

<?php $__env->startSection('title', 'enquiry Now'); ?>

<?php $__env->startSection('content'); ?>
<?php echo $__env->yieldPushContent('scripts'); ?>

<style>
    body {
        background: #fff;
    }
</style>


<body>
    <!-- Page Header Start -->
    <div class="page-header">
        <img src="<?php echo e(asset('frontend/assets/images/about-us-hn.webp')); ?>" alt="Banner" class="page-header-img">

    </div>

     <!--About Us Section Start -->
<!--    <div class="about-us enquiry-now-slide">-->
<!--    <div class="container">-->
<!--        <div class="row">-->

<!--            <div class="col-lg-8">-->

<!--                <?php if(session('success')): ?>-->
<!--                    <div class="alert alert-success">-->
<!--                        <?php echo e(session('success')); ?>-->
<!--                    </div>-->
<!--                <?php endif; ?>-->

<!--                <form action="<?php echo e(route('donation.enquiry.store')); ?>" method="POST">-->
<!--                    <?php echo csrf_field(); ?>-->

<!--                    <div class="form-group">-->
<!--                        <label>Full Name <span>*</span></label>-->
<!--                        <input type="text" name="fullname" value="<?php echo e(old('fullname')); ?>" placeholder="Enter your full name" required>-->
<!--                        <?php $__errorArgs = ['fullname'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>-->
<!--                    </div>-->

<!--                    <div class="form-group">-->
<!--                        <label>Email Address <span>*</span></label>-->
<!--                        <input type="email" name="email" value="<?php echo e(old('email')); ?>" placeholder="Enter your email address" required>-->
<!--                        <?php $__errorArgs = ['email'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>-->
<!--                    </div>-->

<!--                    <div class="form-group">-->
<!--                        <label>Phone Number <span>*</span></label>-->
<!--                        <input type="tel" name="phone" value="<?php echo e(old('phone')); ?>" placeholder="Enter your phone number" required>-->
<!--                        <?php $__errorArgs = ['phone'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>-->
<!--                    </div>-->

<!--                    <div class="form-group">-->
<!--                        <label>State <span>*</span></label>-->
<!--                        <input type="text" name="state" value="<?php echo e(old('state')); ?>" placeholder="Enter your state" required>-->
<!--                        <?php $__errorArgs = ['state'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>-->
<!--                    </div>-->

<!--                    <div class="form-group">-->
<!--                        <label>District <span>*</span></label>-->
<!--                        <input type="text" name="district" value="<?php echo e(old('district')); ?>" placeholder="Enter your district" required>-->
<!--                        <?php $__errorArgs = ['district'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>-->
<!--                    </div>-->

<!--                    <div class="form-group">-->
<!--                        <label>PIN Code <span>*</span></label>-->
<!--                        <input type="text" name="pincode" maxlength="6" value="<?php echo e(old('pincode')); ?>" placeholder="Enter your PIN code" required>-->
<!--                        <?php $__errorArgs = ['pincode'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>-->
<!--                    </div>-->

<!--                    <div class="form-group">-->
<!--                        <label>Address <span>*</span></label>-->
<!--                        <textarea name="address" rows="3" placeholder="Enter your complete address" required><?php echo e(old('address')); ?></textarea>-->
<!--                        <?php $__errorArgs = ['address'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>-->
<!--                    </div>-->

<!--                    <div class="form-group">-->
<!--                        <label>Message (Optional)</label>-->
<!--                        <textarea name="message" rows="4" placeholder="Write your message (optional)"><?php echo e(old('message')); ?></textarea>-->
<!--                    </div>-->

<!--                    <button type="submit" class="btn-submit">-->
<!--                        Donate Now-->
<!--                    </button>-->
<!--                </form>-->

<!--            </div>-->
<!--        </div>-->
<!--    </div>-->
<!--</div>-->


<div class="about-us enquiry-now-slide">
    <div class="container">
        <div class="row">
            <div class="col-lg-8">

                <?php if(session('success')): ?>
                    <div class="alert alert-success">
                        <?php echo e(session('success')); ?>

                    </div>
                <?php endif; ?>

                <form action="<?php echo e(route('donation.enquiry.store')); ?>" method="POST">
                    <?php echo csrf_field(); ?>

