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{% load widget_tweaks %}
<div class="row">
<div class="col-md-6">
<span style="color: rgb(12, 12, 140);" class="fw-bold">Personal Details</span>
</div>
</div>
<br>
<div class="row">
<div class="form-group">
<label class="form-label">Full Name(as per your degree certificate)<span class="text-danger">*</span></label>
{{ form.full_name|add_class:"form-control incr"|attr:'required:true'|attr:'maxlength:100'|attr:"pattern:^[a-zA-Z][a-zA-Z\s,-\.`']*$"}}
<small class="form-text note">NOTE: Allowed special characters are: (",", "-", ".", " ` ", " ' ")</small>
{% if form.full_name.errors %}
<span class="alert-danger"> Please enter Full Name</span>
{% endif %}
</div>
<div class="form-group">
<label class="form-label">Father's Name<span class="text-danger">*</span></label>
{{ form.fathers_name|attr:'class:form-control'|attr:'required:true'|attr:'maxlength:100'|attr:'pattern:^[A-Za-z]+( [A-Za-z]+)*$'}}
{% if form.fathers_name.errors %}
<span class="alert-danger">Please enter Father's Name</span>
{% endif %}
</div>
<div class="form-group">
<label class="form-label">Mother's Name<span class="text-danger">*</span></label>
{{ form.mothers_name|attr:'class:form-control'|attr:'required:true'|attr:'text-danger:true'|attr:'maxlength:100'|attr:'pattern:^[A-Za-z]+( [A-Za-z]+)*$'}}
{% if form.mother_name.errors %}
<span class="alert-danger">Please enter Mother's Name</span>
{% endif %}
</div>
<div class="form-group">
<label class="form-label">Date of Birth<span class="text-danger">*</span></label>
{{ form.date_of_birth|attr:'class:form-control'|attr:'autocomplete:off'| attr:'onkeydown:return false;'|attr:'required:true'|attr:'type:date'}}
{% if form.date_of_birth.errors %}
<span class="alert-danger">Please select a valid date </span>
{% endif %}
<span class="alert-danger errorSpan" id="dobError"></span>
</div>
<div class="form-group">
<label class="form-label">Gender<span class="text-danger">*</span></label>
{{ form.gender|attr:'class:form-select form-select-lg'|attr:'required:true'}}
{% if form.gender.errors %}
<span class="alert-danger">Please select a Gender </span>
{% endif %}
</div>
<div class="form-group">
<label class="form-label">Nationality<span class="text-danger">*</span></label>
{{ form.nationality|attr:'class:form-select form-select-lg'|attr:'required:true'}}
{% if form.nationality.errors %}
<span class="alert-danger">Please select a Nationality </span>
{% endif %}
</div>
<div class="form-group">
<label class="form-label">Address Line 1<span class="text-danger">*</span></label>
{{ form.address_line_1|attr:'class:form-control'|attr:'required:true'|attr:'maxlength:60'}}
{% if form.address_line_1.errors %}
<span class="alert-danger">Please enter Address </span>
{% endif %}
</div>
<div class="form-group">
<label class="form-label">Address Line 2</label>
{{ form.address_line_2|attr:'class:form-control'|attr:'maxlength:40'}}
</div>
<div class="form-group">
<label class="form-label">Address Line 3</label>
{{ form.address_line_3|attr:'class:form-control'|attr:'maxlength:40'}}
</div>
<div class="form-group">
<label for="country" class="bold">Country<span class="text-danger">*</span></label>
{{form.country|attr:'required:true'|attr:'class:form-select form-select-lg'}}
{% if form.country.errors %}
<span class="alert-danger">Please select a Country </span>
{% endif %}
</div>
<div class="form-group">
<label for="state" class="bold">State<span class="text-danger">*</span></label>
{{form.state|attr:'required:true'|attr:'class:form-select form-select-lg'}}
{% if form.state.errors %}
<span class="alert-danger">Please select State </span>
{% endif %}
<span class="alert-danger errorSpan" id="stateError"></span>
</div>
<div class="form-group">
<label for="city" class="bold">City<span class="text-danger">*</span></label>
{{form.city|attr:'required:true'|attr:'pattern:^[A-Za-z]+( [A-Za-z]+)*$'|attr:'class:form-control'|attr:'maxlength:20'}}
{% if form.city.errors %}
<span class="alert-danger">Please enter City </span>
