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

  @if(Auth::check() && !isset($job_detail))
    <div class="row">
      <div class="col-sm-4">
        <div class="form-group">
          {!! Form::label('date_of_application',trans('messages.date_of').' '.trans('messages.application'),[])!!}
          <input type="text" class="form-control datepicker" name="date_of_application" placeholder="{{trans('messages.date_of').' '.trans('messages.application')}}" value="{{isset($job_application) ? $job_application->date_of_application : ''}}">
        </div>
      </div>
      {!! Form::hidden('job_id',isset($job) ? $job->id : '') !!}
    </div>
  @else
    @if(in_array(env('COMPANY_ID'), config('constant.custom_job_application')))
      {!! Form::hidden('job_id',isset($job) ? $job->id : '') !!}
    @else
      <div class="form-group">
        {!! Form::label('job_id',trans('messages.job').' '.trans('messages.title'),[])!!}
        {!! Form::select('job_id',$jobs,isset($job_application) ? $job_application->job_id : (isset($job) ? $job->id : ''),['class'=>'form-control show-tick','title'=>trans('messages.select_one')])!!}
      </div>
    @endif
  @endif

  @if(!isset($job_detail))
    <h4><u>Personal Details</u></h4>
    <h5 style="color:red;">* Indicate Mandatory Fields</h5>

    <div class="row">
      <div class="col-sm-9">
        <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-3">
        <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-6">
        <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($job_application->date_of_birth)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('date_of_birth','') !!}
          </div>
        </div>
    	</div>
      <div class="col-sm-2">
        <div class="form-group">
          {!! Form::label('medical_cond',trans('messages.medical').' '.trans('messages.report'),['class'=>'required']) !!}
          {!! Form::select('medical_cond',translateList('medical_cond'),isset($job_application) ? $job_application->medical_cond : '',['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('zipcode',trans('messages.zipcode'),['class'=>'required']) !!}
          {!! Form::input('text','zipcode',isset($job_application) ? $job_application->zipcode : '',['class'=>'form-control','placeholder'=>trans('messages.zipcode'),'onkeyup'=>'fillAddress(this)'])!!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('unit_no',trans('messages.unit_no'),[]) !!}
  				{!! Form::input('text','unit_no',isset($job_application) ? $job_application->unit_no : '',['class'=>'form-control','placeholder'=>trans('messages.unit_no')])!!}
        </div>
      </div>
      <div class="col-sm-6">
  			<div class="form-group">
  				{!! Form::label('address_line_1',trans('messages.address'),['class'=>'required']) !!}
  				{!! Form::input('text','address_line_1',isset($job_application) ? $job_application->address_line_1 : '',['class'=>'form-control','placeholder'=>trans('messages.address'),'id'=>'address'])!!}
  			</div>
  		</div>
    </div>

    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('primary_contact_number',trans('messages.contact').' '.trans('messages.number').' ('.trans('messages.mobile').')',['class'=>'required']) !!}
          <input type="text" class="form-control text-input" name="primary_contact_number" placeholder="{{trans('messages.mobile')}}" value="{{isset($job_application) ? $job_application->primary_contact_number : ''}}">
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('secondary_contact_number',trans('messages.contact').' '.trans('messages.number').' ('.trans('messages.home').')',[])!!}
          <input type="text" class="form-control text-input" name="secondary_contact_number" placeholder="{{trans('messages.home')}}" value="{{isset($job_application) ? $job_application->secondary_contact_number : ''}}">
        </div>
      </div>
    </div>

    <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) ? $past_work_exp[0]->company : '',['class'=>'form-control','placeholder'=>trans('messages.company').' '.trans('messages.name')])!!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('job_title_1',trans('messages.position'),['class'=>'required']) !!}
  				{!! Form::input('text','job_title_1',isset($past_work_exp[0]->title) ? $past_work_exp[0]->title : '',['class'=>'form-control','placeholder'=>trans('messages.position')])!!}
        </div>
      </div>
    </div>

