@extends('layouts.administrator.master')

@section('title')
    Form Keanggotaan Perseorangan
@endsection
@section('content')
    <div class="nk-content-body">
        <div class="nk-block-head nk-block-head-sm">
            <div class="nk-block-between">
                <div class="nk-block-head-content">
                    <h3 class="nk-block-title page-title">{{ __('Formulir Keanggotaan Perseorangan Pertapindo') }}</h3>
                    <p>{{ __('Kelola data keanggotaan perseorangan') }}</p>
                </div>
            </div>
        </div>
        <div class="nk-block">
            <div class="card card-preview">
                <div class="card-inner">
                    <div class="mx-auto w-50 mb-4">
                        <label for="">{{ __('Foto Diri') }}</label>
                        <input class="filepond form-control"
                            data-url="{{ route('api.admin.upload', ['path' => 'profile']) }}" data-toset="image"
                            data-path="profile">
                        <input type="hidden" name="image">
                    </div>

                    <div class="form-group mb-3">
                        <label class="mb-1">{{ __('Nama Lengkap') }}</label>
                        <input type="text" class="form-control">
                    </div>
                    <div class="row">
                        <div class="col-12 col-lg-6">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Tempat lahir') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-6">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Tanggal Lahir') }}</label>
                                <input type="date" class="form-control form-control-sm">
                            </div>
                        </div>
                        <div class="col-12 col-lg-6">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('No KTP/KK') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-6">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Email') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Alamat') }}</label>
                                <textarea type="text" class="form-control" placeholder="Jalan, Kota, Provinsi, Negara"></textarea>
                            </div>
                        </div>
                        <div class="col-12 col-lg-6">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('No Kontak (WA)') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-6">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Pendidikan Terakhir') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-4">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Nama Perusahaan/Lembaga') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-4">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Lokasi Perusahaan/Lembaga') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-4">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Regional Perusahaan') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-3">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Instagram') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-3">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Facebook') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-3">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('LinkedIn') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-3">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Website') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Riwayat 5 Tahun Terakhir') }}</label>
                                <textarea type="text" class="form-control" placeholder="Jabatan, Perusahaan, Waktu, Lokasi Pekerjaan"></textarea>
                            </div>
                        </div>
                        <div class="col-12">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Pengalaman 5 Tahun Terakhir') }}</label>
                                <textarea type="text" class="form-control" placeholder="Pelatihan, Sertifikasi, Workshop, seminar, dll"></textarea>
                            </div>
                        </div>
                        <div class="col-12">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Prestasi/Penghargaan Diri') }}</label>
                                <textarea type="text" class="form-control" placeholder="Infrastruktur, Juri Lomba, Asesor Kompetisi dll"></textarea>
                            </div>
                        </div>
                        <div class="col-12 col-lg-6">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Lama Bekerja') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12 col-lg-6">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Status Personil') }}</label>
                                <input type="text" class="form-control">
                            </div>
                        </div>
                        <div class="col-12">
                            <div class="form-group mb-3">
                                <label class="mb-1">{{ __('Link Dokumen') }}</label>
                                <input type="file" class="form-control">
                            </div>
                        </div>
                    </div>
                    <div class="mx-auto w-50 mt-4 text-center">
                        <button class="btn btn-primary me-2">{{ __('Update') }}</button>
                        <a href="{{ route('dashboard') }}" class="btn btn-outline-primary">{{ __('Cancel') }}</a>
                    </div>
                </div>
            </div>
        </div>
    </div>
@endsection