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<form class="form-horizontal mt-4" action="" method="POST" enctype="multipart/form-data">
            @csrf
         
              @if (count($errors) > 0)
              <div class="alert alert-danger">
                  <ul>
                      @foreach ($errors->all() as $error)
                          <li>{{ $error }}</li>
                      @endforeach
                  </ul>
              </div>
          @endif
          
          
            @if ($message = Session::get('success'))
            <div class="alert alert-success alert-block">
                <button type="button" class="close" data-dismiss="alert">×</button>
                <strong>{{ $message }}</strong>
            </div>
        @endif
          <div class="row">
            <div class="col-md-12">
             <h4 class="mb-40">Abu Dhabi Summer Outreach Program</h4>
             
                <div class="form-row">
                  <div class="form-group col-md-6">
                      <strong>Name:</strong>
                      <input type="text" name="name" class="form-control"  value="{{ old('name') }}">
                      @if ($errors->has('name'))
                          <span class="text-danger">{{ $errors->first('name') }}</span>
                      @endif
                  </div>

                  <div class="form-group col-md-6">
                    <strong>Email:</strong>
                    <input type="email" name="email" class="form-control"  value="{{ old('email') }}">
                    @if ($errors->has('email'))
                        <span class="text-danger">{{ $errors->first('email') }}</span>
                    @endif
                </div>
                </div>

     

                <div class="form-row">
                  <div class="form-group col-md-6">
                      <strong>Guardian's Contact number:</strong>
                      <input type="phone" name="phone" class="form-control"  value="{{ old('phone') }}">
                      @if ($errors->has('phone'))
                          <span class="text-danger">{{ $errors->first('phone') }}</span>
                      @endif
                  </div>
                  <div class="form-group col-md-6">
                    <strong>Age:</strong>
                    <input type="number" name="age" class="form-control"  value="{{ old('age') }}"> 
                    @if ($errors->has('age'))
                        <span class="text-danger">{{ $errors->first('age') }}</span>
                    @endif
                </div>
                </div>

                <div class="form-row">
                  <div class="form-group col-md-6">
                    <strong>Program the Student is Applying for
                      :</strong>
                    <select class="form-control dropdown" id="program_type" name="program_type">
                      <option value="" selected="selected" disabled="disabled">-- select one --</option>
                      <option value="math immerssion">Math Immersion </option>
                      <option value="abu dhabi outreach">abu dhabi outreach </option>
                      <option value="and both ">and both </option>
                    
                    </select>
                  </div>
                  <div class="form-group col-md-6 mt-30">
                    <strong>Mode of Attending the Course :</strong>
                  <input type="radio" value="Physical" id="physical" name="attend" selected>
                  <label for="physical">Physical</label>
                  <input type="radio" value="online" id="online" name="attend">
                  <label for="online">Online</label> 
                </div>
                </div>

                <div class="form-row">
                  <div class="form-group col-md-6">
                    <strong>Nationality:</strong>
                
                    <select class="form-control dropdown" id="program_type" name="nationality">
                    <option value="" selected="selected" disabled="disabled">-- select one --</option>
                            @foreach ($countries as $country)
                                                           
                                <option value="{{$country->id}}">{{$country->name}} - {{$country->code}}</option>
                            @endforeach
                        </select>
                </div>
                  <div class="form-group col-md-6 mt-30">
                    <strong>Gender:</strong>
                  <input type="radio" value="Male" id="male" name="gender" selected>
                  <label for="male">Male</label>
                  <input type="radio" value="Female" id="female" name="gender">
                  <label for="female">Female</label> 
                  <input type="radio" value="Not to say" id="female" name="Not to say">
                  <label for="female">Prefer not to say</label> 
                </div>
                </div>

                <div class="form-row">
                  <div class="form-group col-md-6">
                    <strong>Food allergies (If any):</strong>
                    <input type="text" name="food" class="form-control"  value="{{ old('food') }}">
                    @if ($errors->has('food'))
                        <span class="text-danger">{{ $errors->first('food') }}</span>
                    @endif
                </div>
                <div class="form-group col-md-6">
                  <strong>Any special assistance request:</strong>
                  <input type="text" name="special" class="form-control"  value="{{ old('special') }}">
                  @if ($errors->has('special'))
                      <span class="text-danger">{{ $errors->first('special') }}</span>
                  @endif
              </div>
                </div>

                <div class="form-row">
                <div class="form-group col-md-6">
                  <strong>Education:</strong>
                  <select class="form-control dropdown" id="education" name="education">
                    <option value="" selected="selected" disabled="disabled">-- select one --</option>
                    <option value="k12">K-12</option>
                    <option value="UG">UG student</option>
                    <option value="PG">PG student</option>
                  </select>
                </div>

                <div class="form-group col-md-6">
                  <strong>Your expectation from the program </strong>
                  <input type="text" name="expectation" class="form-control"  value="{{ old('expectation') }}">
                  @if ($errors->has('expectation'))
                      <span class="text-danger">{{ $errors->first('expectation') }}</span>
                  @endif
              </div>
                </div>
                <div class="form-group ">
                    <div class="col-md-12">
                        
                    </div>

                   
                </div>

                

                <div class="form-row">
                    <div class="form-group col-md-6">
                      <label for="input-file-now" class="ar-label">Upload marksheet <span class="text-danger">*</span></label>
                            <input type="file" id="input-file-now" class="dropify " name="marksheet" data-allowed-file-extensions="[&quot;jpg&quot;, &quot;png&quot;, &quot;jpeg&quot;,&quot;pdf&quot;]" data-max-file-size="5M" >
                                                                      
                  </div>
                
                </div>

                <div class="form-row">
                <div class="form-group">
                  <label><input type="checkbox" name="terms" value="terms"> I understand that my application will be reviewed by the respective teams and only eligible candidates will be invited to attend the course.
                    
                  
                  </label>
                  
              </div>
                </div>

                



                

                 <div class="section-field submit-button">
                     <input type="hidden" name="action"/>
                     <button name="submit" type="submit" value="Send" class="button"> Submit</button>
                 </div>
                 
                </div>
              </div>
         </div>
          </form>