180 lines
6.6 KiB
PHP
180 lines
6.6 KiB
PHP
<?php include 'includes/header.php';?>
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<link href="<?=base_url();?>fassets/global/plugins/select2/css/select2.min.css" rel="stylesheet" type="text/css"/>
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<link href="<?=base_url();?>fassets/global/plugins/select2/css/select2-bootstrap.min.css" rel="stylesheet" type="text/css" />
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<section id="content">
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<div class="content-wrap">
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<div class="container clearfix">
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<div class="row col-mb-50">
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<div class="col-md-5">
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<img src="<?=base_url();?>fassets/images/agent/1.jpg" alt="Image" class="w-100">
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</div>
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<div class="col-md-7">
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<h3>Don't have an Account? Register Now.</h3>
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<form id="register-form" name="register-form" class="row" action="<?=base_url();?>become-an-agent" method="post">
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<p>Kindly fill all manditory ( <span style="color:red">*</span> ) fields</p>
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<div class="col-6 form-group">
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<label for="register-form-name">Name <span class="required" style="color:red;">*</span></label>
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<input type="text" id="register-form-name" data-validation="required" name="agent_name" class="form-control" />
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</div>
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<div class="col-6 form-group">
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<label for="register-form-email">Email Address <span class="required" style="color:red;">*</span></label>
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<input type="text" id="emalidd" data-validation="email" name="agent_email" class="form-control" />
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<div id="alredyhavee" style="color:red;"></div>
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</div>
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<div class="w-100"></div>
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<div class="col-6 form-group">
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<label for="register-form-username">Mobile Number <span class="required" style="color:red;">*</span></label>
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<input type="text" id="register-form-username" data-validation="number length" data-validation-length="10" name="agent_mobile" class="form-control" />
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</div>
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<div class="col-6 form-group">
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<label for="register-form-phone">Pincode <span class="required" style="color:red;">*</span></label>
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<input type="text" id="register-form-phone" data-validation="number length" data-validation-length="6" name="agent_pincode" class="form-control" />
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</div>
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<div class="w-100"></div>
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<div class="form-group col-md-12">
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<label for="inputState">Company <span class="required" style="color:red;">*</span></label>
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<select id="policy_cmp " class="form-select select2" name="agent_cmp" >
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<?php if(isset($cmp)&& $cmp->num_rows()>0)
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{ foreach($cmp->result() as $c)
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{ $cmid=$c->id;
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$cmname=$c->name;?>
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<option value="<?=$cmid;?>" ><?=$cmname;?></option>
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<?php } }?>
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</select>
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</div>
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<div class="w-100"></div>
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<div class="form-group col-md-6">
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<label >Category <span class="required" style="color:red;">*</span></label>
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<select id="policy_cat" class="form-select select2" name="agent_cat[]" multiple>
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<?php if(isset($cat)&& $cat->num_rows()>0)
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{ foreach($cat->result() as $ca)
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{ $cid=$ca->id;
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$cname=$ca->name;?>
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<option value="<?=$cid;?>" ><?=$cname;?></option>
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<?php } }?>
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</select>
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</div>
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<div class="form-group col-md-6">
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<label for="inputState">Language <span class="required" style="color:red;">*</span></label>
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<select id="Racetype" class="form-select select2" name="agent_lang[]" multiple>
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<?php if(isset($race)&& $race->num_rows()>0)
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{ foreach($race->result() as $r)
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{ $rid=$r->id;
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$rname=$r->name;?>
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<option value="<?=$rid;?>" ><?=$rname;?></option>
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<?php } }?>
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</select>
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</div>
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<div class="w-100"></div>
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<div class="col-6 form-group">
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<label for="register-form-password">Choose Password <span class="required" style="color:red;">*</span></label>
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<input type="password" id="passwordd" name="agent_pass" class="form-control" />
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</div>
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<div class="col-6 form-group">
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<label for="register-form-repassword">Re-enter Password <span class="required" style="color:red;">*</span></label>
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<input type="password" id="conform_passwordd" name="agent_cpass" class="form-control" />
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<div id="passnotmatchh" style="color:red;"></div>
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</div>
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<div class="w-100"></div>
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<div class="col-12 form-group">
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<input type="submit" class="btn btn-danger m-0" id="regbtnn" name="becomeagent" value="Register Now">
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</div>
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</form>
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</div>
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</div>
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</div>
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</div>
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</section>
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<?php include 'includes/footer.php';?>
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<script>
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var base_path=$('body').attr('data-path');
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$("#emalidd").focusout(function(){
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var email =$(this).val();
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alert (email);
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var url22=base_path+"Frontend/emailcheck";
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$.post(url22,{email:email},function(res23){
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if(res23==1){ var msg="Email already Exist <a id='removexx' class='dismiss' href='javascript::' style='color:red;margin-left:10px'>x</a>";
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$("#alredyhavee").html(msg); $("#regbtnn").attr("disabled", true); $("#regbtnn").css("cursor", "no-drop");
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$("#emalidd").val("");
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}
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else{ var msg=""; $("#alredyhavee").html(msg);
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$("#regbtnn").attr("disabled", false); $("#regbtnn").css("cursor", "pointer");
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}
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});
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});
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</script>
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<script>
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$("#alredyhavee").on("click","#removexx",function(){
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var msg="";
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$("#alredyhavee").html(msg);
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});
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</script>
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<script>
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$("#conform_passwordd").mouseout(function(){
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var pass =$("#passwordd").val();
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var cpass =$("#conform_passwordd").val();
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if(pass!=cpass){ msg="Password Not Matched <a id='removepassxx' class='dismiss' href='javascript::' style='color:red;margin-left:10px'>x</a>";
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$("#passnotmatchh").html(msg); $("#regbtnn").attr("disabled", true); $("#regbtnn").css("cursor", "no-drop");
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$("#passwordd").val("");
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$("#conform_passwordd").val("");
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}
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else if(pass==cpass){ msg="";
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$("#passnotmatchh").html(msg);
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$("#regbtnn").attr("disabled", false); $("#regbtnn").css("cursor", "pointer");
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}
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});
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</script>
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<script>
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$("#passnotmatchh").on("click","#removepassxx",function(){
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var msg="";
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$("#passnotmatchh").html(msg);
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});
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</script>
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<script src="<?=base_url();?>fassets/global/plugins/select2/js/select2.full.min.js" type="text/javascript"></script>
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<script>
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function initializeSelect2(selectElementObj) {
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selectElementObj.select2({
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width: "100%",
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tags:true
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});
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}
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$("#policy_cat").each(function() {
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initializeSelect2($(this));
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});
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$("#policy_cmp").each(function() {
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initializeSelect2($(this));
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});
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$("#Racetype").each(function() {
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initializeSelect2($(this));
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});
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</script>
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