} | } | ||||
public function viewFormPreview(Request $request){ | public function viewFormPreview(Request $request){ | ||||
$data = array(); | $data = array(); | ||||
$product = Product::where('formT','B')->where('package_name',$request->package)->first(); | $product = Product::where('formT','B')->where('package_name',$request->package)->first(); | ||||
$otc = 0.0; | $otc = 0.0; | ||||
$deposit = $product->deposit; | |||||
$total_monthly = 0; | |||||
$gst =''; | |||||
$promo_st = ''; | |||||
if($request->subscription == '24'){ | |||||
$otc = 0.0; | |||||
$voice = "No"; | |||||
if($request->has('voice')){ | |||||
$voice = $request->voice; | |||||
$voice_price = 20; | |||||
}else { | }else { | ||||
$otc = 300; | |||||
$voice = "No"; | |||||
$voice_price = 0; | |||||
} | } | ||||
$gst = number_format(floatval($product->retail_price) * 1.06,2); | |||||
if ($request->package != "1Gbps" && $request->subscription == '24'){ | |||||
$promo_price = number_format(floatval($product->retail_price) - 10); | |||||
$promo_st = number_format(floatval($promo_price) * 1.06,2); | |||||
$total_monthly = number_format($promo_st + ($voice_price * 1.06), 2); | |||||
} | |||||
else if ($request->package == "1Gbps"){ | |||||
$gst = number_format(floatval($product->retail_price) * 1.06,2); | |||||
$total_monthly = 3730.14; | |||||
} | |||||
else{ | |||||
$gst = number_format(floatval($product->retail_price) * 1.06,2); | |||||
$total_monthly = number_format($gst + ($voice_price * 1.06), 2); | |||||
} | |||||
$voice = "No"; | |||||
if($request->has('voice')){ | |||||
$voice = $request->voice; | |||||
if($request->voice == 'Yes' && $request->subscription == '12'){ | |||||
$otc += 100; | |||||
} | |||||
if($request->subscription == '12' && $voice == 'No'){ | |||||
$otc = 300; | |||||
$deposit = $product->deposit; | |||||
}else if( $request->subscription == '12' && $voice == 'Yes'){ | |||||
$otc = 300 + 100; | |||||
$deposit = $product->deposit; | |||||
}else { | }else { | ||||
$voice = "No"; | |||||
$otc = 0.0; | |||||
$deposit = $product->deposit; | |||||
} | } | ||||
$otc_st = number_format(floatval($otc) * 1.06,2); | |||||
$upfront_total = number_format(floatval($otc_st) + $deposit,2); | |||||
$IP = ''; | $IP = ''; | ||||
if($request->ip == 'custom'){ | if($request->ip == 'custom'){ | ||||
$IP = $request->custom; | $IP = $request->custom; | ||||
'thedate' => $request->thedate, | 'thedate' => $request->thedate, | ||||
)); | )); | ||||
return view('sales.form.business_preview', compact('data','product','deposit','otc','gst','total')); | |||||
return view('sales.form.business_preview', compact('data','coverage','product','deposit','otc', 'otc_st','gst','promo_price','promo_st','total_monthly', 'upfront_total')); | |||||
} | } | ||||
public function storeFormData(Request $request){ | public function storeFormData(Request $request){ | ||||
$packageD = new PackageDetail(); | $packageD = new PackageDetail(); | ||||
$packageD->contract = $request->subscription; | $packageD->contract = $request->subscription; | ||||
$packageD->name = $product->speed; | $packageD->name = $product->speed; | ||||
$packageD->montly_fee = $request->gst; | |||||
if ($request->gst != null){ | |||||
$packageD->montly_fee = $request->gst; | |||||
}else { | |||||
$packageD->montly_fee = $request->promo_st; | |||||
} | |||||
$packageD->voice_fee = $request->voice; | $packageD->voice_fee = $request->voice; | ||||
$packageD->ip = $request->ip; | $packageD->ip = $request->ip; | ||||
$packageD->deposit = $request->deposit; | $packageD->deposit = $request->deposit; | ||||
$product = Product::where('formT','B')->where('package_name',$request->package)->first(); | $product = Product::where('formT','B')->where('package_name',$request->package)->first(); | ||||
$otc = 0.0; | $otc = 0.0; | ||||
$deposit = $product->deposit; | |||||
if($request->subscription == '24'){ | |||||
$otc = 0.0; | |||||
}else { | |||||
$otc = 300; | |||||
} | |||||
$gst = number_format(floatval($product->retail_price) * 1.06,2); | |||||
$total_monthly = 0; | |||||
$gst =''; | |||||
$promo_st = ''; | |||||
$voice = "No"; | $voice = "No"; | ||||
if($request->has('voice')){ | if($request->has('voice')){ | ||||
$voice = $request->voice; | $voice = $request->voice; | ||||
if($request->voice == 'Yes' && $request->subscription == '12'){ | |||||
$otc += 100; | |||||
} | |||||
$voice_price = 20; | |||||
}else { | }else { | ||||
$voice = "No"; | $voice = "No"; | ||||
$voice_price = 0; | |||||
} | |||||
if ($request->package != "1Gbps" && $request->subscription == '24'){ | |||||
$promo_price = number_format(floatval($product->retail_price) - 10); | |||||
$promo_st = number_format(floatval($promo_price) * 1.06,2); | |||||
$total_monthly = number_format($promo_st + ($voice_price * 1.06), 2); | |||||
} | |||||
else if ($request->package == "1Gbps"){ | |||||
$gst = number_format(floatval($product->retail_price) * 1.06,2); | |||||
$total_monthly = 3730.14; | |||||
} | } | ||||
else{ | |||||
$gst = number_format(floatval($product->retail_price) * 1.06,2); | |||||
$total_monthly = number_format($gst + ($voice_price * 1.06), 2); | |||||
} | |||||
if($request->subscription == '12' && $voice == 'No'){ | |||||
$otc = 300; | |||||
$deposit = $product->deposit; | |||||
}else if( $request->subscription == '12' && $voice == 'Yes'){ | |||||
$otc = 300 + 100; | |||||
$deposit = $product->deposit; | |||||
}else { | |||||
$otc = 0.0; | |||||
$deposit = $product->deposit; | |||||
} | |||||
$otc_st = number_format(floatval($otc) * 1.06,2); | |||||
$upfront_total = number_format(floatval($otc_st) + $deposit,2); | |||||
$IP = ''; | $IP = ''; | ||||
if($request->ip == 'custom'){ | if($request->ip == 'custom'){ | ||||
}else{ | }else{ | ||||
$IP = $request->ip; | $IP = $request->ip; | ||||
} | } | ||||
$total = number_format((floatval($product->retail_price) * 1.06) + ($otc * 1.06) + $deposit, 2); | |||||
array_push($data, array( | array_push($data, array( | ||||
'unit_no' => $request->unit_no, | 'unit_no' => $request->unit_no, | ||||
'dealer_id' => $request->dealer_id, | 'dealer_id' => $request->dealer_id, | ||||
)); | )); | ||||
return view('sales.form.dealer.business_preview', compact('data','product','deposit','otc','gst','total')); | |||||
