PLACEMENT CONFIRMATION

@if(isset($my_application->application_id))

STUDENT

@include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputLastName', 'title'=>'Last name' ) ) @include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputFirstName', 'title'=>'First name' ) ) @include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputEngName', 'title'=>'English name (If Applicable)' ) )
@include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputPhone', 'title'=>'Phone Number' ) ) @include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputEmail', 'title'=>'Email' ) ) @include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputWeChatID', 'title'=>'WeChatID' ) )
@include('partial.input', array( 'size'=>'col-lg-12', 'id'=>'inputAddress', 'title'=>'Address' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputGrade', 'title'=>'Grade' ) )
@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.input', array( 'size'=>'col-lg-12', 'id'=>'selectPlacementDateBirth', 'title'=>'Placement Date' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputOfficeUseOnly', 'title'=>'For office use only (1-20)' ) )

HOST PARENTS

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

HOUSEHOLD MEMBERS

@for ($i = 1; $i <= 3; $i++)
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputHHName'.$i, 'title'=>'Name' ) )
@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' ) )
@include('partial.input', array( 'size'=>'col-lg-12', 'id'=>'inputHHJob'.$i, 'title'=>'Relation / Occupation' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputGE'.$i, 'title'=>'Grade/Employer' ) )
@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' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputHHPhone', 'title'=>'Home phone' ) ) @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' ) )
@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.input', array( 'size'=>'col-lg-12', 'id'=>'inputHHPetInfo', 'title'=>'Pet Information' ) )

SCHOOL

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

REPRESENTATIVES

@include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputLCName', 'title'=>'Local Coordinator' ) ) @include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputLCPhone', 'title'=>'Phone' ) ) @include('partial.input', array( 'size'=>'col-lg-4', 'id'=>'inputLCEmail', 'title'=>'Email' ) )
@include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputLCSName', 'title'=>'Program Director' ) ) @include('partial.input', array( 'size'=>'col-lg-6', 'id'=>'inputLCSPhone', 'title'=>'Phone' ) )

Emergency phone number : 1.888-960-6408      Emergency Email Address : contact@anbeducation.com

@else

STUDENT

inputGender)=='f') checked @endif>
inputGender)=='m') checked @endif>

PLACEMENT

HOST PARENTS

HOUSEHOLD MEMBERS

@for ($i = 1; $i <= 3; $i++)
@endfor
host ? (($student->host->selectPetsNo>0)?'checked':'') : ''}}>
host ? (($student->host->selectPetsNo==0)?'checked':'') : ''}}>

SCHOOL

REPRESENTATIVES


Emergency phone number : 1.888-960-6408      Emergency Email Address : contact@anbeducation.com

@endif @include('partial.save')