@section('css')
    @if(config('config.enable_uppercase'))
      <style>
        input[type="text"] { text-transform: uppercase; }
      </style>
    @endif
  @endsection

  @if(Auth::check() && !isset($job_detail))
    <div class="row">
      <div class="col-sm-6">
        <div class="form-group">
          {!! Form::label('date_of_application',trans('messages.date_of').' '.trans('messages.application'),[]) !!}
          <input type="text" class="form-control datepicker" name="date_of_application" placeholder="{{trans('messages.date_of').' '.trans('messages.application')}}" value="{{isset($job_application) ? $job_application->date_of_application : ''}}">
        </div>
      </div>
      <div class="col-sm-6">
        <div class="form-group">
          {!! Form::label('job_id',trans('messages.job').' '.trans('messages.title'),[]) !!}
          {!! Form::select('job_id', $jobs, isset($job_application) ? $job_application->job_id : (isset($job) ? $job->id : ''),['class'=>'form-control show-tick','title'=>trans('messages.select_one')]) !!}
        </div>
      </div>
    </div>
    <hr>
  @else
    {!! Form::hidden('job_id',isset($job) ? $job->id : '') !!}
  @endif

  @if(!isset($job_detail))
    <h4><u>Personal Details</u></h4>
    <div class="row">
      <div class="col-sm-8">
        <div class="form-group">
          {!! Form::label('first_name',trans('messages.name'),['class'=>'required']) !!}
          <input type="text" class="form-control text-input" name="first_name" placeholder="{{trans('messages.name')}}" value="{{isset($job_application) ? $job_application->first_name : ''}}">
        </div>
      </div>
      <div class="col-sm-4">
        <div class="form-group">
          {!! Form::label('gender',trans('messages.gender'),['class'=>'required']) !!}
          <div class="checkbox">
            @foreach(config('lists.gender') as $gender)
              <input type="radio" class="form-control icheck" name="gender" value="{{$gender}}" {{(isset($job_application) && $job_application->gender == $gender) ? 'checked' : ''}}> {{trans('messages.'.$gender)}}
              &nbsp;
            @endforeach
          </div>
        </div>
      </div>
    </div>

    <div class="row">
      <div class="col-sm-8">
        <div class="form-group">
          {!! Form::label('email',trans('messages.email'),[]) !!}
          <input type="email" class="form-control text-input" name="email" placeholder="{{trans('messages.email')}}" value="{{isset($job_application) ? $job_application->email : ''}}">
        </div>
      </div>
    	<div class="col-sm-4">
        <div class="form-group">
      		{!! Form::label('date_of_birth',trans('messages.date_of').' '.trans('messages.birth'),['class'=>'required']) !!}
          <div style="display:flex;">
            {!! Form::selectRange('date_of_birth_day',1,31,isset($job_application->date_of_birth) ? (int) Carbon::parse($job_application->date_of_birth)->format('d') : '',['class' => 'form-control', 'placeholder' => '-- Day --']) !!} &nbsp;
            {!! Form::selectMonth('date_of_birth_mth',isset($job_application->date_of_birth) ? getMonthNumber(Carbon::parse($job_application->date_of_birth)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('date_of_birth_yr',1940,Carbon::now()->year,isset($job_application->date_of_birth) ? Carbon::parse($job_application->date_of_birth)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('date_of_birth','') !!}
          </div>
          {{-- {!! Form::date('date_of_birth', null, ['class' => 'form-control', 'max' => '2099-12-31']) !!} --}}
        </div>
    	</div>
    </div>
    <div class="row">
      <div class="col-sm-8">
  			<div class="form-group">
  				{!! Form::label('address_line_1',trans('messages.address'),['class'=>'required']) !!}
  				{!! Form::input('text','address_line_1',isset($job_application) ? $job_application->address_line_1 : '',['class'=>'form-control','placeholder'=>trans('messages.address')]) !!}
  			</div>
  		</div>
      <div class="col-sm-4">
        <div class="form-group">
          {!! Form::label('zipcode',trans('messages.zipcode'),['class'=>'required']) !!}
          {!! Form::input('text','zipcode',isset($job_application) ? $job_application->zipcode : '',['class'=>'form-control','placeholder'=>trans('messages.zipcode')])  !!}
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('primary_contact_number','Tel No. 1',['class'=>'required']) !!}
          <input type="text" class="form-control text-input" name="primary_contact_number" placeholder="Tel No. 1" value="{{isset($job_application) ? $job_application->primary_contact_number : ''}}">
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('secondary_contact_number','Tel No. 2',[]) !!}
          <input type="text" class="form-control text-input" name="secondary_contact_number" placeholder="Tel No. 2" value="{{isset($job_application) ? $job_application->secondary_contact_number : ''}}">
        </div>
      </div>
      <div class="col-sm-6">
  			<div class="form-group">
  				{!! Form::label('designation',trans('messages.applying_for'),['class'=>'required'])!!}
  				{!! Form::select('designation_id',isset($job->department_id) ? $job->Department->Designation->pluck('name','id')->all() : [], isset($job_application) ? $job_application->designation_id : '',['class'=>'form-control show-tick','title' => trans('messages.select_one')]) !!}
  			</div>
  		</div>
    </div>

