@extends('layouts.app')

@section('content')

<div id="contact" class="container-fluid">
    <section class="mainVisualAreaPc">
        <div class="pageTopBannerPc"></div>
    </section>
    <section class="mainVisualAreaSp">
        <div class="pageTopBannerSp"></div>
    </section>
    <div class="container contentArea contact">
        <div class="title">
            <h1>Contact</h1>
            <span>お問い合わせ</span>
        </div>
        <div class="content">
            <form action="contact/confirm" method="post">
                <table class="contactForm">
                    <tbody>
                        <tr>
                            <th>お名前<span class="required">※</span></th>
                            <td>
                                <input type="text" name="last_name" class="form-control input-box" id="InputLastName" value="{{ old('last_name') }}" placeholder="姓">
                                <input type="text" name="first_name" class="form-control input-box" id="InputFirstName" value="{{ old('first_name') }}" placeholder="名">
                                <span class="validation">{{ $errors->first('last_name') }}</span>
                                <span class="validation">{{ $errors->first('first_name') }}</span>
                            </td>
                        </tr>
                        <tr>
                            <th>お名前(フリガナ)<span class="required">※</span></th>
                            <td>
                                <input type="text" name="last_name_kana" class="form-control input-box" id="InputLastNameKana" value="{{ old('last_name_kana') }}" placeholder="セイ">
                                <input type="text" name="first_name_kana" class="form-control input-box" id="InputFirstNameKana" value="{{ old('last_name_kana') }}" placeholder="メイ">
                                <span class="validation">{{ $errors->first('last_name_kana') }}</span>
                                <span class="validation">{{ $errors->first('first_name_kana') }}</span>
                            </td>
                        </tr>
                        <tr>
                            <th>会社名</th>
                            <td>
                                <input type="text" name="company" class="form-control" id="InputCompany" value="{{ old('company') }}" placeholder="例:株式会社みのる陶器">
                            </td>
                        </tr>
                        <tr>
                            <th>郵便番号<span class="required">※</span></th>
                            <td>
                                <input type="text" name="post" class="form-control" id="InputPost" value="{{ old('post') }}" placeholder="例:509-5202">
                                <span class="validation">{{ $errors->first('post') }}</span>
                            </td>
                        </tr>
                        <tr>
                            <th>ご住所1<span class="required">※</span><br/>(都道府県 市区町村名)</th>
                            <td>
                                <select name="pref" class="select-box m-b-16" id="SelectPref" value="{{ old('pref') }}">
                                    <option value>都道府県を選択</option>
                                    @foreach($prefectures as $prefecture)
                                    <option value="{{ $prefecture->name }}"@if(old('pref') == $prefecture->name) selected @endif>{{ $prefecture->name }}</option>
                                    @endforeach
                                </select>
                                <span class="validation">{{ $errors->first('pref') }}</span>
                                <input type="text" name="address01" class="form-control" id="InputAddress01" value="{{ old('address01') }}" placeholder="例:土岐市下石町">
                                <span class="validation">{{ $errors->first('address01') }}</span>
                            </td>
                        </tr>
                        <tr>
                            <th>ご住所2<span class="required">※</span><br/>(番地・マンション名)</th>
                            <td>
                                <input type="text" name="address02" class="form-control" id="InputAddress02" value="{{ old('address02') }}" placeholder="例:441-2">
                                <span class="validation">{{ $errors->first('address02') }}</span>
                            </td>
                        </tr>
                        <tr>
                            <th>電話番号<span class="required">※</span></th>
                            <td>
                                <input type="text" name="tel" class="form-control" id="InputTel" value="{{ old('tel') }}" placeholder="例:0572-57-3195">
                                <span class="validation">{{ $errors->first('tel') }}</span>
                            </td>
                        </tr>
                        <tr>
                            <th>FAX番号</th>
                            <td>
                                <input type="text" name="fax" class="form-control" id="InputFax" value="{{ old('fax') }}" placeholder="例:0572-57-3197">
                            </td>
                        </tr>
                        <tr>
                            <th>Emailアドレス<span class="required">※</span></th>
                            <td>
                                <input type="text" name="email" class="form-control" id="InputEmail" value="{{ old('email') }}" placeholder="例:メールアドレス">
                                <span class="validation">{{ $errors->first('email') }}</span>
                            </td>
                        </tr>
                        <tr>
                            <th>Emailアドレス(確認用)<span class="required">※</span></th>
                            <td>
                                <input type="text" name="email_confirmation" class="form-control" id="InputEmail" value="{{ old('email_confirmation') }}" placeholder="例:メールアドレス(確認用)">
                                <span class="validation">{{ $errors->first('email_confirmation') }}</span>
                            </td>
                        </tr>
                        <tr>
                            <th>お問い合わせ内容<span class="required">※</span></th>
                            <td>
                                <textarea name="message" class="text-box" id="InputMessage" value="{{ old('message') }}" cols="10" rows="8"></textarea>
                                <span class="validation">{{ $errors->first('message') }}</span>
                            </td>
                        </tr>
                    </tbody>
                </table>
                @csrf
                <div class="contentBtn">
                    <input type="submit" name="action" class="btn btnPrimary" value="確認画面へ">
                </div>
            </form>
        </div>
    </div>
</div>

@endsection