@extends('layouts.main')

@section('content')
{{ Form::open(['route'=>'signup']) }}

<p>
    {{ Form::label('Company Name:') }}
    {{ Form::text('company_name') }}
</p>

<p>
    {{ Form::label('Contact Name:') }}
    {{ Form::text('contact_name') }}
</p>

<p>
    {{ Form::label('Company Address:') }}
    {{ Form::text('address') }}
</p>

<p>
    {{ Form::label('City:') }}
    {{ Form::text('city_id') }}
</p>

<p>
    {{ Form::label('State:') }}
    {{ Form::text('state_id') }}
</p>

<p>
    {{ Form::label('Zipcode:') }}
    {{ Form::text('zipcode') }}
</p>

<p>
    {{ Form::label('Email:') }}
    {{ Form::text('email') }}
</p>

<p>
    {{ Form::label('Primary Contact Phone:      Ext:') }}
    {{ Form::text('phone[]') }}{{ Form::text('phone[]') }}{{ Form::text('phone[]') }}{{ Form::text('phone[]') }}
</p>

<p>
    {{ Form::label('Fax:') }}
    {{ Form::text('fax') }}
</p>

<p>
    {{ Form::submit('Sign Up') }}
    {{ Form::reset('Cancel') }}
</p>


{{ Form::close() }}
@stop