<!DOCTYPE html>
<html lang="id">
<head>
    <meta charset="UTF-8">
    <title>Form Pendaftaran SPMB</title>
    <meta name="viewport" content="width=device-width, initial-scale=1.0">

    <!-- Bootstrap -->
    <link href="https://cdn.jsdelivr.net/npm/bootstrap@5.3.2/dist/css/bootstrap.min.css" rel="stylesheet">

    <style>
        body{
            background:#f4f6fb;
        }
        .card{
            border-radius:20px;
            box-shadow:0 10px 25px rgba(0,0,0,.08);
        }
        .section-title{
            background:linear-gradient(135deg,#0b2c4d,#5a2d82);
            color:white;
            padding:12px 20px;
            border-radius:14px;
            margin-bottom:20px;
            font-weight:bold;
        }
        .btn-submit{
            background:#f5c400;
            color:#0b2c4d;
            font-weight:bold;
            padding:14px;
            border-radius:30px;
        }
    </style>
</head>
<body>

<div class="container my-5">
    <div class="card p-4">

        <h3 class="text-center fw-bold text-primary mb-3">
            FORM PENDAFTARAN PESERTA DIDIK BARU
        </h3>

        <p class="text-center text-muted mb-4">
            SMK PGRI 01 Sukorejo Tahun Pelajaran 2026/2027
        </p>

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

            </div>
        <?php endif; ?>

        
        <?php if(session('id')): ?>
            <div class="text-center mb-4">
                <a href="<?php echo e(route('bukti.pendaftaran', session('id'))); ?>"
                   class="btn btn-primary">
                   Download Bukti Pendaftaran (PDF)
                </a>
            </div>
        <?php endif; ?>

        <form action="<?php echo e(route('daftar.preview')); ?>" method="POST">
            <?php echo csrf_field(); ?>

            
            <div class="section-title">Data Calon Peserta Didik</div>

            <div class="row g-3">
                <div class="col-md-6">
                    <label class="form-label">Nama Lengkap</label>
                    <input type="text" name="nama_lengkap" class="form-control" required>
                </div>

                <div class="col-md-6">
                    <label class="form-label">No Telepon</label>
                    <input type="text" name="no_telepon" class="form-control" required>
                </div>

                <div class="col-md-6">
                    <label class="form-label">NISN</label>
                    <input type="text" name="nisn" class="form-control">
                </div>

                <div class="col-md-6">
                    <label class="form-label">Sekolah Asal</label>
                    <input type="text" name="sekolah_asal" class="form-control">
                </div>

                <div class="col-md-6">
                    <label class="form-label">Tempat Lahir</label>
                    <input type="text" name="tempat_lahir" class="form-control">
                </div>

                <div class="col-md-6">
                    <label class="form-label">Tanggal Lahir</label>
                    <input type="date" name="tanggal_lahir" class="form-control">
                </div>

                <div class="col-md-6">
                    <label class="form-label">Jenis Kelamin</label>
                    <select name="jenis_kelamin" class="form-select">
                        <option value="">-- Pilih --</option>
                        <option>Laki-laki</option>
                        <option>Perempuan</option>
                    </select>
                </div>

                <div class="col-md-6">
                    <label class="form-label">Agama</label>
                    <select name="agama" class="form-select">
                        <option value="">-- Pilih --</option>
                        <option>Islam</option>
                        <option>Kristen</option>
                        <option>Katholik</option>
                        <option>Hindhu</option>
                        <option>Budha</option>
                        <option>Konghucu</option>
                    </select>
                </div>

                <div class="col-md-6">
                    <label class="form-label">Anak Ke .... Dari .... Bersaudara</label>
                    <input type="text" name="anak_ke" class="form-control">
                </div>

                <div class="col-md-6">
                    <label class="form-label">Status Anak</label>
                    <select name="status_anak" class="form-select">
                        <option value="">-- Pilih --</option>
                        <option>Anak Kandung</option>
                        <option>Anak Angkat</option>
                    </select>
                </div>

                <div class="col-md-12">
                    <label class="form-label">Alamat Murid</label>
                    <textarea name="alamat_murid" class="form-control"></textarea>
                </div>