    <hr>

    {{ getCustomFields('job-application-form',$custom_field_values) }}
    <hr>

    {{-- @if(config('config.enable_custom_field'))
      {{ getCustomFields('job-application-form',$custom_field_values) }}
      <hr>
    @endif --}}

    <h4><u>Education & Professional Training</u></h4>
    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('edu_from_1',trans('messages.from'),['class'=>'required']) !!}
          <div style="display:flex;">
            {!! Form::selectMonth('edu_from_1_mth',!empty($past_education[0]->from) ? getMonthNumber(\Carbon\Carbon::parse($past_education[0]->from)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('edu_from_1_yr',1940,\Carbon\Carbon::now()->year,!empty($past_education[0]->from) ? \Carbon\Carbon::parse($past_education[0]->from)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('edu_from_1','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('edu_to_1',trans('messages.to'),['class'=>'required']) !!}
          <div style="display:flex;">
            {!! Form::selectMonth('edu_to_1_mth',!empty($past_education[0]->to) ? getMonthNumber(\Carbon\Carbon::parse($past_education[0]->to)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('edu_to_1_yr',1940,\Carbon\Carbon::now()->year,!empty($past_education[0]->to) ? \Carbon\Carbon::parse($past_education[0]->to)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('edu_to_1','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('institute_1',trans('messages.institute').' '.trans('messages.name'),['class'=>'required']) !!}
          {!! Form::input('text','institute_1',isset($past_education[0]->institution) ? $past_education[0]->institution : '',['class'=>'form-control','placeholder'=>trans('messages.institute').' '.trans('messages.name')]) !!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('education_level_1',trans('messages.education').' '.trans('messages.level'),['class'=>'required']) !!}
  				{!! Form::select('education_level_1',$education_levels,isset($past_education[0]->level) ? $past_education[0]->level : '',['class'=>'form-control input-xlarge show-tick','title' => trans('messages.select_one')]) !!}
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('edu_from_2',trans('messages.from'),[]) !!}
          <div style="display:flex;">
            {!! Form::selectMonth('edu_from_2_mth',!empty($past_education[1]->from) ? getMonthNumber(\Carbon\Carbon::parse($past_education[1]->from)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('edu_from_2_yr',1940,\Carbon\Carbon::now()->year,!empty($past_education[1]->from) ? \Carbon\Carbon::parse($past_education[1]->from)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('edu_from_2','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('edu_to_2',trans('messages.to'),[]) !!}
          <div style="display:flex;">
            {!! Form::selectMonth('edu_to_2_mth',!empty($past_education[1]->to) ? getMonthNumber(\Carbon\Carbon::parse($past_education[1]->to)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('edu_to_2_yr',1940,\Carbon\Carbon::now()->year,!empty($past_education[1]->to) ? \Carbon\Carbon::parse($past_education[1]->to)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('edu_to_2','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('institute_2',trans('messages.institute').' '.trans('messages.name')) !!}
          {!! Form::input('text','institute_2',isset($past_education[1]->institution) ? $past_education[1]->institution : '',['class'=>'form-control','placeholder'=>trans('messages.institute').' '.trans('messages.name')]) !!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('education_level_2',trans('messages.education').' '.trans('messages.level'),[]) !!}
  				{!! Form::select('education_level_2',$education_levels,isset($past_education[1]->level) ? $past_education[1]->level : '',['class'=>'form-control input-xlarge show-tick','title' => trans('messages.select_one')]) !!}
        </div>
      </div>
    </div>

