{{ getPhrase('admission_details')}}

{{ Form::label('username', getphrase('username')) }} * {{ Form::text('username', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => 'username')) }}
{{ Form::label('email', getphrase('email')) }} * {{ Form::text('email', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => 'email')) }}
{{ Form::label('name', getphrase('name')) }} * {{ Form::text('name', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => 'name')) }}
{{ Form::label('phone', getphrase('phone')) }} * {{ Form::text('phone', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => 'phone')) }}
@include('common.online-selection-view', array('class'=>'custom-row-6'))

{{ getPhrase('previous_educational_details')}}

{{ Form::label('previous_highest_qualification', getphrase('highest_qualification')) }} {{ Form::text('previous_highest_qualification', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => '5th')) }}
{{ Form::label('previous_highest_qualification_percentage', getphrase('percentage')) }} {{ Form::text('previous_highest_qualification_percentage', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => '85.9')) }}
{{ Form::label('year_passing', getphrase('year_passed')) }} {{ Form::text('year_passing', $value = null , $attributes = array('class'=>'form-control', 'placeholder' => '2016')) }}
{{ Form::label('previous_institute_name', getphrase('previous_institute_name')) }} {{ Form::textarea('previous_institute_name', $value = null , $attributes = array('class'=>'form-control', 'rows'=>'5', 'placeholder' => 'Stanford University')) }}
{{ Form::label('previous_institute_address', getphrase('institute_address')) }} {{ Form::textarea('previous_institute_address', $value = null , $attributes = array('class'=>'form-control', 'rows'=>'5', 'placeholder' => '450 Serra Mall, Stanford, CA 94305, United States')) }}