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<div class="row">
  <div class="col-sm-1">
    <div class="form-group">
      {!! Form::label('contact[prefix]', 'Prefix', ['class' => 'control-label']) !!}
      {!! Form::text('contact[prefix]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.prefix']) !!}
    </div>
  </div>
  <div class="col-sm-3">
    <div class="form-group" ng-class="{ 'has-error': errors.donor.contact.first_name }">
      {!! Form::label('contact[first_name]', "@{{ errors.donor.contact.first_name ? 'First Name is required *' : 'First Name *' }}",
      ['class' => 'control-label']) !!}
      {!! Form::text('contact[first_name]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.first_name', 'maxlength' => '50']) !!}
      {{--<span class="help-block" ng-if="errors.donor.contact.first_name.length > 0">--}}
        {{--<strong>@{{ errors.donor.contact.first_name }}</strong>--}}
      {{--</span>--}}
    </div>
  </div>
  <div class="col-sm-2">
    <div class="form-group">
      {!! Form::label('contact[middle_name]', 'Middle Name', ['class' => 'control-label']) !!}
      {!! Form::text('contact[middle_name]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.middle_name', 'maxlength' => '50']) !!}
    </div>
  </div>
  <div class="col-sm-3">
    <div class="form-group" ng-class="{ 'has-error': errors.donor.contact.last_name }">
      {!! Form::label('contact[last_name]', "@{{ errors.donor.contact.last_name ? 'Last Name is required *' : 'Last Name *' }}", ['class' => 'control-label']) !!}
      {!! Form::text('contact[last_name]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.last_name', 'maxlength' => '50']) !!}
      {{--<span class="help-block" ng-if="errors.donor.contact.last_name.length > 0">--}}
        {{--<strong>@{{ errors.donor.contact.last_name }}</strong>--}}
      {{--</span>--}}
    </div>
  </div>
  <div class="col-sm-1">
    <div class="form-group">
      {!! Form::label('contact[suffix]', 'Suffix', ['class' => 'control-label']) !!}
      {!! Form::text('contact[suffix]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.suffix', 'maxlength' => '5']) !!}
    </div>
  </div>
</div>
@if(isset($logged_in_user) && ($logged_in_user->checkPermissions(array('Administrator', 'Donations Administrator'), array('National','Staff'))))
	@if(isset($users))
		<div class="row">
			<div class="col-md-5">
				{!! Form::label('donor[user_id]', 'User', ['class' => 'control-label']) !!} <i class="fa fa-info-circle" data-container="body" data-toggle="popover" data-placement="bottom" data-content="The User ID will associate this Donor Profile with an active User in the system. After a User ID has been assigned, Donations data will be associated with the User account, and the User will be able to view their own Donations and Pledge data and history upon logging into the system." data-original-title="What is this?"></i>
				{!! Form::select('user_id', $users, FALSE, ['class' => 'form-control select2', 'ng-model' => 'donor.user_id', 'ng-selected' => 'donor.user_id']) !!}
			</div>
			<div class="col-md-3">
				{!! Form::label('contact[full_name]', 'Full name (from archived system)', ['class' => 'control-label']) !!}
				{!! Form::text('contact[full_name]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.full_name', 'maxlength' => '64']) !!}
			</div>
		</div>
	@endif
@endif
<div class="row">
	<div class="col-md-2">
		<div class="form-group" ng-class="{ 'has-error': errors.donor.nssar.length > 0}">
			{!! Form::label('contact[nssar_id]', 'NSSAR #', ['class'=> 'control-label']) !!}
			{!! Form::number('contact[nssar_id]', FALSE, ['class'=> 'form-control', 'id' => 'nssar_id',
            'ng-model' => 'donor.nssar_id',
            'placeholder'=> 'SAR Member?']) !!}
			<span class="help-block" ng-if="errors.donor.nssar.length > 0">
                <strong>@{{ errors.donor.nssar }}</strong>
            </span>
		</div>
	</div>
	<div class="col-md-3">
		{!! Form::label('contact[company]', 'Company', ['class' => 'control-label']) !!}
		{!! Form::text('contact[company]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.company', 'maxlength' => '128']) !!}
	</div>
	<div class="col-sm-6">
		{!! Form::label('contact[title]', 'National Title', ['class' => 'control-label']) !!}
		{!! Form::text('contact[title]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.title', 'maxlength' => '128']) !!}
	</div>
</div>
<div class="row">
	<div class="col-sm-2">
		{!! Form::label('contact[state_id]', 'Society/State', ['class' => 'control-label']) !!}
		{!! Form::select('contact[state_id]', $states, FALSE,
		['class' => 'form-control',
		'ng-model' => 'donor.state_id',
		'ng-change' => 'getChapters(donor.state_id)']) !!}
	</div>
	<div class="col-sm-2" >
		{!! Form::label('chapter_id', 'Chapter', ['class'=> 'control-label']) !!}
		<select ng-model="donor.chapter_id" class="form-control">
			<option ng-repeat="chapter in chapters" value="@{{chapter.id}}" ng-selected="chapter.id==donor.chapter_id">@{{chapter.name}}</option>
		</select>
	</div>
</div>
<div class="row">
	<div class="col-sm-2">
		{!! Form::label('state_number', 'State Number', ['class'=> 'control-label']) !!}