                <div class="col-md-12">
                    <label class="form-label">Riwayat Penyakit</label>
                    <textarea name="riwayat_penyakit" class="form-control"></textarea>
                </div>
            </div>

            
            <div class="section-title mt-4">Data Orang Tua / Wali</div>

            <div class="row g-3">
                <div class="col-md-6">
                    <label class="form-label">Nama Ayah</label>
                    <input type="text" name="nama_ayah" class="form-control">
                </div>

                <div class="col-md-6">
                    <label class="form-label">Nama Ibu</label>
                    <input type="text" name="nama_ibu" class="form-control">
                </div>

                <div class="col-md-12">
                    <label class="form-label">Alamat Orang Tua</label>
                    <textarea name="alamat_orangtua" class="form-control"></textarea>
                </div>

                <div class="col-md-6">
                    <label class="form-label">No Telepon Orang Tua</label>
                    <input type="text" name="telepon_orangtua" class="form-control">
                </div>

                <div class="col-md-6">
                    <label class="form-label">Nomor KIP (isi - jika tidak memiliki Nomor KIP )</label>
                    <input type="text" name="nomor_kip" class="form-control">
                </div>

                <div class="col-md-6">
                    <label class="form-label">Pekerjaan Ayah</label>
                    <input type="text" name="pekerjaan_ayah" class="form-control" required>
                </div>

                <div class="col-md-6">
                    <label class="form-label">Pekerjaan Ibu</label>
                    <input type="text" name="pekerjaan_ibu" class="form-control" required>
                </div>

                <div class="col-md-6">
                    <label class="form-label">Pendidikan Ayah</label>
                    <select name="pendidikan_ayah" class="form-select" required>
                        <option value="">-- Pilih --</option>
                        <option>SD</option><option>SMP</option>
                        <option>SMA/SMK</option><option>D3</option>
                        <option>S1</option><option>S2</option><option>S3</option>
                    </select>
                </div>

                <div class="col-md-6">
                    <label class="form-label">Pendidikan Ibu</label>
                    <select name="pendidikan_ibu" class="form-select" required>
                        <option value="">-- Pilih --</option>
                        <option>SD</option><option>SMP</option>
                        <option>SMA/SMK</option><option>D3</option>
                        <option>S1</option><option>S2</option><option>S3</option>
                    </select>
                </div>

                <div class="col-md-6">
                    <label class="form-label">Penghasilan Ayah / Bulan</label>
                    <select name="penghasilan_ayah" class="form-select" required>
                        <option value="">-- Pilih --</option>
                        <option value="<1000000">&lt; 1.000.000</option>
                        <option value="1000000-2000000">1–2 Juta</option>
                        <option value="2000000-3000000">2–3 Juta</option>
                        <option value=">3000000">&gt; 3 Juta</option>
                    </select>
                </div>

                <div class="col-md-6">
                    <label class="form-label">Penghasilan Ibu / Bulan</label>
                    <select name="penghasilan_ibu" class="form-select" required>
                        <option value="">-- Pilih --</option>
                        <option value="<1000000">&lt; 1.000.000</option>
                        <option value="1000000-2000000">1–2 Juta</option>
                        <option value="2000000-3000000">2–3 Juta</option>
                        <option value=">3000000">&gt; 3 Juta</option>
                    </select>
                </div>
            </div>

            
            <div class="section-title mt-4">Pilihan Jurusan</div>

            <select name="jurusan" class="form-select" required>
                <option value="">-- Pilih Jurusan --</option>
                <option>PPLG</option>
                <option>TO</option>
                <option>MPLB</option>
            </select>

            <div class="text-center mt-5">
                <button type="submit" class="btn btn-submit w-50">
                    Lanjut Preview Data
                </button>
            </div>

            <div class="text-center mt-5">
                <a href="<?php echo e(url('/')); ?>" class="btn btn-submit w-50">
                    Kembali Ke halaman Utama
                </a>
            </div>

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


</body>
</html>
<?php /**PATH C:\xampp\htdocs\spmb-skagris\resources\views/pendaftaran/create.blade.php ENDPATH**/ ?>