return view('sales.form.dealer.business_preview', compact('data','coverage','product','deposit','otc', 'otc_st','gst','promo_price','promo_st','total_monthly', 'upfront_total')); | |||||
} | } | ||||
public function storeFormDataD(Request $request){ | public function storeFormDataD(Request $request){ | ||||
$packageD = new PackageDetail(); | $packageD = new PackageDetail(); | ||||
$packageD->contract = $request->subscription; | $packageD->contract = $request->subscription; | ||||
$packageD->name = $product->speed; | $packageD->name = $product->speed; | ||||
$packageD->montly_fee = $request->gst; | |||||
if ($request->gst != null){ | |||||
$packageD->montly_fee = $request->gst; | |||||
}else { | |||||
$packageD->montly_fee = $request->promo_st; | |||||
} | |||||
$packageD->voice_fee = $request->voice; | $packageD->voice_fee = $request->voice; | ||||
$packageD->ip = $request->ip; | $packageD->ip = $request->ip; | ||||
$packageD->deposit = $request->deposit; | $packageD->deposit = $request->deposit; | ||||
} | } | ||||
} | } | ||||
} | } | ||||
public function checkEmailTemplate($subscriber_id){ | |||||
$subscriber = Subscriber::where('subscriber_id',$subscriber_id)->first(); | |||||
if(!empty($subscriber)){ | |||||
$form = Form::where('_id',$subscriber->_id)->first(); | |||||
$product = Product::where('speed',$form->PackageDetail->name)->where('formT',$form->type_application)->first(); | |||||
} | |||||
return view('email.invoiceb', compact ('form', 'product')); | |||||
} | |||||
} | } |
$otc = 0.0; | $otc = 0.0; | ||||
$deposit = 300; | $deposit = 300; | ||||
}else if($request->citizenship != 'Malaysian' && $request->subscription == '24' && $voice == 'Yes') { | }else if($request->citizenship != 'Malaysian' && $request->subscription == '24' && $voice == 'Yes') { | ||||
$otc = 100; | |||||
$otc = 0.0; | |||||
$deposit = 300; | $deposit = 300; | ||||
}else if($request->citizenship == 'Malaysian' && $request->subscription == '24'){ | }else if($request->citizenship == 'Malaysian' && $request->subscription == '24'){ | ||||
$otc = 0.0; | $otc = 0.0; | ||||
$street = $request->street; | $street = $request->street; | ||||
} | } | ||||
if (!empty($request->nric_passport1)){ | |||||
$nokp = $request->nric_passport1; | |||||
}else { | |||||
$nokp = $request->nric_passport2; | |||||
} | |||||
array_push($data, array( | array_push($data, array( | ||||
'dealer_id' => $request->dealer_id, | 'dealer_id' => $request->dealer_id, | ||||
'coverage' => $request->coverage, | 'coverage' => $request->coverage, | ||||
'package' => $request->package, | 'package' => $request->package, | ||||
'application' => $request->application, | 'application' => $request->application, | ||||
'name' => $request->name, | 'name' => $request->name, | ||||
'nric_passport' => $request->nric_passport, | |||||
'nric_passport' => $nokp, | |||||
'ip' => $request->ip, | 'ip' => $request->ip, | ||||
'gender' => $request->gender, | 'gender' => $request->gender, | ||||
'race' => $request->race, | 'race' => $request->race, | ||||
'email' => $request->email | 'email' => $request->email | ||||
)); | )); | ||||
$pg = $request->package; | |||||
return view('sales.form.dealer.residential_package', compact('data','pg','citizen')); | |||||
$product = Product::where('formT','R')->where('package_name',$request->package)->first(); | |||||
return view('sales.form.dealer.residential_package', compact('data','product','citizen')); | |||||
} | } | ||||
public function viewFormPreviewD(Request $request){ | public function viewFormPreviewD(Request $request){ | ||||
$voice = "No"; | $voice = "No"; | ||||
if($request->has('voice')){ | if($request->has('voice')){ | ||||
$voice = $request->voice; | $voice = $request->voice; | ||||
$voice_price = 20; | |||||
}else { | }else { | ||||
$voice = "No"; | |||||
$voice = "No"; | |||||
$voice_price = 0; | |||||
} | |||||
$total_monthly = 0; | |||||
$gst =''; | |||||
$promo_st = ''; | |||||
if ($request->package != "1Gbps" && $request->subscription == '24'){ | |||||
$promo_price = number_format(floatval($product->retail_price) - 10); | |||||
$promo_st = number_format(floatval($promo_price) * 1.06,2); | |||||
$total_monthly = number_format($promo_st + ($voice_price * 1.06), 2); | |||||
} | |||||
else{ | |||||
$gst = number_format(floatval($product->retail_price) * 1.06,2); | |||||
$total_monthly = number_format($gst + ($voice_price * 1.06), 2); | |||||
} | } | ||||
if($request->citizenship != 'Malaysian' && $request->subscription == '12' && $voice == 'No'){ | if($request->citizenship != 'Malaysian' && $request->subscription == '12' && $voice == 'No'){ | ||||
$otc = 300; | $otc = 300; | ||||
$deposit = $product->deposit; | |||||
$deposit = 300; | |||||
}else if($request->citizenship != 'Malaysian' && $request->subscription == '12' && $voice == 'Yes'){ | }else if($request->citizenship != 'Malaysian' && $request->subscription == '12' && $voice == 'Yes'){ | ||||
$otc = 300 + 100; | $otc = 300 + 100; | ||||
$deposit = $product->deposit; | |||||
$deposit = 300; | |||||
}else if($request->citizenship != 'Malaysian' && $request->subscription == '24' && $voice == 'No'){ | }else if($request->citizenship != 'Malaysian' && $request->subscription == '24' && $voice == 'No'){ | ||||
$otc = 0.0; | $otc = 0.0; | ||||
$deposit = 300; | $deposit = 300; | ||||
}else if($request->citizenship != 'Malaysian' && $request->subscription == '24' && $voice == 'Yes') { | }else if($request->citizenship != 'Malaysian' && $request->subscription == '24' && $voice == 'Yes') { | ||||
$otc = 0.0; | |||||
$deposit = 300 + 100; | |||||
$otc = 100; | |||||
$deposit = 300; | |||||
}else if($request->citizenship == 'Malaysian' && $request->subscription == '24'){ | }else if($request->citizenship == 'Malaysian' && $request->subscription == '24'){ | ||||
$otc = 0.0; | $otc = 0.0; | ||||
$deposit = $product->deposit; | $deposit = $product->deposit; | ||||
$deposit = $product->deposit; | $deposit = $product->deposit; | ||||
} | } | ||||
$gst = 0; $total = 0; | |||||
if($product->promotion_price != '0' && $request->subscription == '24'){ | |||||
$gst = number_format(floatval($product->promotion_price) * 1.06,2); | |||||
$total = number_format((floatval($product->promotion_price) * 1.06) + ($otc * 1.06) + $deposit, 2); | |||||
}else if($product->promotion_price == '0'){ | |||||
