PLACEMENT CONFIRMATION

STUDENT

@include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputLastName', 'title'=>'Last name', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputFirstName', 'title'=>'First name', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputEngName', 'title'=>'English name (If Applicable)', 'class'=>'inputRequired' ) )
@include('partial.dateform', array( 'id'=>'selectStudent', 'title'=>'Birthdate', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputGrade', 'title'=>'Grade', 'class'=>'inputRequired' ) )
@include('partial.radio', array( 'size'=>'col-xs-6', 'name'=>'radioGender', 'title'=>'Gender', 'radioContents' => ['f'=>'Female', 'm'=>'Male'] ) )

PLACEMENT

@include('partial.radio', array( 'size'=>'col-xs-6', 'name'=>'radioHostStatus', 'title'=>'Host family status', 'radioContents' => ['p'=>'Permanent', 't'=>'Temporary'] ) )
@include('partial.radio', array( 'size'=>'col-xs-6', 'name'=>'radioReplacement', 'title'=>'Replacement?', 'radioContents' => ['y'=>'Yes', 'n'=>'No'] ) )
@include('partial.dateform', array( 'id'=>'selectPlacementDate', 'title'=>'Placement Date', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputMID', 'title'=>'Move-In Date', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputOfficeUseOnly', 'title'=>'For office use only (1-20)', 'class'=>'inputRequired integer' ) )

HOST PARENTS

@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputHostMomName', 'title'=>'Host Mom Name', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputMomCellPhone', 'title'=>'Cell phone', 'class'=>'inputRequired' ) )
@include('partial.dateform', array( 'id'=>'selectMomBirth', 'title'=>'Host Mom Birthdate', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputHostMomCareer', 'title'=>'Host Mom Career', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputMomEmail', 'title'=>'Email', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputHostDadName', 'title'=>'Host Dad Name', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputDadCellPhone', 'title'=>'Cell phone', 'class'=>'inputRequired' ) )
@include('partial.dateform', array( 'id'=>'selectDadBirth', 'title'=>'Host Dad Birthdate', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputHostDadCareer', 'title'=>'Host Dad Career', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputDadEmail', 'title'=>'Email', 'class'=>'inputRequired' ) )

HOUSEHOLD MEMBERS

@for ($i = 1; $i <= 3; $i++)
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputHHName'.$i, 'title'=>'Name', 'class'=>'inputRequired' ) )
@include('partial.radio', array( 'size'=>'col-xs-6', 'name'=>'inputHHGender'.$i, 'title'=>'Gender', 'radioContents' => ['f'=>'female', 'm'=>'male'] ) )
@include('partial.dateform', array( 'id'=>'selectHHBirth'.$i, 'title'=>'Date of Birth', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-12', 'id'=>'inputHHJob'.$i, 'title'=>'Relation / Occupation', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputGE'.$i, 'title'=>'Grade/Employer', 'class'=>'inputRequired' ) )
@include('partial.radio', array( 'size'=>'col-xs-6', 'name'=>'inputLiveHome'.$i, 'title'=>'Lives at home? ', 'radioContents' => ['y'=>'Yes', 'n'=>'No'] ) )
@endfor
@include('partial.input', array( 'size'=>'col-lg-12', 'id'=>'inputHHAddress', 'title'=>'Home address', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputHHPhone', 'title'=>'Home phone', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSchoolDist', 'title'=>'School district', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputHHNearAirPort', 'title'=>'Nearest International Airport', 'class'=>'inputRequired' ) )
@include('partial.radio', array( 'size'=>'col-xs-6', 'name'=>'inputHHOwnRoom', 'title'=>'Have own room? ', 'radioContents' => ['y'=>'Yes', 'n'=>'No'] ) )
@include('partial.radio', array( 'size'=>'col-xs-6', 'name'=>'inputHHPet', 'title'=>'pets? ', 'radioContents' => ['y'=>'Yes', 'n'=>'No'] ) )
@include('partial.checkbox', array( 'size'=>'col-xs-4', 'title'=>'type of pet ', 'checkContents' => ['dog1'=>'dog', 'cat1'=>'cat', 'other1'=>'other'] ) )
@include('partial.input', array( 'size'=>'col-lg-12', 'id'=>'inputHHOtherPets', 'title'=>'other pets(please specify)', 'class'=>'inputRequired' ) )

SCHOOL

@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSchName', 'title'=>'Name', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSchType', 'title'=>'School Type', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-12', 'id'=>'inputSchAddress', 'title'=>'Address', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSchPhone', 'title'=>'Phone', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSchFax', 'title'=>'Fax', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSchWebsite', 'title'=>'Website', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSchOTDate', 'title'=>'Orientation dates', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSchFSS', 'title'=>'Fall semester starts', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSchSSS', 'title'=>'Spring semester starts', 'class'=>'inputRequired' ) )

REPRESENTATIVES

@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputLCName', 'title'=>'Local Coordinator', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputLCPhone', 'title'=>'Phone', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputLCSName', 'title'=>'Local Coordinator Supervisor', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputLCSPhone', 'title'=>'Phone', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSCName', 'title'=>'Student Coordinator', 'class'=>'inputRequired' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputSCPhone', 'title'=>'Phone', 'class'=>'inputRequired' ) )
@include('partial.input', array( 'size'=>'col-lg-12', 'id'=>'inputWEChat', 'title'=>'WeChat ID', 'class'=>'inputRequired' ) )
@include('partial.save')