<div class="form-group mb-50">
		<label class="text-bold-600">Full Name<span class="red-star">*</span></label>
		<?php echo Form::text('name',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'100']); ?>

	 </div>
	 <div class="form-group mb-50 ">
		<label class="text-bold-600" for="exampleInputEmail1">Email ID<span class="red-star">*</span></label>
		<?php echo Form::email('email',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'255']); ?>

	 </div>
	 <div class="row">
		<div class="form-group col-md-6 col-12">
		   <label class="text-bold-600">Password<span class="red-star">*</span></label>
		   <input type="password" name="password" class="form-control" id="password">
		   <label class="text-bold-600" style="margin-top: 10px;">Confirm Password<span class="red-star">*</span></label>
		   <input type="password" name="confirm_password" id="confirm_password" class="form-control">
		</div>

		<div class="form-group col-md-6 col-12">
		   <div class="alert alert-warning password-alert d-sm-block" role="alert" style="margin-top: 25px;">
			  
				 <p class="requirements leng"><i class="icofont-check-alt fa-check" style="color: green;"></i><i class="icofont-close-line fa-times" style="color: red;"></i> 8 or more letters</p>
				 <p class="requirements big-letter"><i class="icofont-check-alt fa-check" style="color: green;"></i><i class="icofont-close-line fa-times" style="color: red;"></i> atleast 1 capital letter</p>
				 <p class="requirements num"><i class="icofont-check-alt fa-check" style="color: green;"></i><i class="icofont-close-line fa-times" style="color: red;"></i> at least 1 number</p>
				 <p class="requirements special-char"><i class="icofont-check-alt fa-check" style="color: green;"></i><i class="icofont-close-line fa-times" style="color: red;"></i> at least 1 special character</p>
			  
		   </div>
		</div>

		
		<div class="form-group col-md-12 col-12">
		   <label class="text-bold-600">Address 1<span class="red-star">*</span></label>
		   <?php echo Form::text('address_1',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'100']); ?>

		</div>
		<div class="form-group col-md-12 col-12">
		   <label class="text-bold-600">Address 2</label>
		   
		   <?php echo Form::text('address_2',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'100']); ?>

		</div>
		<div class="form-group col-md-6 col-12">
		   <label class="text-bold-600">City<span class="red-star">*</span></label>
		   <?php echo Form::text('city',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'45']); ?>

		</div>
		<div class="form-group col-md-6 col-12">
		   <label class="text-bold-600">State<span class="red-star">*</span></label>
		    <?php echo Form::text('state',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'45']); ?>

		</div>
		<div class="form-group col-md-6 col-12">
		   <label class="text-bold-600">Zip code<span class="red-star">*</span></label>
		    <?php echo Form::text('zipcode',null,['class'=>'form-control js-number','autocomplete'=>'nope','maxlength'=>'11']); ?>

		</div>
		<div class="form-group col-md-6 col-12">
		   <label class="text-bold-600">Country<span class="red-star">*</span></label>
		    <?php echo Form::text('country',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'56']); ?>

		</div>
		<div class="form-group col-md-12 col-12">
		   <label class="text-bold-600" for="exampleInputPassword1">Phone<span class="red-star">*</span></label>
		   <div class="row">
			  <div class="col-md-1">
				 <i class='bx bx-plus' style="font-size: 1.20em; padding: 8px;"></i>
			  </div>
			  <div class="col-md-2">
				  <?php echo Form::text('code',null,['class'=>'form-control js-number','autocomplete'=>'nope','maxlength'=>'3','style'=>'width:60px']); ?>

			  </div>
			  <div class="col-md-4">
				 <?php echo Form::text('phone',null,['class'=>'form-control js-number','autocomplete'=>'nope','maxlength'=>'10']); ?>

			  </div>
		   </div>
		</div>

		<div class="form-group col-md-12 col-12">
		   <label class="text-bold-600" for="music_academy">Academy Name</label>
		   <?php echo Form::text('music_academy',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'100']); ?>

		</div>
		<div class="form-group col-md-12 col-12">
		   <label class="text-bold-600" for="teacher_name">Music Stream</label>
		   <?php echo Form::text('music_stream',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'100']); ?>

		</div>
		<div class="form-group col-md-6 col-6">
		   <label class="text-bold-600" for="teacher_name">Is Academy</label>
		   <?php echo Form::select('is_academy', array('1'=>'Yes','0'=>'No'),null,['class'=>'form-control','id'=>'status-column']); ?>

		  
		   
		</div>
		<div class="form-group col-md-6 col-6">
		   <label class="text-bold-600" for="teacher_name">Status</label>
		   <?php echo Form::select('status', array('1'=>'Activte','Inactive'=>'Deactivate'),null,['class'=>'form-control','id'=>'status-column']); ?>

		  
		</div>
	 </div>
	 
	 <div class="col-12 d-flex justify-content-end">
			<button type="submit" class="btn btn-primary mr-1 mb-1">Submit</button>
			<button type="reset" class="btn btn-light-secondary mr-1 mb-1">Reset</button>
		  </div>
<?php /**PATH /home/shahul2020/swarkul/resources/views/site/admin/form.blade.php ENDPATH**/ ?>