$gst = number_format(floatval($product->retail_price) * 1.06,2); | |||||
$total = number_format((floatval($product->retail_price) * 1.06) + ($otc * 1.06) + $deposit, 2); | |||||
} | |||||
$otc_st = number_format(floatval($otc) * 1.06,2); | |||||
$upfront_total = number_format(floatval($otc_st) + $deposit,2); | |||||
array_push($data, array( | array_push($data, array( | ||||
'dealer_id' => $request->dealer_id, | 'dealer_id' => $request->dealer_id, | ||||
'coverage' => $request->coverage, | 'coverage' => $request->coverage, | ||||
'thedate' => $request->thedate, | 'thedate' => $request->thedate, | ||||
)); | )); | ||||
return view('sales.form.dealer.residential_preview', compact('data','coverage','product','deposit','otc','gst','total')); | |||||
return view('sales.form.dealer.residential_preview', compact('data','coverage','product','deposit','otc', 'otc_st','gst','promo_price','promo_st','total_monthly', 'upfront_total')); | |||||
} | } | ||||
public function storeFormDataD(Request $request){ | public function storeFormDataD(Request $request){ | ||||
$pathVisaB = '/'.$destinationPath.'/visaB.'.strtolower($icon->getClientOriginalExtension()); | $pathVisaB = '/'.$destinationPath.'/visaB.'.strtolower($icon->getClientOriginalExtension()); | ||||
} | } | ||||
if($request->hasfile('payment_receipt')){ | |||||
$icon = $request->file('payment_receipt'); | |||||
$icon->move($destinationPath,'payment_receipt.'.strtolower($icon->getClientOriginalExtension())); | |||||
$pathPaymentReceipt = '/'.$destinationPath.'/payment_receipt.'.strtolower($icon->getClientOriginalExtension()); | |||||
} | |||||
// staff | // staff | ||||
$staff = Staff::with('StaffDetail')->where('_id',$request->dealer_id)->first(); | $staff = Staff::with('StaffDetail')->where('_id',$request->dealer_id)->first(); | ||||
if(!empty($staff)){ | if(!empty($staff)){ | ||||
$sdl->back_ic = $pathIconB; | $sdl->back_ic = $pathIconB; | ||||
$sdl->visaF = $pathVisaF; | $sdl->visaF = $pathVisaF; | ||||
$sdl->visaB = $pathVisaB; | $sdl->visaB = $pathVisaB; | ||||
$sdl->paymentReceipt = $pathPaymentReceipt; | |||||
$sdl->signature = '/'.$destinationPath.'/signature_form.jpg'; | $sdl->signature = '/'.$destinationPath.'/signature_form.jpg'; | ||||
$packageD = new PackageDetail(); | $packageD = new PackageDetail(); | ||||
$packageD->contract = $request->subscription; | $packageD->contract = $request->subscription; | ||||
$packageD->name = $product->speed; | $packageD->name = $product->speed; | ||||
$packageD->montly_fee = $request->gst; | |||||
if ($request->gst != null){ | |||||
$packageD->montly_fee = $request->gst; | |||||
}else { | |||||
$packageD->montly_fee = $request->promo_st; | |||||
} | |||||
$packageD->voice_fee = $request->voice; | $packageD->voice_fee = $request->voice; | ||||
$packageD->deposit = $request->deposit; | $packageD->deposit = $request->deposit; | ||||
$packageD->upfront_payment = $request->otc; | $packageD->upfront_payment = $request->otc; | ||||
$sl->subscriber()->save($sdl); | $sl->subscriber()->save($sdl); | ||||
$sl->packagedetail()->save($packageD); | $sl->packagedetail()->save($packageD); | ||||
$f_id = $this->sendInvoice($su_id); | $f_id = $this->sendInvoice($su_id); | ||||
$stat = new FormStatus(); | $stat = new FormStatus(); | ||||
$stat->form_id = $f_id; | $stat->form_id = $f_id; |
@if($form->type_application == 'R') | @if($form->type_application == 'R') | ||||
<p>Residential Package - {{ $product->package_name }}</p> | <p>Residential Package - {{ $product->package_name }}</p> | ||||
@elseif($form->type_application == 'B') | @elseif($form->type_application == 'B') | ||||
<p>Business Package - {{ $product->package_name }}</p> | |||||
<p>City Broadband Business Package - {{ $product->package_name }}</p> | |||||
@endif | @endif | ||||
</td> | </td> | ||||
</tr> | </tr> | ||||
</tr> | </tr> | ||||
<tr> | <tr> | ||||
<td colspan="2" style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | <td colspan="2" style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | ||||
<b>Subscribe for Voice</b> | |||||
@if($form->voice_fee == 'Yes') | |||||
<p>YES</p> | |||||
@elseif($form->voice_fee == 'No') | |||||
<p>NO</p> | |||||
<b> Voice Plan</b> | |||||
@if($form->PackageDetail->voice_fee == 'Yes') | |||||
<p>Yes</p> | |||||
@elseif($form->PackageDetail->voice_fee == 'No') | |||||
<p>No</p> | |||||
@endif | @endif | ||||
</td> | </td> | ||||
</tr> | </tr> | ||||
<tr> | <tr> | ||||
<td colspan="2" style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | <td colspan="2" style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | ||||
<b>Service Installation Address</b> | <b>Service Installation Address</b> | ||||
<p>{{ $form->Subscriber->unit_no }}, {{ $form->Subscriber->street }}, {{ $form->Subscriber->postcode }}, {{ $form->Subscriber->city }}, {{ $form->Subscriber->state }}</p> | |||||
<p>{{ $form->Subscriber->unit_no }}, {{ ucwords($form->Subscriber->street) }}, {{ $form->Subscriber->postcode }}, {{ $form->Subscriber->city }}, {{ $form->Subscriber->state }}</p> | |||||
</td> | </td> | ||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
<tr> | <tr> | ||||
<td style="padding: 10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | <td style="padding: 10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | ||||
<b>Company Name</b> | <b>Company Name</b> | ||||
<p>{{ $form->Subscriber->company_name }}</p> | |||||
<p>{{ ucwords($form->Subscriber->company_name) }}</p> | |||||
</td> | </td> | ||||
<td style="padding: 10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | <td style="padding: 10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | ||||
<b>Company Reg.No</b> | <b>Company Reg.No</b> | ||||
<tr> | <tr> | ||||
<td style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | <td style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | ||||
<b>Upfront Payment</b> | <b>Upfront Payment</b> | ||||
<p>{{ $form->PackageDetail->upfront_payment }}</p> | |||||
<p>RM {{ $form->PackageDetail->upfront_payment }}</p> | |||||
</td> | </td> | ||||
<td style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | <td style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | ||||
<b>Deposit</b> | <b>Deposit</b> | ||||
<p>{{ $form->PackageDetail->deposit }}</p> | |||||
<p>RM {{ $form->PackageDetail->deposit }}</p> | |||||
</td> | </td> | ||||