    <hr>

    <h4><u>Working Experience</u></h4>
    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('work_from_1',trans('messages.from'),['class'=>'required']) !!}
          <div style="display:flex;">
            {!! Form::selectMonth('work_from_1_mth',!empty($past_work_exp[0]->from) ? getMonthNumber(\Carbon\Carbon::parse($past_work_exp[0]->from)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('work_from_1_yr',1940,\Carbon\Carbon::now()->year,!empty($past_work_exp[0]->from) ? \Carbon\Carbon::parse($past_work_exp[0]->from)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('work_from_1','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('work_to_1',trans('messages.to'),['class'=>'required']) !!}
          <div style="display:flex;">
            {!! Form::selectMonth('work_to_1_mth',!empty($past_work_exp[0]->to) ? getMonthNumber(\Carbon\Carbon::parse($past_work_exp[0]->to)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('work_to_1_yr',1940,\Carbon\Carbon::now()->year,!empty($past_work_exp[0]->to) ? \Carbon\Carbon::parse($past_work_exp[0]->to)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('work_to_1','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('company_1',trans('messages.company'),['class'=>'required']) !!}
          {!! Form::input('text','company_1',isset($past_work_exp[0]->company) ? $past_work_exp[0]->company : '',['class'=>'form-control','placeholder'=>trans('messages.company').' '.trans('messages.name')]) !!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('job_title_1',trans('messages.job').' '.trans('messages.title'),['class'=>'required']) !!}
  				{!! Form::input('text','job_title_1',isset($past_work_exp[0]->title) ? $past_work_exp[0]->title : '',['class'=>'form-control','placeholder'=>trans('messages.job').' '.trans('messages.title')]) !!}
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          @if (env('COMPANY_ID') == 34)
            {!! Form::label('work_from_2',trans('messages.from'),['class'=>'required']) !!}
          @else
            {!! Form::label('work_from_2',trans('messages.from'),[]) !!}
          @endif
          <div style="display:flex;">
            {!! Form::selectMonth('work_from_2_mth',!empty($past_work_exp[1]->from) ? getMonthNumber(\Carbon\Carbon::parse($past_work_exp[1]->from)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('work_from_2_yr',1940,\Carbon\Carbon::now()->year,!empty($past_work_exp[1]->from) ? \Carbon\Carbon::parse($past_work_exp[1]->from)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('work_from_2','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          @if (env('COMPANY_ID') == 34)
            {!! Form::label('work_to_2',trans('messages.to'),['class'=>'required']) !!}
          @else
            {!! Form::label('work_to_2',trans('messages.to'),[]) !!}
          @endif
          <div style="display:flex;">
            {!! Form::selectMonth('work_to_2_mth',!empty($past_work_exp[1]->to) ? getMonthNumber(\Carbon\Carbon::parse($past_work_exp[1]->to)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('work_to_2_yr',1940,\Carbon\Carbon::now()->year,!empty($past_work_exp[1]->to) ? \Carbon\Carbon::parse($past_work_exp[1]->to)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('work_to_2','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          @if (env('COMPANY_ID') == 34)
            {!! Form::label('company_2',trans('messages.company'),['class'=>'required']) !!}
          @else
            {!! Form::label('company_2',trans('messages.company'),[]) !!}
          @endif
          {!! Form::input('text','company_2',isset($past_work_exp[1]->company) ? $past_work_exp[1]->company : '',['class'=>'form-control','placeholder'=>trans('messages.company').' '.trans('messages.name')]) !!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          @if (env('COMPANY_ID') == 34)