    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('work_from_2',trans('messages.from'),['class'=>'required']) !!}
          <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">
          {!! Form::label('work_to_2',trans('messages.to'),['class'=>'required']) !!}
          <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">
          {!! Form::label('company_2',trans('messages.company'),['class'=>'required'])!!}
          {!! Form::input('text','company_2',isset($past_work_exp[1]->company) ? $past_work_exp[1]->company : '',['class'=>'form-control','placeholder'=>trans('messages.company').' '.trans('messages.name')])!!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('job_title_2',trans('messages.position'),['class'=>'required'])!!}
  				{!! Form::input('text','job_title_2',isset($past_work_exp[1]->title) ? $past_work_exp[1]->title : '',['class'=>'form-control','placeholder'=>trans('messages.position')])!!}
        </div>
      </div>
    </div>
    {{-- Row 3 --}}
    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          <label>{{trans('messages.from')}}</label>
          <div style="display:flex;">
            {!! Form::selectMonth('work_from_3_mth',!empty($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($past_work_exp[2]->from)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('work_from_3','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          <label>{{trans('messages.to')}}</label>
          <div style="display:flex;">
            {!! Form::selectMonth('work_to_3_mth',!empty($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) ? $past_work_exp[2]->company : '',['class'=>'form-control','placeholder'=>trans('messages.company').' '.trans('messages.name')])!!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('job_title_3',trans('messages.position'),[])!!}
  				{!! Form::input('text','job_title_3',isset($past_work_exp[2]->title) ? $past_work_exp[2]->title : '',['class'=>'form-control','placeholder'=>trans('messages.position')])!!}
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-3">
        <div class="form-group">
          <label>{{trans('messages.from')}}</label>
          <div style="display:flex;">
            {!! Form::selectMonth('work_from_4_mth',!empty($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($past_work_exp[3]->from)->format('Y') : '',['class' => 'form-control', 'placeholder' => '-- Year --']) !!}
            {!! Form::hidden('work_from_4','') !!}
          </div>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          <label>{{trans('messages.to')}}</label>
          <div style="display:flex;">
            {!! Form::selectMonth('work_to_4_mth',!empty($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) ? $past_work_exp[3]->company : '',['class'=>'form-control','placeholder'=>trans('messages.company').' '.trans('messages.name')])!!}
        </div>
      </div>
      <div class="col-sm-3">
        <div class="form-group">
          {!! Form::label('job_title_4',trans('messages.position'),[])!!}
  				{!! Form::input('text','job_title_4',isset($past_work_exp[3]->title) ? $past_work_exp[3]->title : '',['class'=>'form-control','placeholder'=>trans('messages.position')])!!}
        </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','Are you currently undergoing long - term medical treatment ?',[])!!}
          @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) && $medical_declaration[0]->condition == "Yes") ? 'checked' : ''}}> Yes &nbsp
            </div>
            <div id="medical_text_field_1" style="display:block;">
          @else
            <div class="checkbox">
              <input type="radio" class="form-control icheck" name="medical_con_1" value="No" checked > No &nbsp
              <input type="radio" class="form-control icheck" name="medical_con_1" value="Yes" id="medical_cbx_1"> Yes &nbsp
            </div>
            <div id="medical_text_field_1" style="display:none;">
          @endif
          {!! Form::input('text','medical_text_1',isset($medical_declaration[0]->description) ? $medical_declaration[0]->description : '',['class'=>'form-control','placeholder'=>'Please Specify'])!!}
          </div>
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-12">
        <div class="form-group">
          {!! Form::label('medical_2','Have you undergone any major operations and stayed in hospital before ?',[])!!}
          @if(Auth::check() && !isset($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) && $medical_declaration[1]->condition == "Yes") ? 'checked' : ''}}> Yes &nbsp
            </div>
            <div id="medical_text_field_2" style="display:block;">
          @else
            <div class="checkbox">
              <input type="radio" class="form-control icheck" name="medical_con_2" value="No" checked > No &nbsp
              <input type="radio" class="form-control icheck" name="medical_con_2" value="Yes" id="medical_cbx_2"> Yes &nbsp
            </div>
            <div id="medical_text_field_2" style="display:none;">
          @endif
          {!! Form::input('text','medical_text_2',isset($medical_declaration[1]->description) ? $medical_declaration[1]->description : '',['class'=>'form-control','placeholder'=>'Please Specify'])!!}
          </div>
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-12">
        <div class="form-group">
          {!! Form::label('medical_3','Are you suffering from any physical impairment or disease including mental illness, deafness, handicap and etc ?',[])!!}
          @if(Auth::check() && !isset($job_detail))
            <div class="checkbox">
              <input type="radio" class="form-control icheck" name="medical_con_3" value="No" {{(isset($medical_declaration[2]->condition) && $medical_declaration[2]->condition == "No") ? 'checked' : ''}}> No &nbsp
              <input type="radio" class="form-control icheck" name="medical_con_3" value="Yes" id="medical_cbx_3" {{(isset($medical_declaration[2]->condition) && $medical_declaration[2]->condition == "Yes") ? 'checked' : ''}}> Yes &nbsp
            </div>
            <div id="medical_text_field_3" style="display:block;">
          @else
            <div class="checkbox">
              <input type="radio" class="form-control icheck" name="medical_con_3" value="No" checked > No &nbsp
              <input type="radio" class="form-control icheck" name="medical_con_3" value="Yes" id="medical_cbx_3"> Yes &nbsp
            </div>
            <div id="medical_text_field_3" style="display:none;">
          @endif
          {!! Form::input('text','medical_text_3',isset($medical_declaration[2]->description) ? $medical_declaration[2]->description : '',['class'=>'form-control','placeholder'=>'Please Specify'])!!}
          </div>
        </div>
      </div>
    </div>