</tr> | </tr> | ||||
<tr> | <tr> | ||||
<td style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | <td style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | ||||
<b>Monthly Broadband Fee (incl. ST)</b> | <b>Monthly Broadband Fee (incl. ST)</b> | ||||
<p>{{ $form->PackageDetail->montly_fee }}</p> | |||||
<p>RM {{ $form->PackageDetail->montly_fee }}</p> | |||||
</td> | </td> | ||||
<td style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | <td style="padding:10px 15px" width="50%" valign="middle" align="center" bgcolor="#eee"> | ||||
<b>Voice Fee</b> | |||||
<b>Voice Fee (incl. ST</b> | |||||
@if($form->PackageDetail->voice_fee == 'Yes') | @if($form->PackageDetail->voice_fee == 'Yes') | ||||
@if( date('d/m/Y', strtotime($form->created_at)) >= '03/02/2020' ) | |||||
<p>RM 20</p> | |||||
@else | |||||
<p>RM 30</p> | |||||
@endif | |||||
<p>RM 21.20</p> | |||||
@else | @else | ||||
<p>RM 0</p> | <p>RM 0</p> | ||||
@endif | @endif |
<div class="row"> | <div class="row"> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Type Application</b> <small style="color: red">*</small></label> | |||||
<label><b>Application Type</b> <small style="color: red">*</small></label> | |||||
<div> | <div> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="application" value="New" checked="">New | <input type="radio" name="application" value="New" checked="">New | ||||
<!-- </a> --> | <!-- </a> --> | ||||
</div> | </div> | ||||
<!-- <div class="pull-left"> | |||||
<a href="{{url('/application-form/residential/address/step1')}}"> | |||||
<div class="pull-left"> | |||||
<a href="javascript:history.back()"> | |||||
<input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | <input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | ||||
</a> | </a> | ||||
</div> --> | |||||
</div> | |||||
<div class="clearfix"></div> | <div class="clearfix"></div> | ||||
</div> | </div> | ||||
</div> | </div> |
<input type="hidden" name="caddress" value="{{$a['caddress']}}"> | <input type="hidden" name="caddress" value="{{$a['caddress']}}"> | ||||
<input type="hidden" name="ccity" value="{{$a['ccity']}}"> | <input type="hidden" name="ccity" value="{{$a['ccity']}}"> | ||||
<input type="hidden" name="postcode" value="{{$a['postcode']}}"> | <input type="hidden" name="postcode" value="{{$a['postcode']}}"> | ||||
<input type="hidden" name="ccity" value="{{$a['ccity']}}"> | |||||
<input type="hidden" name="cstate" value="{{$a['cstate']}}"> | |||||
<input type="hidden" name="package" value="{{ $a['package'] }}"> | <input type="hidden" name="package" value="{{ $a['package'] }}"> | ||||
<input type="hidden" name="application" value="{{$a['application']}}"> | <input type="hidden" name="application" value="{{$a['application']}}"> | ||||
<input type="hidden" name="company_name" value="{{$a['company_name']}}"> | <input type="hidden" name="company_name" value="{{$a['company_name']}}"> | ||||
<div class="row"> | <div class="row"> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<label>You have selected:</label> | <label>You have selected:</label> | ||||
<p>Business package - {{ $pg }}</p> | |||||
<p>City Broadband Business - {{ $pg }}</p> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
<!-- Contract --> | <!-- Contract --> | ||||
<div class="row"> | <div class="row"> | ||||
<div class="col-md-6"> | |||||
<div class="col-md-12"> | |||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Subscription / Contract Period </b> <small style="color: red">*</small></label> | <label><b>Subscription / Contract Period </b> <small style="color: red">*</small></label> | ||||
<div> | <div> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="subscription" value="12">12 Months (Rm 300) | |||||
<input type="radio" id="subscription1" name="subscription" value="12">12 Months | |||||
</label> | </label> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="subscription" value="24" checked="">24 Months | |||||
<input type="radio" id="subscription2" name="subscription" value="24" checked="">24 Months | |||||
</label> | </label> | ||||
</div> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Billing Cycle</b> <small style="color: red">*</small></label> | |||||
<div> | |||||
@if ($pg != "1Gbps") | |||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="billing" value="monthly" checked="" readonly="">Monthly | |||||
<input type="checkbox" id="10off" checked=""> <small id="10off1">RM10 off every month for 24 months</small> | |||||
</label> | </label> | ||||
@endif | |||||
</div> | </div> | ||||
<small id="OTC" style="color:blue; display:none">A one-time charge of RM300 applies for 12 months subscription.</small> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p style="margin-bottom: 0px !important">Would you like to subscribe for 1 Voice Line + 1 Dect phone (RM20) ? <br><small style="color:red">Deposit RM100 is required for new activation voice for 12months contract</small></p> | |||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p style="margin-bottom: 0px !important">Add on Voice Plan and 1 Dect Phone at RM20/month ? <br><small style="color:red"> A deposit of RM100 is required for new voice activation tied to 12 months contract.</small></p> | |||||
</label> | </label> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="fixed_ip" id="fixed_ip" value="Yes"><p>Would you like to subscribe for Fixed IP?</p> | |||||
<input type="checkbox" name="fixed_ip" id="fixed_ip" value="Yes"><p>Add on subscribtion for Fixed IP?</p> | |||||
</label> | </label> | ||||
<select name="ip" id="ip" class="form-control" onchange="yesnoCheck(this);"> | <select name="ip" id="ip" class="form-control" onchange="yesnoCheck(this);"> | ||||
<option value="" >Please Select</option> | <option value="" >Please Select</option> | ||||
<option value="no">No</option> | <option value="no">No</option> | ||||
<option value="1 Fixed IP RM200/1P/Month">1 Fixed IP RM200/1P/Month</option> | <option value="1 Fixed IP RM200/1P/Month">1 Fixed IP RM200/1P/Month</option> | ||||
<option value="5 Fixed IP RM400/1P/Month">5 Fixed IP RM400/1P/Month</option> | <option value="5 Fixed IP RM400/1P/Month">5 Fixed IP RM400/1P/Month</option> | ||||
<option value ="custom">Custome Fixed IP</option> | |||||
<option value ="custom">Custom Fixed IP</option> | |||||