            {!! Form::label('job_title_2',trans('messages.job').' '.trans('messages.title'),['class'=>'required']) !!}
          @else
            {!! Form::label('job_title_2',trans('messages.job').' '.trans('messages.title'),[]) !!}
          @endif
  				{!! Form::input('text','job_title_2',isset($past_work_exp[1]->title) ? $past_work_exp[1]->title : '',['class'=>'form-control','placeholder'=>trans('messages.job').' '.trans('messages.title')]) !!}
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('work_from_3',trans('messages.from'),[]) !!}
          <div style="display:flex;">
            {!! Form::selectMonth('work_from_3_mth',!empty($past_work_exp[2]->from) ? getMonthNumber(\Carbon\Carbon::parse($past_work_exp[2]->from)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('work_from_3_yr',1940,\Carbon\Carbon::now()->year,!empty($past_work_exp[2]->from) ? \Carbon\Carbon::parse($past_work_exp[2]->from)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('work_from_3','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('work_to_3',trans('messages.to'),[]) !!}
          <div style="display:flex;">
            {!! Form::selectMonth('work_to_3_mth',!empty($past_work_exp[2]->to) ? getMonthNumber(\Carbon\Carbon::parse($past_work_exp[2]->to)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('work_to_3_yr',1940,\Carbon\Carbon::now()->year,!empty($past_work_exp[2]->to) ? \Carbon\Carbon::parse($past_work_exp[2]->to)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('work_to_3','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('company_3',trans('messages.company')) !!}
          {!! Form::input('text','company_3',isset($past_work_exp[2]->company) ? $past_work_exp[2]->company : '',['class'=>'form-control','placeholder'=>trans('messages.company').' '.trans('messages.name')]) !!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('job_title_3',trans('messages.job').' '.trans('messages.title'),[]) !!}
  				{!! Form::input('text','job_title_3',isset($past_work_exp[2]->title) ? $past_work_exp[2]->title : '',['class'=>'form-control','placeholder'=>trans('messages.job').' '.trans('messages.title')]) !!}
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('work_from_4',trans('messages.from'),[]) !!}
          <div style="display:flex;">
            {!! Form::selectMonth('work_from_4_mth',!empty($past_work_exp[3]->from) ? getMonthNumber(\Carbon\Carbon::parse($past_work_exp[3]->from)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('work_from_4_yr',1940,\Carbon\Carbon::now()->year,!empty($past_work_exp[3]->from) ? \Carbon\Carbon::parse($past_work_exp[3]->from)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('work_from_4','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('work_to_4',trans('messages.to'),[]) !!}
          <div style="display:flex;">
            {!! Form::selectMonth('work_to_4_mth',!empty($past_work_exp[3]->to) ? getMonthNumber(\Carbon\Carbon::parse($past_work_exp[3]->to)->format('F')) : '',['class' => 'form-control', 'placeholder' => '-- Month --']) !!} &nbsp;
            {!! Form::selectYear('work_to_4_yr',1940,\Carbon\Carbon::now()->year,!empty($past_work_exp[3]->to) ? \Carbon\Carbon::parse($past_work_exp[3]->to)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('work_to_4','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('company_4',trans('messages.company')) !!}
          {!! Form::input('text','company_4',isset($past_work_exp[3]->company) ? $past_work_exp[3]->company : '',['class'=>'form-control','placeholder'=>trans('messages.company').' '.trans('messages.name')]) !!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('job_title_4',trans('messages.job').' '.trans('messages.title'),[]) !!}
          {!! Form::input('text','job_title_4',isset($past_work_exp[3]->title) ? $past_work_exp[3]->title : '',['class'=>'form-control','placeholder'=>trans('messages.job').' '.trans('messages.title')]) !!}
        </div>
      </div>
    </div>

