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Filename : 751ed68905c54f4b7ae4c2a188383d66af02e0ca.php
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<?php $__env->startSection('title', 'Visa'); ?>

<?php $__env->startSection('body'); ?>

<style>
  [class~="form"] {
    background: none;
  }

  h2 {
    border-bottom: 2px solid #253d52;
  }
</style>
<!--====== QUICK ENQUIRY FORM ==========-->
<section>
  <div class="form form-spac rows">
    <div class="container">
      <!-- TITLE & DESCRIPTION -->
      <div class="spe-title col-md-12">
        <h2>Visa <span>Application</span></h2>
        <!-- <div class="title-line">
						<div class="tl-1"></div>
						<div class="tl-2"></div>
						<div class="tl-3"></div>
					</div> -->
        <br><br>
      </div>

      <!--====== COMMON NOTICE ==========-->
      <div class="col-md-6 col-sm-6 col-xs-12 wow fadeInRight" data-wow-duration="1s">
        <div class="rows book_poly">
          <h3><?php echo e($s_country); ?> Travel Visa Requirements </h3>

          <?php if(isset($visaRequirement)): ?>
          <?php echo $visaRequirement->requirements; ?>

          <?php else: ?>
          No Record Found For <strong><?php echo e($s_country); ?></strong>
          <?php endif; ?>
        </div>
      </div>

      <div class="col-md-6 col-sm-6 col-xs-12 form_1 wow fadeInLeft" data-wow-duration="1s">
        <!--====== THANK YOU MESSAGE ==========-->


        <?php echo Form::open(['url' => 'visaapplicationsave','class'=>'col s12','enctype'=>'multipart/form-data']); ?>

        <ul class="visa-apply-form-1 mt-20">
          <li>
            <input type="text" name="first_name" value="" id="ename" placeholder="First Name" required>
          </li>
          <li>
            <input type="text" name="last_name" value="" id="ename" placeholder="Last Name">
          </li>
          <li>
            <input type="email" name="email" value="" id="eemail" placeholder="Email id" required>
          </li>
          <li>
            <input type="text" name="mobile" value="" id="ename" placeholder="Mobile" required>
          </li>

          <li>
            <input type="text" name="profession" value="" id="ename" placeholder="Profession" required>
          </li>

          <li>
            <input type="text" name="company" value="" id="ename" placeholder="Company">
          </li>

          <li>
            <input type="text" name="address" value="" id="ecity" placeholder="Address" required>
          </li>

          <li>
            <input type="text" name="passport_no" value="" placeholder="Passport No" required>
          </li>

          <li>
            <input type="text" name="arrival_date" value="" id="from" placeholder="Arrival Date" required>
          </li>

          <li>
            <h4>Applicant Image</h4>
          </li>

          <li>
            <input type="file" name="image_user" value="">
          </li>

          <li>
            <h4>Passport Image</h4>
          </li>

          <li>
            <input type="file" name="image_passport" value="">
          </li>

          <input type="hidden" name="country" value="<?php echo e($s_country); ?>">
          <li>
            <input type="submit" value="Submit" id="send_button">
          </li>
        </ul>
        <?php echo Form::close(); ?>

      </div>

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

<?php $__env->stopSection(); ?>
<?php echo $__env->make('frontend.layout.app', array_except(get_defined_vars(), array('__data', '__path')))->render(); ?>