</select> | </select> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<input name="custom" id="custom" placeholder="Enter Custome Fixed IP" style="display: none;" class="form-control" type="text" required="" aria-required="true"> | |||||
<input name="custom" id="custom" placeholder="Enter Custom Fixed IP" style="display: none;" class="form-control" type="text" required="" aria-required="true"> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<p class="text">1. Standard contract period is 24 months unless otherwise stated.</p> | <p class="text">1. Standard contract period is 24 months unless otherwise stated.</p> | ||||
<p class="text">2. Preferred appointment date is subject to the availability of required infrastructure and/ or equipment.</p> | <p class="text">2. Preferred appointment date is subject to the availability of required infrastructure and/ or equipment.</p> | ||||
<p class="text">3. Early termination will subject to RM500 penalty.</p> | <p class="text">3. Early termination will subject to RM500 penalty.</p> | ||||
<p class="text">4. Separete penalty charge for broadband and voice</p> | |||||
<p class="text">4. Separate penalty charge for broadband and voice home plan.</p> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<!-- </a> --> | <!-- </a> --> | ||||
</div> | </div> | ||||
<!-- <div class="pull-left"> | |||||
<a href="{{url('/application-form/residential/address/step1')}}"> | |||||
<input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | |||||
</a> | |||||
</div> --> | |||||
<div class="pull-left"> | |||||
<a href="javascript:history.back()"> | |||||
<input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | |||||
</a> | |||||
</div> | |||||
<div class="clearfix"></div> | <div class="clearfix"></div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
$('footer').removeClass('reached-bottom'); | $('footer').removeClass('reached-bottom'); | ||||
} | } | ||||
}); | }); | ||||
$('#subscription1').change(function(){ | |||||
if(document.getElementById('subscription1').checked){ | |||||
$('#OTC').show(); | |||||
document.getElementById('10off').checked = false; | |||||
$('#10off').hide(); | |||||
$('#10off1').hide(); | |||||
} | |||||
}); | |||||
$('#subscription2').change(function(){ | |||||
if(document.getElementById('subscription2').checked){ | |||||
$('#OTC').hide(); | |||||
document.getElementById('10off').checked = true; | |||||
$('#10off').show(); | |||||
$('#10off1').show(); | |||||
} | |||||
}); | |||||
</script> | </script> | ||||
<style> | <style> | ||||
select { | select { |
<input type="hidden" name="ip" value="{{$a['ip']}}"> | <input type="hidden" name="ip" value="{{$a['ip']}}"> | ||||
<input type="hidden" name="rfs" value="{{$a['thedate']}}"> | <input type="hidden" name="rfs" value="{{$a['thedate']}}"> | ||||
<input type="hidden" name="deposit" value="{{ $deposit }}"> | <input type="hidden" name="deposit" value="{{ $deposit }}"> | ||||
<input type="hidden" name="otc" value="{{ $otc }}"> | |||||
<input type="hidden" name="otc" value="{{ $otc_st }}"> | |||||
<input type="hidden" name="gst" value="{{ $gst }}"> | <input type="hidden" name="gst" value="{{ $gst }}"> | ||||
<input type="hidden" name="total" value="{{ $total }}"> | |||||
<input type="hidden" name="promo_st" value="{{ $promo_st }}"> | |||||
<input type="hidden" name="total_monthly" value="{{ $total_monthly }}"> | |||||
<div class="tracking-process"></div> | <div class="tracking-process"></div> | ||||
<label><b>Subscription Details</b></label> | <label><b>Subscription Details</b></label> | ||||
<table class="table table-sm table-bordered"> | <table class="table table-sm table-bordered"> | ||||
<tbody> | <tbody> | ||||
<tr><th width="50%">Type Application</th> | |||||
<tr><th width="50%">Application Type</th> | |||||
<td>{{$a['application']}}</td> | <td>{{$a['application']}}</td> | ||||
</tr> | </tr> | ||||
<tr><th width="50%">Business Package</th> | |||||
<td>{{$a['package']}}</td> | |||||
<tr><th width="50%">Package</th> | |||||
<td>City Broadband Business {{$a['package']}}</td> | |||||
</tr> | </tr> | ||||
@if ($a['subscription']==24 && ($a['package'] != '1Gbps')) | |||||
<tr><th width="50%">Promotion</th> | |||||
<td>RM10 off for 24 months</td> | |||||
</tr> | |||||
@endif | |||||
<tr><th width="50%">Contract Term</th> | <tr><th width="50%">Contract Term</th> | ||||
<td>{{$a['subscription']}}Months</td> | |||||
<td>{{$a['subscription']}} Months</td> | |||||
</tr> | </tr> | ||||
<tr><th width="50%">Checking and Evaluation, Date</th> | |||||
<tr><th width="50%">Preferred Installation Date</th> | |||||
<td>{{$a['thedate']}}</td> | <td>{{$a['thedate']}}</td> | ||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
<hr><label><b>Add-On(s)</b></label> | <hr><label><b>Add-On(s)</b></label> | ||||
<table class="table table-sm table-bordered"> | <table class="table table-sm table-bordered"> | ||||
<tbody> | <tbody> | ||||
<tr><th width="50%">Subscribe for Voice</th> | |||||
<tr><th width="50%">Voice Plan</th> | |||||
<td>{{$a['voice']}}</td> | <td>{{$a['voice']}}</td> | ||||
</tr> | </tr> | ||||
<tr><th width="50%">IP</th> | <tr><th width="50%">IP</th> | ||||
<td>{{$a['company_name']}}</td> | <td>{{$a['company_name']}}</td> | ||||
</tr> | </tr> | ||||
<tr><th width="50%">Address</th> | <tr><th width="50%">Address</th> | ||||
<td>{{$a['caddress']}}</td> | |||||
<td>{{ucwords($a['caddress'])}}</td> | |||||
</tr> | </tr> | ||||
<tr><th width="50%">Postcode</th> | <tr><th width="50%">Postcode</th> | ||||
<td>{{$a['postcode']}}</td> | <td>{{$a['postcode']}}</td> | ||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
</table> | </table> | ||||
<hr><label><b>Montly Recurring Fee</b></label> | |||||
<hr><label><b>Montly Recurring Charges</b></label> | |||||
@if($a['package']!='1Gbps' && $a['subscription']=='24') | |||||
<br><small> Promotion: RM10 off for 24 months</small> | |||||
@endif | |||||
<table class="table table-sm table-bordered"> | <table class="table table-sm table-bordered"> | ||||
<tbody> | <tbody> | ||||
<tr> | <tr> | ||||
<th>Description</th> | <th>Description</th> | ||||
<th>Price excl. ST</th> | |||||
<th>With ST (6%)</th> | |||||
<th>Price exclude ST</th> | |||||
<th>With ST 6%</th> | |||||
</tr> | </tr> | ||||
<tr><th>Broadband Fee</th> | |||||