    <hr>

    <h4><u>Declaration</u></h4>
    <div class="row">
      <div class="col-sm-12">
        <div class="form-group">
          {!! Form::label('medical_1','Have you suffered, or are suffering from any mental condition or illness?',[]) !!}
          @if(Auth::check() && !isset($job_detail))
            <div class="checkbox">
              <input type="radio" class="form-control icheck" name="medical_con_1" value="No" {{(isset($medical_declaration[0]->condition) && $medical_declaration[0]->condition == "No") ? 'checked' : ''}}> No &nbsp
              <input type="radio" class="form-control icheck" name="medical_con_1" value="Yes" id="medical_cbx_1" {{(isset($medical_declaration[0]->condition) && $medical_declaration[0]->condition == "Yes") ? 'checked' : ''}}> Yes &nbsp
            </div>
            <div id="medical_text_field_1" style="display:block;">
              {!! Form::input('text','medical_text_1',isset($medical_declaration[0]->description) ? $medical_declaration[0]->description : '',['class'=>'form-control','placeholder'=>'Please Specify']) !!}
            </div>
          @else
            <div class="checkbox">
              <input type="radio" class="form-control icheck" name="medical_con_1" value="No" checked > No &nbsp
              <input type="radio" class="form-control icheck" name="medical_con_1" value="Yes" id="medical_cbx_1"> Yes &nbsp
            </div>
            <div id="medical_text_field_1" style="display:none;">
              {!! Form::input('text','medical_text_1',isset($medical_declaration[0]->description) ? $medical_declaration[0]->description : '',['class'=>'form-control','placeholder'=>'Please Specify']) !!}
            </div>
          @endif
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-12">
        <div class="form-group">
          {!! Form::label('medical_2','Have you suffered, or are suffering from any medical condition, illness, disease or physical impairment (eg loss of sight, limb, hearing)?',[]) !!}
          @if(Auth::check() && !isset($job_detail))
            <div class="checkbox">
              <input type="radio" class="form-control icheck" name="medical_con_2" value="No" {{(isset($medical_declaration[1]->condition) && $medical_declaration[1]->condition == "No") ? 'checked' : ''}}> No &nbsp
              <input type="radio" class="form-control icheck" name="medical_con_2" value="Yes" id="medical_cbx_2" {{(isset($medical_declaration[1]->condition) && $medical_declaration[1]->condition == "Yes") ? 'checked' : ''}}> Yes &nbsp
            </div>
            <div id="medical_text_field_2" style="display:block;">
              {!! Form::input('text','medical_text_2',isset($medical_declaration[1]->description) ? $medical_declaration[1]->description : '',['class'=>'form-control','placeholder'=>'Please Specify']) !!}
            </div>
          @else
            <div class="checkbox">
              <input type="radio" class="form-control icheck" name="medical_con_2" value="No" checked > No &nbsp
              <input type="radio" class="form-control icheck" name="medical_con_2" value="Yes" id="medical_cbx_2"> Yes &nbsp
            </div>
            <div id="medical_text_field_2" style="display:none;">
              {!! Form::input('text','medical_text_2',isset($medical_declaration[1]->description) ? $medical_declaration[1]->description : '',['class'=>'form-control','placeholder'=>'Please Specify']) !!}
            </div>
          @endif
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-12">
        <div class="form-group">
          {!! Form::label('declare_1','Have you been charged with any offence in a Court of Law in any country (including cases where the outcome is pending, as well as traffic offences)?',[]) !!}
          @if(Auth::check() && !isset($job_detail))
            <div class="checkbox">
              <input type="radio" class="form-control icheck" name="declare_con_1" value="No" {{(isset($offence_declaration[0]->condition) && $offence_declaration[0]->condition == "No") ? 'checked' : ''}}> No &nbsp
              <input type="radio" class="form-control icheck" name="declare_con_1" value="Yes" id="declare_cbx_1" {{(isset($offence_declaration[0]->condition) && $offence_declaration[0]->condition == "Yes") ? 'checked' : ''}}> Yes &nbsp
            </div>
            <div id="declare_text_field_1" style="display:block;">
              {!! Form::input('text','declare_text_1',isset($offence_declaration[0]->description) ? $offence_declaration[0]->description : '',['class'=>'form-control','placeholder'=>'Please Specify']) !!}
            </div>
          @else
            <div class="checkbox">
              <input type="radio" class="form-control icheck" name="declare_con_1" value="No" checked > No &nbsp
              <input type="radio" class="form-control icheck" name="declare_con_1" value="Yes" id="declare_cbx_1"> Yes &nbsp
            </div>
            <div id="declare_text_field_1" style="display:none;">
              {!! Form::input('text','declare_text_1',isset($offence_declaration[0]->description) ? $offence_declaration[0]->description : '',['class'=>'form-control','placeholder'=>'Please Specify']) !!}
            </div>
          @endif
        </div>
      </div>
    </div>

