{% extends "layout.html" %}
{% block content %}
<script src="js/data.js"></script>
<script src="js/registerform.js"></script>
<h1>Registration</h1>
{% if closed %}
{% set disabled="disabled" %}
<div class="alert alert-danger">
<strong>Registration has been closed!</strong><br/>
For any further questions, please contact: <a class="alert-link" href="mailto:ggdworkshop@cmat.edu.uy">ggdworkshop@cmat.edu.uy</a>
</div>
{% endif %}
<div class="alert alert-info">
<strong>Please note that registration does not imply any kind of financial support</strong><br/>
</div>
<form id="registerform" method="POST" action novalidate="novalidate">
<fieldset {{ disabled }}>
<!-- Nombre y Apellido -->
<div class="row">
<div class="form-group col-xs-12 col-sm-6">
<label class="control-label" for="nombre">First Name</label>
<div class="input-container">
<input id="nombre" class="form-control" name="nombre" type="text">
</div>
</div>
<div class="form-group col-xs-12 col-sm-6">
<label class="control-label" for="apellido">Last Name</label>
<div class="input-container">
<input id="apellido" class="form-control" name="apellido" type="text">
</div>
</div>
</div>
<!-- Título y Afiliación -->
<div class="row">
<div class="form-group col-xs-12 col-sm-6">
<label class="control-label" for="titulo">Title</label>
<div class="input-container">
<input id="titulo" class="form-control" name="titulo"
placeholder="Professor, Post Doc, Grad Student(1st year, 2nd year, etc..)" type="text">
</div>
</div>
<div class="form-group col-xs-12 col-sm-6">
<label class="control-label " for="afiliacion">Affiliation</label>
<div class="input-container">
<input id="afiliacion" class="form-control" name="afiliacion"
placeholder="Which university or organization" type="text">
</div>
</div>
</div>
<!-- Ciudad y Pais -->
<div class="row">
<div class="form-group col-xs-12 col-sm-6">
<label class=" control-label" for="ciudad">City</label>
<div class="input-container">
<input id="ciudad" name="ciudad" class="form-control" type="text">
</div>
</div>
<div class="form-group col-xs-12 col-sm-6">
<label class=" control-label" for="pais">Country</label>
<div class="input-container">
<select {{ disabled }} id="pais" name="pais">
<option></optoon>
</select>
</div>
</div>
</div>
<!-- Email -->
<div class="row">
<div class="form-group col-xs-12">
<label class="control-label" for="email">Email</label>
<div class="input-container">
<input id="email" class="form-control" name="email"
placeholder="mail@example.com" type="email">
</div>
</div>
</div>
<!-- Beggining date and Endig Date-->
<div class="row">
<div class="form-group col-xs-12 col-sm-6">
<label class="control-label " for="txtbda">Beginning date attending</label>
<div class="input-container">
<input id="txtbda" class="form-control" placeholder="DD/MM/AAAA" name="bda">
</div>
</div>
<div class="form-group col-xs-12 col-sm-6">
<label class="control-label " for="txteda">Ending date attending</label>
<div class="input-container">
<input id="txteda" class="form-control" placeholder="DD/MM/AAAA" name="eda">
</div>
</div>
</div>
<!-- Financial Support -->
<!-- <div class="row">
<div class="form-group col-xs-12">
<label class="control-label" for="sifinan">
Are you asking for support from the conference?
</label>
<div class="radios input-container">
<label class="radio-inline"><input id="sifinan" type="radio" name="financiacion" value="1">Yes</label>
<label class="radio-inline"><input id="nofinan" type="radio" name="financiacion" value="0">No</label>
</div>
<div class="col-sm-8 alert alert-info" style="display:none;margin:10px 0px 5px 0px;">
<em class="text-justify">
We have submitted funding requests and hope to cover the housing
for a shared room, but we cannot make a guarantee at this time
</em>
</div>
</div>
</div>-->
<!-- Invitation and letter of -->
<div class="row">
<!-- <div class="form-group col-xs-12 col-sm-6">
<label class="control-label" for="invited">
Were you invited to participate in this conference?
</label>
<div class="input-container">
<div class="radio">
<label><input id="invited" type="radio" name="invited" value="1">Yes, I was previously invited</label>
</div>
<div class="radio">
<label><input id="noinvited" type="radio" name="invited" value="0">No, I am applying (Registration committee will notifiy you if accepted)</label>
</div>
</div>
</div>-->
<div class="form-group col-xs-12 col-sm-12">
<label class="control-label" for="invited">
Do you need a letter of invitation?
</label>
<div class="input-container">
<label class="radio-inline"><input id="sifinan" type="radio" name="letterinvited" value="1">Yes</label>
<label class="radio-inline"><input id="nofinan" type="radio" name="letterinvited" value="0">No</label>
</div>
</div>
</div>
<!-- Rooming Preferences -->
<div class="row">
<div class="form-group col-xs-12 col-sm-6">
<label class="control-label " for="roomtype">Rooming Preference</label>
<div class="input-container">
<select {{ disabled }} id="roomtype" name="roomtype">
<option></optoon>
</select>
</div>
</div>
<div class="form-group col-xs-12 col-sm-6">
<label class=" control-label" for="roomate">Name of preferred roommate (if any)</label>
<div class="input-container">
<input id="roomate" name="roomate" class="form-control"
type="text">
</div>
</div>
</div>
<!--Captcha -->
<div class="row">
<div class="form-group col-xs-12">
<div class="input-container">
<div class="g-recaptcha"
data-sitekey="{{ sitekey }}"
data-callback="recaptchaCallback">
</div>
<input type="hidden" class="hiddenRecaptcha required" name="hiddenRecaptcha" id="hiddenRecaptcha">
</div>
</div>
</div>
<!-- Confirm Button -->
<div class="row">
<div class="form-group col-xs-12 col-sm-8">
<button type="submit" class="btn-lg btn btn-primary">Register</button>
</div>
</div>
<!--<fieldset disabled="disabled">-->
</form>
<div id="statusmsg" class="alert alert-error">
</div>
<!--{% if flash("submit-register-err") %}
<div id="statusmsg" class="alert alert-error">
<strong>Error!</strong>
{% for msg in flash("submit-register-err") %}
<kbd>{{ msg }}.</kdb>
{% endfor %}
</div>
{% endif %}-->
<div id="msgModal" class="modal fade" role="dialog">
<div class="modal-dialog">
<div class="modal-content">
<div class="modal-header">
<button type="button" class="close" data-dismiss="modal">×</button>
<h4 class="modal-title">Surface Dynamics 2018 Workshop Registration</h4>
</div>
<div class="modal-body">
<div class="alert">
</div>
</div>
<!--<div class="modal-footer">
<button type="button" class="btn btn-default" data-dismiss="modal">Sí
</button>
<button type="button" class="btn btn-default" data-dismiss="modal">No
</button>
</div>-->
</div>
</div>
</div>
{% endblock %}