<td>{{ $product->retail_price }}</td> | |||||
<td>{{ $gst }}</td> | |||||
<tr><th>City Broadband Business - {{$a['package']}}</th> | |||||
@if($a['package']!='1Gbps' && $a['subscription']=='24') | |||||
<td><span style="text-decoration: line-through;">RM{{ $product->retail_price }}</span> RM{{ $promo_price}}</td> | |||||
<td>RM{{ $promo_st }}</td> | |||||
@else | |||||
<td>RM{{ $product->retail_price }}</td> | |||||
<td>RM{{ $gst }}</td> | |||||
@endif | |||||
</tr> | </tr> | ||||
<tr><th colspan="2">Deposit</th> | |||||
@if($a['voice']=='Yes') | |||||
<tr><th>Voice Home Plan</th> | |||||
<td> | |||||
RM20 | |||||
</td> | |||||
<td> | <td> | ||||
{{ $deposit }} | |||||
RM21.20 | |||||
</td> | </td> | ||||
</tr> | </tr> | ||||
<tr><th colspan="2">OTC</th> | |||||
<td>{{ $otc }}</td> | |||||
@endif | |||||
<tr><th colspan="2">Total Charges</th> | |||||
<td><b>RM{{ $total_monthly }}</b></td> | |||||
</tr> | |||||
</tbody> | |||||
</table> | |||||
<hr><label><b>Upfront Charges</b></label> | |||||
<table class="table table-sm table-bordered"> | |||||
<tbody> | |||||
<tr> | |||||
<th>Description</th> | |||||
<th>Price exclude ST</th> | |||||
<th>With ST 6%</th> | |||||
</tr> | |||||
<tr><th>One Time Charges</th> | |||||
<td>RM{{ $otc }}</td> | |||||
<td>RM{{ $otc_st }}</td> | |||||
</tr> | |||||
<tr><th colspan="2">Deposit</th></th> | |||||
<td>RM{{ $deposit}}</td> | |||||
</tr> | </tr> | ||||
<tr><th colspan="2">Total Charges</th> | <tr><th colspan="2">Total Charges</th> | ||||
<td>{{ $total }}</td> | |||||
<td><b>RM{{ $upfront_total }}</b></td> | |||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
</table> | </table> | ||||
<small>All upfront charges will need to be paid prior installation. You will receive an email once your application has been processed.</small> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="photocopy" id="photocopy" value="24" required /> <p>Photocopy of NRIC(both side) or passport minimum (12 months validity) and visa minimum 6 months validity)</p> | |||||
<input type="checkbox" name="photocopy" id="photocopy" value="24" required /> <p>Photocopy of bothsides MyKad/Passport (for non-Malaysian)</p> | |||||
</label> | </label> | ||||
</div> | </div> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="formss" id="formss" value="24" required /> <p>Photocopy of Form 9, 24, 44 & 49 </p> | |||||
<input type="checkbox" name="formss" id="formss" value="24" required /> <p><small>Local Registered Company</small><br>Photocopy of Form 9/Form 13/Notice of Registration (Section 15)/Certificate of Incorporation (Section 17)/Section 28/Certificateof Practice issued by the relevant authority (NGO/Association /Cooperative) | |||||
<br><small>Foreign Registered Company</small><br>Form 79/Form 80/Form 80a/Form 83/Form 83a/Section 562(1)</p> | |||||
</label> | </label> | ||||
</div> | </div> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="consent" id="consent" value="24" required /> <p>I hereby consent to the collection, use, | <input type="checkbox" name="consent" id="consent" value="24" required /> <p>I hereby consent to the collection, use, | ||||
disclosure of my personal information in accordance with the <b> Privacy Policy </b> available one www.citybroadband.my.</p> | |||||
disclosure of my personal information in accordance with the <b><a href="https://www.citybroadband.my/privacy-policy-2/" > Privacy Policy</a></b> available one www.citybroadband.my.</p> | |||||
</label> | </label> | ||||
</div> | </div> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="declare" id="declare" value="24" required /> <p>I hereby declare that the above information, documents, and | <input type="checkbox" name="declare" id="declare" value="24" required /> <p>I hereby declare that the above information, documents, and | ||||
any appendices attached are true and valid. I have read and understood the contents of this form and agreed to be bound by <b> Terms & Condition </b> | |||||
any appendices attached are true and valid. I have read and understood the contents of this form and agreed to be bound by <b> <a href="https://www.citybroadband.my/terms-conditions/">Terms & Condition</a> </b> | |||||
as stated on the next page of this form which accompany the subscription of product(s) and/ or service(s). Allo Technology Sdn Bhd reserve the rights | as stated on the next page of this form which accompany the subscription of product(s) and/ or service(s). Allo Technology Sdn Bhd reserve the rights | ||||
to refuse any application at any given time should any of the information is incorrect. | to refuse any application at any given time should any of the information is incorrect. | ||||
</p> | </p> | ||||
<div class="col-md-6"> | <div class="col-md-6"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Front IC / Passport</b> <small style="color: red">*</small></label> | |||||
<label><b>MyKad / Passport (Front)</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="front_ic" name="front_ic" multiple onchange="validateImage1()" class="form-control" required /> | <input type="file" id="front_ic" name="front_ic" multiple onchange="validateImage1()" class="form-control" required /> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-6"> | <div class="col-md-6"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Rear IC/ Passport</b> <small style="color: red">*</small></label> | |||||
<label><b>MyKad/ Passport (Back)</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="back_ic" name="back_ic" multiple onchange="validateImage2()" class="form-control" required /> | <input type="file" id="back_ic" name="back_ic" multiple onchange="validateImage2()" class="form-control" required /> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<!-- <div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Front Visa</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="visaF" name="visaF" multiple onchange="validateImage5()" class="form-control" required /> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Rear Visa</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="visaB" name="visaB" multiple onchange="validateImage6()" class="form-control" required /> | |||||
</div> | |||||
</div> --> | |||||
<div class="col-md-6"> | |||||