{% endif %}
</div>
<div class="form-group">
<label for="pin_code" class="bold">Pin Code<span class="text-danger">*</span></label>
{{form.pin_code|attr:'required:true'|attr:'class:form-control'|attr:'type:number'}}
{% if form.pin_code.errors %}
<span class="alert-danger">Please enter Pin Code </span>
{% endif %}
<span class="alert-danger errorSpan" id="pincodeError"></span>
</div>
<!-- <div class="form-group">
<label for="phoneId" class="bold">Primary Number<span class="text-danger">*</span></label>
<div class="flex-container">
{{form.phone|attr:'required:true'|attr:'maxlength:15'|attr:'class:form-control'}}
</div>
{% if form.phone.errors %}
<span class="alert-danger">Please enter Primary mobile number </span>
{% endif %}
<span id="phoneError" class="alert-danger"></span>
</div>
<div class="form-group">
<label for="mobileId" class="bold">Alternate Number<span class="text-danger">*</span></label>
<div class="flex-container">
{{form.mobile|attr:'required:true'|attr:'maxlength:15'|attr:'class:form-control'}}
</div>
{% if form.mobile.errors %}
<span class="alert-danger">Please enter Alternate mobile number </span>
{% endif %}
<span id="mobileError" class="alert-danger"></span>
</div> -->
<div class="form-group">
<label for="phoneId" class="bold">Primary Number<span class="text-danger">*</span></label>
<div class="flex-container">
{{form.phone|attr:'required:true'|attr:'maxlength:15'|attr:'class:form-control'}}
</div>
{% if form.phone.errors %}
<span id="phoneError" class="alert-danger">Please enter Primary mobile number </span>
{% endif %}
<span class="alert-danger errorSpan" id="primaryError"></span>
</div>
<div class="form-group">
<label for="mobileId" class="bold">Alternate Number<span class="text-danger">*</span></label>
<div class="flex-container">
{{form.mobile|attr:'required:true'|attr:'maxlength:15'|attr:'class:form-control'}}
</div>
{% if form.mobile.errors %}
<span id="mobileError" class="alert-danger">Please enter Alternate mobile number </span>
{% endif %}
<span class="alert-danger errorSpan" id="alternateError"></span>
</div>
<div class="form-group">
<label for="email_id" class="bold">Email ID<span class="text-danger">*</span></label>
{{form.email_id|attr:'required:true'|attr:'pattern:[^@]+@[^@]+\.[a-zA-Z]{2,}'|attr:'maxlength:50'|attr:'class:form-control'}}
{% if form.email.errors %}
<span class="alert-danger">Please enter an email</span>
{% endif %}
</div>
<div class="form-group">
<label for="current_location" class="bold">Preferred Exam Location<span class="text-danger">*</span></label>
{{form.current_location|attr:'class:form-select form-select-lg'|attr:'required:true'}}
{% if form.current_location.errors %}
<span class="alert-danger">Please select Preferred Exam Location </span>
{% endif %}
</div>
<div class="form-group">
<label for="linkedinProfile" class="bold">Linkendln Profile Link</label>
{{form.linkedin_profile|attr:'class:form-control'}}
{% if form.linkedin_profile.errors %}
<span class="alert-danger">Please enter a valid url </span>
{% endif %}
</div>
{% if form.alternate_email_id.label %}
<div class="form-group">
<label for="alternate_email_id" class="bold">{{form.alternate_email_id.label}} <span class="required"> *</span></label>
{{form.alternate_email_id|attr:'required:true'|attr:'pattern:[^@]+@[^@]+\.[a-zA-Z]{2,}'|attr:'maxlength:50'|attr:'class:form-control'}}
<small class="form-text note">{{form.alternate_email_id.help_text}}</small>
{% if form.mobile.errors %}
<span class="alert-danger">Please enter an alternate email </span>
{% endif %}
</div>
{% endif %}
{% if form.teaching_mode.label %}
<div class="form-group">
<label class="form-label">{{form.teaching_mode.label}}</label>
{{form.teaching_mode|attr:'class:form-control'|attr:'required:true'}}
<small class="form-text note">{{form.teaching_mode.help_text}}</small>
{% if form.teaching_mode.errors %}
<span class="alert-danger">Please select Teaching Mode </span>
{% endif %}
</div>
{% endif %}
</div>
<br>
<br>
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