%PDF-
%PDF-
Mini Shell
Mini Shell
<div class="modal fade text-left" id="addBranch" tabindex="-1" role="dialog" aria-labelledby="myModalLabel35" aria-hidden="true">
<div class="modal-dialog modal-lg" role="document">
<div class="modal-content">
<div class="modal-header" style="background-color:#1E9FF2;">
<h3 class="modal-title" id="myModalLabel35"> Create New Branch</h3>
<button type="button" class="close" data-dismiss="modal" aria-label="Close">
<span aria-hidden="true">×</span>
</button>
</div>
<div class="card-content >
<div class="card-body">
<form action="/structure/add" method="POST" enctype="multipart/form-data" class="steps-validation wizard-circle">
<!-- Step 1 -->
<h6><span class="_label"></span> Branch Information</h6>
<fieldset>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label for="organisationStructureId">
Branch Name :
<span class="danger">*</span>
</label>
<input type="text" name="name" id="name" class="form-control required">
</div>
</div>
<div id="structureParent_div" class="col-md-6 d-none">
<div class="form-group">
<label for="description">
<span class="_label"></span> Description :
<span class="danger">*</span>
</label>
<textarea name="de" id="description" class="form-control required" rows="4">
</textarea>
</div>
</div>
</div>
<div class="row">
<div id="structureParent_div" class="col-md-6">
<div class="form-group">
<label for="regionId">
<span class="_label"></span> Region :
<span class="danger">*</span>
</label>
<select name="regionId" id="structureParentId" class="form-control required">
<option class="form-control" value="0" >Select Region</option>
<option class="form-control" value="1" >South-East</option>
<option class="form-control" value="2" >South-West</option>
</select>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label for="email">
<span class="_label"></span> Email Address :
<span class="danger">*</span>
</label>
<input type="text" class="form-control required" id="email" name="email">
</div>
</div>
</div>
</fieldset>
<!-- Step 2 -->
<h6><span class="_label"></span> Head</h6>
<fieldset>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label for="proposalTitle3">
First Name :
<span class="danger">*</span>
</label>
<input type="text" class="form-control required" id="headFirstName" name="headFirstName">
</div>
<div class="form-group">
<label for="headLastName">
Last Name :
<span class="danger">*</span>
</label>
<input type="text" class="form-control required" id="headLastName" name="headLastName">
</div>
<div class="form-group">
<label for="headMiddleName">
Middle Name :
</label>
<input type="text" class="form-control " id="headMiddleName" name="headMiddleName">
</div>
<div class="form-group">
<label for="headEmail">
Email Address :
<span class="danger">*</span>
</label>
<input type="email" class="form-control required" id="headEmail" name="headEmail">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label for="headLevel">Rank/Level :</label>
<select name="headGradeId" id="headLevel" class="form-control required">
<option class="form-control">Select Grade </option>
<% grades.forEach(grade =>{ %>
<option value="<%= grade.id %>" class="form-control" > <%= grade.title %></option>
<% }) %>
</select>
</div>
<div class="" id="">
<div class="form-group">
<img class="img-responsive" id="blah1" <% /*src="/storage/" */ %>alt="your image" />
</div>
</div>
<span class="form-group">
<label>Head Image</label>
<div class="custom-file">
<input type="file" class="custom-file-input" id="headImage" name="headImage" onchange="readURL(this,1)">
<label class="custom-file-label" for="headImage">Choose file</label>
</div>
</span>
</div>
</div>
</fieldset>
<!-- Step 3 -->
<h6><span class="_label"></span> Assistant Head</h6>
<fieldset>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label for="proposalTitle3">
First Name :
<span class="danger">*</span>
</label>
<input type="text" class="form-control required" id="assistantFirstName" name="assistantFirstName">
</div>
<div class="form-group">
<label for="assistantLastName">
Last Name :
<span class="danger">*</span>
</label>
<input type="text" class="form-control required" id="assistantLastName" name="assistantLastName">
</div>
<div class="form-group">
<label for="assistantMiddleName">
Middle Name :
</label>
<input type="text" class="form-control " id="assistantMiddleName" name="assistantMiddleName">
</div>
<div class="form-group">
<label for="assistantEmail">
Email Address :
<span class="danger">*</span>
</label>
<input type="email" class="form-control required" id="assistantEmail" name="assistantEmail">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label for="assistantLevel">Rank/Level :</label>
<select name="assistantGradeId" id="assistantLevel" class="form-control required">
<option class="form-control">Select Grade </option>
<% grades.forEach(grade =>{ %>
<option value="<%= grade.id %>" class="form-control" > <%= grade.title %></option>
<% }) %>
</select>
</div>
<div class="" id="">
<div class="form-group">
<img class="img-responsive" id="blah2" <% /*src="/storage/" */ %>alt="your image" />
</div>
</div>
<span class="form-group">
<label>Assistant Image</label>
<div class="custom-file">
<input type="file" class="custom-file-input" id="headImage" name="assistantImage" onchange="readURL(this, 2)">
<label class="custom-file-label" for="headImage">Choose file</label>
</div>
</span>
</div>
</div>
</fieldset>
</form>
</div>
</div>
</div>
</div>
Zerion Mini Shell 1.0