<div class="col-md-12"> | |||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Company Form 9 & 44</b> <small style="color: red">*</small></label> | |||||
<label><b>Form 9/Form 13/Notice of Registration (Section 15)/Certificate of Incorporation (Section 17)/Section 28/Certificateof Practice issued by the relevant authority (NGO/Association /Cooperative)</b> <small style="color: red">*Local Registered Company</small><br> | |||||
<b>Form 79/Form 80/Form 80a/Form 83/Form 83a/Section 562(1) </b ><small style="color: red">*Foreign Registered Company</small></label> | |||||
<input type="file" id="form9" name="form9" multiple onchange="validateImage4()" class="form-control" required /> | <input type="file" id="form9" name="form9" multiple onchange="validateImage4()" class="form-control" required /> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Company Form 24 / 49</b></label> | |||||
<input type="file" id="form_24" name="form_24" multiple onchange="validateImage3()" class="form-control" /> | |||||
</div> | |||||
</div> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> |
<div class="row"> | <div class="row"> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Type Application</b> <small style="color: red">*</small></label> | |||||
<label><b>Application Type</b> <small style="color: red">*</small></label> | |||||
<div> | <div> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="application" value="New" checked="">New | <input type="radio" name="application" value="New" checked="">New | ||||
<!-- </a> --> | <!-- </a> --> | ||||
</div> | </div> | ||||
<!-- <div class="pull-left"> | |||||
<a href="{{url('/application-form/residential/address/step1')}}"> | |||||
<div class="pull-left"> | |||||
<a href="javascript:history.back()"> | |||||
<input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | <input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | ||||
</a> | </a> | ||||
</div> --> | |||||
</div> | |||||
<div class="clearfix"></div> | <div class="clearfix"></div> | ||||
</div> | </div> | ||||
</div> | </div> |
<div class="tracking-process" ></div> | <div class="tracking-process" ></div> | ||||
<div> | <div> | ||||
<div class="inner-pane"> | |||||
<div class="inner-pane"> | |||||
<div class="row"> | <div class="row"> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<label>You have selected:</label> | <label>You have selected:</label> | ||||
<p>Business package - {{ $pg }}</p> | |||||
<p>City Broadband Business - {{ $pg }}</p> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
<!-- Contract --> | <!-- Contract --> | ||||
<div class="row"> | <div class="row"> | ||||
<div class="col-md-6"> | |||||
<div class="col-md-12"> | |||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Subscription / Contract Period </b> <small style="color: red">*</small></label> | <label><b>Subscription / Contract Period </b> <small style="color: red">*</small></label> | ||||
<div> | <div> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="subscription" value="12">12 Months (Rm 300) | |||||
<input type="radio" id="subscription1" name="subscription" value="12">12 Months | |||||
</label> | </label> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="subscription" value="24" checked="">24 Months | |||||
<input type="radio" id="subscription2" name="subscription" value="24" checked="">24 Months | |||||
</label> | </label> | ||||
</div> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Billing Cycle</b> <small style="color: red">*</small></label> | |||||
<div> | |||||
@if ($pg != "1Gbps") | |||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="billing" value="monthly" checked="" readonly="">Monthly | |||||
<input type="checkbox" id="10off" checked=""> <small id="10off1">RM10 off every month for 24 months</small> | |||||
</label> | </label> | ||||
@endif | |||||
</div> | </div> | ||||
<small id="OTC" style="color:blue; display:none">A one-time charge of RM300 applies for 12 months subscription.</small> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p>Would you like to subscribe for 1 Voice Line + 1 Dect phone (RM20) ?<br><small style="color:red">Deposit RM100 is required for new activation voice for 12months contract</small></p> | |||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p style="margin-bottom: 0px !important">Add on Voice Plan and 1 Dect Phone at RM20/month ? <br><small style="color:red"> A deposit of RM100 is required for new voice activation tied to 12 months contract.</small></p> | |||||
</label> | </label> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="fixed_ip" id="fixed_ip" value="Yes"><p>Would you like to subscribe for Fixed IP?</p> | |||||
<input type="checkbox" name="fixed_ip" id="fixed_ip" value="Yes"><p>Add on subscribtion for Fixed IP?</p> | |||||
</label> | </label> | ||||
<select name="ip" id="ip" class="form-control" onchange="yesnoCheck(this);"> | <select name="ip" id="ip" class="form-control" onchange="yesnoCheck(this);"> | ||||
<option value="" >Please Select</option> | <option value="" >Please Select</option> | ||||
<option value="no">No</option> | <option value="no">No</option> | ||||
<option value="1 Fixed IP RM200/1P/Month">1 Fixed IP RM200/1P/Month</option> | <option value="1 Fixed IP RM200/1P/Month">1 Fixed IP RM200/1P/Month</option> | ||||
<option value="5 Fixed IP RM400/1P/Month">5 Fixed IP RM400/1P/Month</option> | <option value="5 Fixed IP RM400/1P/Month">5 Fixed IP RM400/1P/Month</option> | ||||
<option value ="custom">Custome Fixed IP</option> | |||||
<option value ="custom">Custom Fixed IP</option> | |||||
</select> | </select> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<input name="custom" id="custom" placeholder="Enter Custome Fixed IP" style="display: none;" class="form-control" type="text"> | |||||
<input name="custom" id="custom" placeholder="Enter Custom Fixed IP" style="display: none;" class="form-control" type="text" required="" aria-required="true"> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="row"> | <div class="row"> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Checking and Evaluation, Date</b> <small style="color: red">*</small></label> | |||||
<label><b>Preferred appointment date</b> <small style="color: red">*</small></label> | |||||
<div class="input-group date" id="sDate"> | <div class="input-group date" id="sDate"> | ||||
