@extends('layouts.app')
@section('content')
<div class="container">
    <div class="row">
        <div class="col-md-8 col-md-offset-2">
            <div class="panel panel-default">
                <div class="panel-heading">Escalate</div>
                <form action="{{route('submit-escalate')}}" method="post">
                    {{ csrf_field() }}
                    <div>
                        <label for="customer_name">Your Name</label>
                        <input id="customer_name" name="customer_name" type="text" required="required" value="{{ old('customer_name') }}">
                        @if ($errors->has('customer_name'))
                        <span class="help-block">
                            <strong>{{ $errors->first('customer_name') }}</strong>
                        </span>
                        @endif
                    </div>            
                    <div>
                        <label for="email">Your Email</label>
                        <input type="email" name="email" id="email" value="{{ old('email') }}">
                        @if ($errors->has('email'))
                        <span class="help-block">
                            <strong>{{ $errors->first('email') }}</strong>
                        </span>
                        @endif
                    </div>
                    <div>
                        <input type="hidden" name="code" value="{{ session()->get( 'code' ) }}" />
                        <input type="submit" value="Escalate">
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>
@endsection