    <div class="row">
      <div class="col-sm-12">
        <div class="form-group">
          {!! Form::label('declare_1','Have you ever been dismissed or discharged from the service of any company ?',[])!!}
          @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) && $offence_declaration[0]->condition == "Yes") ? 'checked' : ''}}> Yes &nbsp
          </div>
          <div id="declare_text_field_1" style="display:block;">
          @else
          <div class="checkbox">
            <input type="radio" class="form-control icheck" name="declare_con_1" value="No" checked > No &nbsp
            <input type="radio" class="form-control icheck" name="declare_con_1" value="Yes" id="declare_cbx_1"> Yes &nbsp
          </div>
          <div id="declare_text_field_1" style="display:none;">
          @endif
          {!! Form::input('text','declare_text_1',isset($offence_declaration[0]->description) ? $offence_declaration[0]->description : '',['class'=>'form-control','placeholder'=>'Please Specify'])!!}
          </div>
        </div>
      </div>
    </div>

    <hr>

    @if(Auth::check() && !isset($job_detail))
    @else
      <h4><u>Terms & Conditions</u></h4>
      <div class="row">
  			<div class="col-sm-12">
  				<p>I am currently <b><u>NOT</u></b> working as a civil servant or a Volunteer Special Constabulary (VSC) personnel. I shall immediately declare to the Company if I am working as a civil servant / VSC.
          Failing to do so, I shall be accountable for any sort of outcome thereafter.</p>
  			</div>
  		</div>
      <div class="row">
  			<div class="col-sm-12">
  				<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-12">
  				<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-12">
  				<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><strong>{{trans('messages.applying_as_user',['attribute' => Auth::user()->full_name])}}</strong></p>
  @endif