    <hr>

    @if(Auth::check() && !isset($job_detail))
    @else
      <h4><u>Terms & Conditions</u></h4>
      <div class="row">
        <div class="col-sm-1">
          <div class="checkbox">
    				<label>
    					{!! Form::checkbox('disclaimer',1,null,['id' => 'disclaimerCbx', 'class' => 'icheck']) !!}
    				</label>
    			</div>
        </div>
    		<div class="col-sm-11">
          <p>I am currently <b><u>NOT</u></b> working as a civil servant. I shall immediately declare to the Company if I am working as a civil servant. Failing to do so, I shall be accountable for any sort of outcome thereafter.</p>
    		</div>
    	</div>
      <div class="row">
        <div class="col-sm-1">
          <div class="checkbox">
    				<label>
    					{!! Form::checkbox('disclaimer2',1,null,['id' => 'disclaimerCbx2', 'class' => 'icheck']) !!}
    				</label>
    			</div>
        </div>
    		<div class="col-sm-11">
    			<p>I authorize the Company to make reference to all my past employers on my job performance / experience.</p>
    		</div>
    	</div>
      <div class="row">
        <div class="col-sm-1">
          <div class="checkbox">
    				<label>
    					{!! Form::checkbox('disclaimer3',1,null,['id' => 'disclaimerCbx3', 'class' => 'icheck']) !!}
    				</label>
    			</div>
        </div>
    		<div class="col-sm-11">
    			<p>I further give consent to the Company for my personal data to be used for work purposes. E.g. sending my resume to clients, submitting my particulars to PLRD
            or to release my information to government departments (CPF, MOM, etc..) whenever requested.</p>
    		</div>
    	</div>
      <div class="row">
        <div class="col-sm-1">
          <div class="checkbox">
    				<label>
    					{!! Form::checkbox('disclaimer4',1,null,['id' => 'disclaimerCbx4', 'class' => 'icheck']) !!}
    				</label>
    			</div>
        </div>
    		<div class="col-sm-11">
    			<p>I confirm that all the above facts in this application form are true and accurate to the best of my knowledge. I have not deliberately omitted any relevant fact.
              I understand that should any of the above information turn out to be false or inaccurate, I will be subjected to appropriate action.</p>
    		</div>
    	</div>
    @endif

