

<?php $__env->startSection('content'); ?>

<div class="row justify-content-center">
    <div class="col-md-6">

```
    <div class="card p-4">

        <h4 class="text-center mb-3">Student Enquiry</h4>

        <?php if(session('success')): ?>
            <div class="alert alert-success"><?php echo e(session('success')); ?></div>
        <?php endif; ?>

        <?php if(isset($partner)): ?>
            <div class="alert alert-info">
                Referred by <b><?php echo e($partner->full_name); ?></b><br>
                Code: <?php echo e($partner->referral_code); ?>

            </div>
        <?php endif; ?>

        <form method="POST" action="<?php echo e(route('lead.submit')); ?>">
            <?php echo csrf_field(); ?>

            <input type="text" name="name" class="form-control mb-2" placeholder="Full Name" required>

            <input type="text" name="phone" class="form-control mb-2" placeholder="Mobile Number" required>

            <input type="email" name="email" class="form-control mb-2" placeholder="Email">

            <select name="country" class="form-control mb-2" required>
                <option value="">Select Country</option>
                <option>Canada</option>
                <option>UK</option>
                <option>USA</option>
                <option>Australia</option>
            </select>

            <select name="intake" class="form-control mb-3" required>
                <option value="">Select Intake</option>
                <option>Jan</option>
                <option>May</option>
                <option>Sep</option>
            </select>
            <select name="counselor_id" required>
    <option value="">Select Counselor</option>

    <?php $__currentLoopData = $counselors; $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $counselor): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
        <option value="<?php echo e($counselor->id); ?>">
            <?php echo e($counselor->name); ?>

        </option>
    <?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
</select>

            <button class="btn btn-primary w-100">Submit</button>

        </form>

    </div>

</div>
```

</div>

<?php $__env->stopSection(); ?>

<?php echo $__env->make('layouts.app', array_diff_key(get_defined_vars(), ['__data' => 1, '__path' => 1]))->render(); ?><?php /**PATH /home2/jitrealx/public_html/zoho/resources/views/landing/page.blade.php ENDPATH**/ ?>