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<div class="text-lg lead fw-bold client-form-title mt-5 pt-5">New Client</div><br> <div class="row p-5"> <div class="col-sm-6" style="border-right: 1px solid rgba(4, 4, 4, 0.253);"> <form action="" class="opacity-75 company-info"> <div class="form-group"> <label for="CompanyName">Company Name</label> <input type="text" name="CompanyName" id="companyname" class="form-control rounded-0"> </div> <div class="form-group"> <label for="CompanyAddress">Company Address</label> <input type="text" name="CompanyAddress" id="companyaddress" class="form-control rounded-0"> </div> <div class="form-group"> <label for="TIN">TIN</label> <input type="text" name="TIN" id="tin" class="form-control rounded-0"> </div> <div class="form-group"> <label for="CompanyEmail">Company Email</label> <input type="text" name="CompanyEmail" id="companyemail" class="form-control rounded-0"> </div> <div class="form-group"> <label for="CEO">CEO</label> <input type="text" name="CEO" id="ceo" class="form-control rounded-0"> </div> <div class="form-group"> <label for="CEODateOfBirth">Date of Birth</label> <input type="date" name="CEODateOfBirth" id="dob" class="form-control rounded-0"> </div> <div class="form-group"> <label for="CEOContactInformation">Contact Information <sup class="text-danger"><strong>(email or phone#)</strong></sup></label> <input type="text" name="CEOContactInformation" id="ceoContactInformation" class="form-control rounded-0"> </div> </form> </div> <div class="col-sm-6"> <div class="row"> <div class="col-sm-12"> <form action="" class="opacity-75 client-rep"> <div class="form-group"> <label for="RepresentativeName">Representative Name</label> <input type="text" name="RepresentativeName" id="representative" class="form-control rounded-0"> </div> <div class="form-group"> <label for="RepresentativeContactInformation">Contact Information</label> <input type="text" name="RepresentativeContactInformation" id="contactinfo" class="form-control rounded-0"> </div> <div class="form-group"> <label for="RepresentativeDateOfBirth">Date of Birth</label> <input type="date" class="form-control rounded-0" name="RepresentativeDateOfBirth" id="repDOB"> </div> <div class="form-group"> <label for="RepresentativeAddress">Address</label> <input type="text" class="form-control rounded-0" name="RepresentativeAddress" id="repAddress"> </div> <div class="form-group"> <label for="RepresentativePosition">Position</label> <input type="text" name="RepresentativePosition" id="position" class="form-control rounded-0"> </div> </form> </div><hr> <div class="col-sm-12"> <div class="col-sm-12"> <span class="badge bg-transparent text-danger"><strong>*optional</strong></span> <form action="" id="services"> <div class="row"> @foreach ($services as $item) <div class="col-sm-3"> <input type="checkbox" name="Service[]" id="service-{{$item->id}}" value="{{$item->id}}">{{$item->Service}} </div> @endforeach </div> </form> </div> </div> </div> <button class="btn rounded-0 float-right mt-5 position-absolute submit-new-client" style="bottom: 0; right: 0; background-color: #063D58; color: whitesmoke;">Submit</button> </div> </div>
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