		{!! Form::text('state_number', FALSE, ['class'=> 'form-control', 'id' => 'state_number', 'ng-model' => 'donor.state_number', 'maxlength' => '20']) !!}
	</div>
	<div class="col-sm-2">
		{!! Form::label('chapter_number', 'Chapter Number', ['class'=> 'control-label']) !!}
		{!! Form::text('chapter_number', FALSE, ['class'=> 'form-control', 'id' => 'chapter_number', 'ng-model' => 'donor.chapter_number', 'maxlength' => '20']) !!}
	</div>
</div>
<div class="row">

</div>
<div class="row">

</div>
@if(Sentinel::getUser()->checkPermissions(array('Administrator', 'Donations Administrator'), array('National', 'Staff')))
	<div class="row">
		<div class="col-sm-2">
			{!! Form::label('status_id', 'Status', ['class'=> 'control-label']) !!}
			{!! Form::select('status_id', $donor_status, FALSE,  ['class'=> 'form-control', 'ng-model' => 'donor.status_id']) !!}
		</div>
		<div class="col-sm-2">
			{!! Form::label('type_id', 'Donor Type', ['class'=> 'control-label']) !!}
			{!! Form::select('type_id', $donor_types, '',  ['class'=> 'form-control', 'ng-model' => 'donor.contact.type_id']) !!}
		</div>
	</div>
@endif
<div class="row">
	<div class="col-sm-6">
		{{--<div class="form-group" ng-class="{ 'has-error': errors.donor.contact.address.length > 0 }">--}}
		<div class="form-group" ng-class="{ 'has-error': errors.donor.contact.address }">
{{--			{!! Form::label('contact[address]', 'Street Address *', ['class' => 'control-label']) !!}--}}
			{!! Form::label('contact[address]', "@{{ errors.donor.contact.address ? 'Street Address is required *' : 'Street Address *' }}", ['class' => 'control-label']) !!}
			{!! Form::text('contact[address]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.address', 'maxlength' => '128']) !!}
			{{--<span class="help-block" ng-if="errors.donor.contact.address.length > 0">--}}
				{{--<strong>@{{ errors.donor.contact.address }}</strong>--}}
			{{--</span>--}}
		</div>
	</div>
	<div class="col-sm-3">
		{!! Form::label('contact[address_2]', 'Apt/Suite', ['class' => 'control-label']) !!}
		{!! Form::text('contact[address_2]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.address_2', 'maxlength' => '50']) !!}
	</div>
</div>
<div class="row">
	<div class="col-sm-3">
		<div class="form-group" ng-class="{ 'has-error': errors.donor.contact.city}">
			{!! Form::label('contact[city]', "@{{ errors.donor.contact.city ? 'City is required *' : 'City * ' }}", ['class' => 'control-label']) !!}
			{!! Form::text('contact[city]',  FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.city', 'maxlength' => '50']) !!}
			{{--<span class="help-block" ng-if="errors.donor.contact.city.length > 0">--}}
				{{--<strong>@{{ errors.donor.contact.city }}</strong>--}}
			{{--</span>--}}
		</div>
	</div>
	<div class="col-sm-3">
		<div class="form-group" ng-class="{ 'has-error': errors.donor.contact.state}">
			{!! Form::label('contact[state]', "@{{ errors.donor.contact.state ? 'State is required *' : 'State *' }}", ['class' => 'control-label']) !!}
			{!! Form::select('contact[state]', $geo_states, FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.state']) !!}
			{{--<span class="help-block" ng-if="errors.donor.contact.state.length > 0">--}}
				{{--<strong>@{{ errors.donor.contact.state }}</strong>--}}
			{{--</span>--}}
		</div>
	</div>
	<div class="col-sm-3">
		<div class="form-group" ng-class="{ 'has-error': errors.donor.contact.postal_code }">
			{!! Form::label('contact[postal_code]', "@{{ errors.donor.contact.postal_code ? 'Postal code is required *' : 'Postal Code/Zip *' }}", ['class' => 'control-label']) !!}
			{!! Form::text('contact[postal_code]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.postal_code', 'maxlength' => '11']) !!}
			{{--<span class="help-block" ng-if="errors.donor.contact.postal_code.length > 0">--}}
				{{--<strong>@{{ errors.donor.contact.postal_code }}</strong>--}}
			{{--</span>--}}
		</div>
	</div>
</div>
<div class="row">
	<div class="col-sm-4">
		<div class="form-group" ng-class="{ 'has-error': errors.donor.contact.email }">
			{!! Form::label('contact[email]', "@{{ errors.donor.contact.email ? 'Email is required *' : 'Email *' }}", ['class' => 'control-label']) !!}
			{!! Form::text('contact[email]', FALSE, ['class' => 'form-control', 'ng-model' => 'donor.contact.email', 'maxlength' => '128']) !!}
			{{--<span class="help-block" ng-if="errors.donor.contact.email.length > 0">--}}
				{{--<strong>@{{ errors.donor.contact.email }}</strong>--}}
			{{--</span>--}}
		</div>
	</div>
	<div class="col-sm-4">
		<div class="form-group" ng-class="{ 'has-error': errors.donor.contact.phone_number}">
			{!! Form::label('contact[phone_number]', "@{{ errors.donor.contact.phone_number ? 'Phone Number is required *' : 'Phone Number *' }}", ['class' => 'control-label']) !!}
			{!! Form::text('contact[phone_number]', FALSE, ['class' => 'form-control phone-number', 'ng-model' => 'donor.contact.phone_number', 'maxlength' => '25']) !!}
			{{--<span class="help-block" ng-if="errors.donor.contact.phone_number.length > 0">--}}
				{{--<strong>@{{ errors.donor.contact.phone_number }}</strong>--}}
			{{--</span>--}}
		</div>
	</div>
</div>