name="advertiserCompanyAddress" value="{{$fields['advertiserCompanyAddress']}}" type="text" placeholder="Advertiser Company Address">
			</div>

			<div class="form-group col-sm-6">
				<label for="advertiserCompanyActivityCode">Activity Code</label>
				<input id="advertiserCompanyActivityCode" class="form-control" name="advertiserCompanyActivityCode" value="{{$fields['advertiserCompanyActivityCode']}}" type="text" placeholder="Advertiser Activity Code">
			</div>

			<div class="form-group col-sm-6">
				<label for="advertiserCompanyActivity">Activity Description</label>
				<input id="advertiserCompanyActivity" class="form-control" name="advertiserCompanyActivity" value="{{$fields['advertiserCompanyActivity']}}" type="text" placeholder="Description of activities">
			</div>

			<div class="form-group col-sm-6">
				<label for="advertiserCompanyLicenseNumber">License Number And Date Of Issuance</label>
				<input id="advertiserCompanyLicenseNumber" class="form-control" name="advertiserCompanyLicenseNumber" value="{{$fields['advertiserCompanyLicenseNumber']}}" type="text" placeholder="License Number And Date Of Issuance">
			</div>

			<div class="form-group col-sm-6">
				<label for="advertiserCompanyIDNum">Indetification Number</label>
				<input id="advertiserCompanyIDNum" class="form-control" name="advertiserCompanyIDNum" value="{{$fields['advertiserCompanyIDNum']}}" type="text" placeholder="EIN">
			</div>

			<div class="form-group col-sm-6">
				<label for="advertiserCompanyEIN">EIN</label>
				<input id="advertiserCompanyEIN" class="form-control" name="advertiserCompanyEIN" value="{{$fields['advertiserCompanyEIN']}}" type="text" placeholder="EIN">
			</div>

			<div class="form-group col-sm-6">
				<label for="advertiserCompanyPhone">Phone Number</label>
				<input id="advertiserCompanyPhone" class="form-control" name="advertiserCompanyPhone" value="{{$fields['advertiserCompanyPhone']}}" type="text" placeholder="Phone Number">
			</div>
		</div>

		<fieldset class="row">
			<legend>Authorized Person</legend>

			<div class="form-group col-sm-6">
				<label for="advertiserCompanyAuthorizedPersonName">Name</label>
				<input id="advertiserCompanyAuthorizedPersonName" class="form-control" name="advertiserCompanyAuthorizedPersonName" value="{{$fields['advertiserCompanyAuthorizedPersonName']}}" type="text" placeholder="Name">
			</div>

			<div class="form-group col-sm-6">
				<label for="advertiserCompanyAuthorizedPersonAddress">Address</label>
				<input id="advertiserCompanyAuthorizedPersonAddress" class="form-control" name="advertiserCompanyAuthorizedPersonAddress" value="{{$fields['advertiserCompanyAuthorizedPersonAddress']}}" type="text" placeholder="Address">
			</div>

			<div class="form-group col-sm-3">
				<label for="advertiserCompanyAuthorizedPersonPIN">PIN Number</label>
				<input id="advertiserCompanyAuthorizedPersonPIN" class="form-control" name="advertiserCompanyAuthorizedPersonPIN" value="{{$fields['advertiserCompanyAuthorizedPersonPIN']}}" type="text" placeholder="ID">
			</div>

			<div class="form-group col-sm-3">
				<label for="advertiserCompanyAuthorizedPersonID">ID Number</label>
				<input id="advertiserCompanyAuthorizedPersonID" class="form-control" name="advertiserCompanyAuthorizedPersonID" value="{{$fields['advertiserCompanyAuthorizedPersonID']}}" type="text" placeholder="ID">
			</div>

			<div class="form-group col-sm-6">
				<label for="advertiserCompanyAuthorizedPersonPlaceOfIssuance">Place Of Issuance</label>
				<input id="advertiserCompanyAuthorizedPersonPlaceOfIssuance" class="form-control" name="advertiserCompanyAuthorizedPersonPlaceOfIssuance" value="{{$fields['advertiserCompanyAuthorizedPersonPlaceOfIssuance']}}" type="text" placeholder="ID">
			</div>
		</fieldset>
	</fieldset>

	<fieldset>
		<legend>Ad Message Info</legend>

		<div class="form-group col-sm-6">
			<label for="advertisingDimensionsDuration">Add dimensions / duration</label>
			<input id="advertisingDimensionsDuration" class="form-control" name="advertisingDimensionsDuration" value="{{$fields['advertisingDimensionsDuration']}}" type="text">
		</div>

		<div class="form-group col-sm-6">
			<label for="advertisingType">Advertising type</label>
			<input id="advertisingType" class="form-control" name="advertisingType" value="{{$fields['advertisingType']}}" type="text" placeholder="">
		</div>

		<div class="form-group col-sm-6">
			<label for="adDesignedBy">Ad Designed By</label>
			<input id="adDesignedBy" class="form-control" name="adDesignedBy" value="{{$fields['adDesignedBy']}}" type="text" placeholder="Design agency">
		</div>
	</fieldset>

	<button class="btn btn-default" type="submit">Save</button>
</form>
@stop