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

  {{-- Signature Portion --}}
  @if(Auth::check() && !isset($job_detail))
    {{-- Submit Button (Backend) --}}
    {!! Form::submit(isset($buttonText) ? $buttonText : trans('messages.submit').' '.trans('messages.application'),['id'=>'m-submit', 'class'=>'btn btn-primary pull-right']) !!}
  @else
  <br><br>
  <div class="row">
    <div class="col-sm-12">
      <div class="form-group">
        <div style="text-align:center;">Please sign below to agree with the terms and conditions before submitting your application.</div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-sm-12">
      <div class="form-group">
        <div id="drawSign" scroll="false" style="width:100%; margin:0 auto; display: flex; justify-content: center;">
          <canvas id="cSign" style="border: 2pt solid black;"></canvas>
        </div>
      </div>
    </div>
  </div>
  <div class="row" style="display:flex; justify-content: center;">
    <div class="col-md-12" style="display:flex; justify-content: space-between; width: 100%; max-width: 600px;">
      <div class="form-group">
        <a id="clear-canvas" class="btn btn-success">{!! trans('messages.clear').' '.trans('messages.signature') !!}</a>
      </div>
      <div class="form-group">
        {{-- Submit Button (Frontend) --}}
        {!! Form::submit(isset($buttonText) ? $buttonText : trans('messages.submit').' '.trans('messages.application'),['id'=>'m-submit', 'class'=>'btn btn-primary pull-right', 'disabled'=>'true']) !!}
      </div>
    </div>
  </div>
  {!! Form::hidden('img_string','',['id' => 'signature_string'])!!}
  @endif



  @section('js')
    {!! Html::script('https://cdnjs.cloudflare.com/ajax/libs/fabric.js/1.7.22/fabric.min.js') !!}
  	<script>
      var element = document.getElementById("drawSign");
      var width = element.offsetWidth ;   // width of canvas
      var height = element.offsetHeight;  // height of canvas
      var canvas = new fabric.Canvas('cSign');

      canvas.isDrawingMode = true;
      canvas.selection = false;
      fabric.Object.prototype.selectable = false;   // prevent drawing objects to be draggable or clickable
      canvas.freeDrawingBrush.width = 4;            // size of the drawing brush

      function responsive() {
        var width = 600 ;
        var height = 400;
        if (element.offsetWidth < 600) { width = element.offsetWidth; height =  width * 2/3; }
        canvas.setHeight(height);
        canvas.setWidth(width);
        canvas.setDimensions({'width':width,'height':height},{'backstoreOnly':false,'cssOnly':true});
      }

      responsive();

      // Resize canvas
      window.addEventListener('resize', function(){ responsive(); });

      var btn_clear = document.getElementById('clear-canvas');
      btn_clear.onclick = function(){
        canvas.clear();
        canvas.backgroundColor = "white";  // use this background colour to check the actual canvas size
        document.getElementById("m-submit").disabled = true;
      };

      // Event to check when something is drawn on the canvas
      canvas.on('path:created', function(event){
        document.getElementById("m-submit").disabled = false;
      });

      // Convert signature to data url upon submit
      var btn_submit = document.getElementById('m-submit');
      btn_submit.onclick = function(){
        var dataURL = canvas.toDataURL({ format: 'png', quality: 0.8 });
        var signature_field = document.getElementById('signature_string');
        signature_field.value = dataURL;
        // canvas.clear();
      };

      $('#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";
      });
      $('#declare_cbx_2').on('ifChecked', function () {
        document.getElementById("declare_text_field_2").style.display = "block";
      });
      $('#declare_cbx_2').on('ifUnchecked', function () {
        document.getElementById("declare_text_field_2").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";
      });
      $('#medical_cbx_3').on('ifChecked', function () {
        document.getElementById("medical_text_field_3").style.display = "block";
      });
      $('#medical_cbx_3').on('ifUnchecked', function () {
        document.getElementById("medical_text_field_3").style.display = "none";
      });

      // Get address
      function fillAddress(input){
        var postalCode = input.value;
        if (postalCode.length == 6) {
          $.ajax({
            type:"GET",
            url:"/one-map/getAddress",
            data:{ zipcode: postalCode },
            success:function(address){
              $('#address').val(address['ADDRESS']);
            }
          });
        }
      }
  	</script>
  @endsection