                    <div class="form-group">
                        <label>Full Name <span>*</span></label>
                        <input type="text" name="fullname" value="<?php echo e(old('fullname')); ?>" placeholder="Enter your full name" required>
                        <?php $__errorArgs = ['fullname'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                    </div>

                    <div class="form-group">
                        <label>Email Address <span>*</span></label>
                        <input type="email" name="email" value="<?php echo e(old('email')); ?>" placeholder="Enter your email address" required>
                        <?php $__errorArgs = ['email'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                    </div>
                    
                    
                    <div class="form-group">
                        <label>Phone Number <span>*</span></label>
                        <input type="tel" name="phone" value="<?php echo e(old('phone')); ?>" placeholder="Enter your phone number"
                            maxlength="10" inputmode="numeric" pattern="[0-9]{10}"
                            oninput="this.value=this.value.replace(/[^0-9]/g,'').slice(0,10)" required>
                        <?php $__errorArgs = ['phone'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                    </div>

                    <!--<div class="form-group">-->
                    <!--    <label>Phone Number <span>*</span></label>-->
                    <!--    <input type="tel" name="phone" value="<?php echo e(old('phone')); ?>" placeholder="Enter your phone number" required>-->
                    <!--    <?php $__errorArgs = ['phone'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>-->
                    <!--</div>-->

                    <div class="form-group">
                        <label>State <span>*</span></label>
                        <input type="text" name="state" value="<?php echo e(old('state')); ?>" placeholder="Enter your state" required>
                        <?php $__errorArgs = ['state'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                    </div>

                    <div class="form-group">
                        <label>District <span>*</span></label>
                        <input type="text" name="district" value="<?php echo e(old('district')); ?>" placeholder="Enter your district" required>
                        <?php $__errorArgs = ['district'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                    </div>
                    
                    <div class="form-group">
                            <label>PIN Code <span>*</span></label>
                            <input type="text" name="pincode" value="<?php echo e(old('pincode')); ?>" placeholder="Enter your PIN code"
                                maxlength="6" inputmode="numeric" pattern="[0-9]{6}"
                                oninput="this.value=this.value.replace(/[^0-9]/g,'').slice(0,6)" required>
                            <?php $__errorArgs = ['pincode'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                    </div>

                    <!--<div class="form-group">-->
                    <!--    <label>PIN Code <span>*</span></label>-->
                    <!--    <input type="text" name="pincode" maxlength="6" value="<?php echo e(old('pincode')); ?>" placeholder="Enter your PIN code" required>-->
                    <!--    <?php $__errorArgs = ['pincode'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>-->
                    <!--</div>-->

                    <div class="form-group">
                        <label>Address <span>*</span></label>
                        <textarea name="address" rows="3" placeholder="Enter your complete address" required><?php echo e(old('address')); ?></textarea>
                        <?php $__errorArgs = ['address'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                    </div>

                    <div class="form-group">
                        <label>Message (Optional)</label>
                        <textarea name="message" rows="4" placeholder="Write your message (optional)"><?php echo e(old('message')); ?></textarea>
                    </div>

                    <div class="form-group">
                        <div class="g-recaptcha" data-sitekey="<?php echo e(config('services.recaptcha.site_key')); ?>"></div>
                        <?php $__errorArgs = ['g-recaptcha-response'];
$__bag = $errors->getBag($__errorArgs[1] ?? 'default');
if ($__bag->has($__errorArgs[0])) :
if (isset($message)) { $__messageOriginal = $message; }
$message = $__bag->first($__errorArgs[0]); ?> <small class="text-danger"><?php echo e($message); ?></small> <?php unset($message);
if (isset($__messageOriginal)) { $message = $__messageOriginal; }
endif;
unset($__errorArgs, $__bag); ?>
                    </div>

                    <button type="submit" class="btn-submit">
                        Donate Now
                    </button>
                </form>

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


<script src="https://www.google.com/recaptcha/api.js" async defer></script>


  



<?php $__env->stopSection(); ?>
<?php echo $__env->make('layouts.app', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH /home/gauteert/public_html/demo/resources/views/frontend/enquiry-now.blade.php ENDPATH**/ ?>