  @else
    <p><b>{{trans('messages.applying_as_user',['attribute' => Auth::user()->full_name])}}</b></p>
  @endif

  @if(Auth::check() && !isset($job_detail))
    {{-- Backend --}}
    @if (in_array(env('COMPANY_ID'),[118,175]))
      @include('upload.index',['module' => 'job-application-nric', 'upload_button' => trans('messages.upload').' '.trans('messages.nric').' (Front & Back)', 'module_id' => isset($job_application) ? $job_application->id : ''])
      <br>
    @endif
    @if (in_array(env('COMPANY_ID'),[118]))
      @include('upload.index',['module' => 'job-application-medical', 'upload_button' => trans('messages.upload').' '.trans('messages.medical'), 'module_id' => isset($job_application) ? $job_application->id : ''])
      <br>
    @endif
  @else
    {{-- Application Portal --}}
    @if (in_array(env('COMPANY_ID'),[118,175]))
      @include('upload.index',['module' => 'job-application-nric','upload_button' => trans('messages.upload').' '.trans('messages.nric').' (Front & Back)','module_id' => isset($job_application) ? $job_application->id : ''])
      <br>
    @endif
    @if (in_array(env('COMPANY_ID'),[118]))
      @include('upload.index',['module' => 'job-application-medical', 'upload_button' => trans('messages.upload').' '.trans('messages.medical'), 'module_id' => isset($job_application) ? $job_application->id : ''])
      <br>
    @endif
    @if (request()->path() != "direct-application" && env('COMPANY_ID') != 79)
      <a href="/jobs" class="btn btn-default pull-left">{!! trans('messages.back_to').' '.trans('messages.job').' '.trans('messages.post') !!}</a>
    @endif
  @endif

  @if(Auth::check() && !isset($job_detail))
    {!! Form::submit(isset($buttonText) ? $buttonText : trans('messages.submit').' '.trans('messages.application'),['id' => 'm-submit', 'class' => 'btn btn-primary pull-right']) !!}
  @else
    {!! Form::submit(isset($buttonText) ? $buttonText : trans('messages.submit').' '.trans('messages.application'),['id' => 'm-submit', 'class' => 'btn btn-primary pull-right', 'disabled' => 'true']) !!}
  @endif

  @section('js')
    <script>
      var a = [$('#disclaimerCbx'), $('#disclaimerCbx2'), $('#disclaimerCbx3'), $('#disclaimerCbx4')];
      for(var i in a ) {
        a[i].on('ifChecked', function () {
          document.getElementById("m-submit").disabled = !($('#disclaimerCbx')[0].checked && $('#disclaimerCbx2')[0].checked && $('#disclaimerCbx3')[0].checked && $('#disclaimerCbx4')[0].checked);
    		});

        a[i].on('ifUnchecked', function () {
          document.getElementById("m-submit").disabled = !($('#disclaimerCbx')[0].checked && $('#disclaimerCbx2')[0].checked && $('#disclaimerCbx3')[0].checked && $('#disclaimerCbx4')[0].checked);
    		});
      }

      $('#declare_cbx_1').on('ifChecked', function () {
        document.getElementById("declare_text_field_1").style.display = "block";
      });
      $('#declare_cbx_1').on('ifUnchecked', function () {
        document.getElementById("declare_text_field_1").style.display = "none";
      });

      $('#medical_cbx_1').on('ifChecked', function () {
        document.getElementById("medical_text_field_1").style.display = "block";
      });
      $('#medical_cbx_1').on('ifUnchecked', function () {
        document.getElementById("medical_text_field_1").style.display = "none";
      });

      $('#medical_cbx_2').on('ifChecked', function () {
        document.getElementById("medical_text_field_2").style.display = "block";
      });
      $('#medical_cbx_2').on('ifUnchecked', function () {
        document.getElementById("medical_text_field_2").style.display = "none";
      });
    </script>
  @endsection