<input type="text" name="thedate" id="thedate" class="form-control" required="" aria-required="true"> | <input type="text" name="thedate" id="thedate" class="form-control" required="" aria-required="true"> | ||||
<label><b>Notes: </b></label> | <label><b>Notes: </b></label> | ||||
<div class="text"> | <div class="text"> | ||||
<p class="text">1. Standard contract period is 24 months unless otherwise stated.</p> | <p class="text">1. Standard contract period is 24 months unless otherwise stated.</p> | ||||
<p class="text">2. Checking and Evaluation date is subject to the availability of required infrastructure and/ or equipment.</p> | |||||
<p class="text">2. Preferred appointment date is subject to the availability of required infrastructure and/ or equipment.</p> | |||||
<p class="text">3. Early termination will subject to RM500 penalty.</p> | <p class="text">3. Early termination will subject to RM500 penalty.</p> | ||||
<p class="text">4. Separete penalty charge for broadband and voice</p> | |||||
<p class="text">4. Separate penalty charge for broadband and voice home plan.</p> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<!-- </a> --> | <!-- </a> --> | ||||
</div> | </div> | ||||
<!-- <div class="pull-left"> | |||||
<a href="{{url('/application-form/residential/address/step1')}}"> | |||||
<input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | |||||
</a> | |||||
</div> --> | |||||
<div class="pull-left"> | |||||
<a href="javascript:history.back()"> | |||||
<input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | |||||
</a> | |||||
</div> | |||||
<div class="clearfix"></div> | <div class="clearfix"></div> | ||||
</div> | </div> | ||||
</div> | </div> |
<input type="hidden" name="ip" value="{{$a['ip']}}"> | <input type="hidden" name="ip" value="{{$a['ip']}}"> | ||||
<input type="hidden" name="rfs" value="{{$a['thedate']}}"> | <input type="hidden" name="rfs" value="{{$a['thedate']}}"> | ||||
<input type="hidden" name="deposit" value="{{ $deposit }}"> | <input type="hidden" name="deposit" value="{{ $deposit }}"> | ||||
<input type="hidden" name="otc" value="{{ $otc }}"> | |||||
<input type="hidden" name="otc" value="{{ $otc_st }}"> | |||||
<input type="hidden" name="gst" value="{{ $gst }}"> | <input type="hidden" name="gst" value="{{ $gst }}"> | ||||
<input type="hidden" name="total" value="{{ $total }}"> | |||||
<input type="hidden" name="promo_st" value="{{ $promo_st }}"> | |||||
<input type="hidden" name="total_monthly" value="{{ $total_monthly }}"> | |||||
<div class="tracking-process"></div> | <div class="tracking-process"></div> | ||||
<div> | <div> | ||||
<div class="inner-pane-white"> | |||||
<div class="inner-pane-white"> | |||||
<!-- Preview --> | <!-- Preview --> | ||||
<div class="row"> | <div class="row"> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<label><b>Subscription Details</b></label> | <label><b>Subscription Details</b></label> | ||||
<table class="table table-sm table-bordered"> | <table class="table table-sm table-bordered"> | ||||
<tbody> | <tbody> | ||||
<tr><th width="50%">Type Application</th> | |||||
<tr><th width="50%">Application Type</th> | |||||
<td>{{$a['application']}}</td> | <td>{{$a['application']}}</td> | ||||
</tr> | </tr> | ||||
<tr><th width="50%">Business Package</th> | |||||
<td>{{$a['package']}}</td> | |||||
<tr><th width="50%">Package</th> | |||||
<td>City Broadband Business {{$a['package']}}</td> | |||||
</tr> | |||||
@if ($a['subscription']==24 && ($a['package'] != '1Gbps')) | |||||
<tr><th width="50%">Promotion</th> | |||||
<td>RM10 off for 24 months</td> | |||||
</tr> | </tr> | ||||
@endif | |||||
<tr><th width="50%">Contract Term</th> | <tr><th width="50%">Contract Term</th> | ||||
<td>{{$a['subscription']}}Months</td> | |||||
<td>{{$a['subscription']}} Months</td> | |||||
</tr> | </tr> | ||||
<tr><th width="50%">Checking and Evaluation, Date</th> | |||||
<tr><th width="50%">Preferred Installation Date</th> | |||||
<td>{{$a['thedate']}}</td> | <td>{{$a['thedate']}}</td> | ||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
<hr><label><b>Add-On(s)</b></label> | <hr><label><b>Add-On(s)</b></label> | ||||
<table class="table table-sm table-bordered"> | <table class="table table-sm table-bordered"> | ||||
<tbody> | <tbody> | ||||
<tr><th width="50%">Subscribe for Voice</th> | |||||
<tr><th width="50%">Voice Plan</th> | |||||
<td>{{$a['voice']}}</td> | <td>{{$a['voice']}}</td> | ||||
</tr> | </tr> | ||||
<tr><th width="50%">IP</th> | <tr><th width="50%">IP</th> | ||||
<td>{{$a['company_name']}}</td> | <td>{{$a['company_name']}}</td> | ||||
</tr> | </tr> | ||||
<tr><th width="50%">Address</th> | <tr><th width="50%">Address</th> | ||||
<td>{{$a['caddress']}}</td> | |||||
<td>{{ucwords($a['caddress'])}}</td> | |||||
</tr> | </tr> | ||||
<tr><th width="50%">Postcode</th> | <tr><th width="50%">Postcode</th> | ||||
<td>{{$a['postcode']}}</td> | <td>{{$a['postcode']}}</td> | ||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
</table> | </table> | ||||
<hr><label><b>Montly Recurring Fee</b></label> | |||||
<hr><label><b>Montly Recurring Charges</b></label> | |||||
@if($a['package']!='1Gbps' && $a['subscription']=='24') | |||||
<br><small> Promotion: RM10 off for 24 months</small> | |||||
@endif | |||||
<table class="table table-sm table-bordered"> | <table class="table table-sm table-bordered"> | ||||
<tbody> | <tbody> | ||||
<tr> | <tr> | ||||
<th>Description</th> | <th>Description</th> | ||||
<th>Price excl. ST</th> | |||||
<th>With ST (6%)</th> | |||||
<th>Price exclude ST</th> | |||||
<th>With ST 6%</th> | |||||
</tr> | </tr> | ||||
<tr><th>Broadband Fee</th> | |||||
<td>{{ $product->retail_price }}</td> | |||||
<td>{{ $gst }}</td> | |||||
<tr><th>City Broadband Business - {{$a['package']}}</th> | |||||
@if($a['package']!='1Gbps' && $a['subscription']=='24') | |||||
<td><span style="text-decoration: line-through;">RM{{ $product->retail_price }}</span> RM{{ $promo_price}}</td> | |||||
<td>RM{{ $promo_st }}</td> | |||||
@else | |||||
<td>RM{{ $product->retail_price }}</td> | |||||
<td>RM{{ $gst }}</td> | |||||
@endif | |||||
</tr> | </tr> | ||||
<tr><th colspan="2">Deposit</th> | |||||
@if($a['voice']=='Yes') | |||||
<tr><th>Voice Home Plan</th> | |||||
<td> | |||||
RM20 | |||||
</td> | |||||
<td> | <td> | ||||
{{ $deposit }} | |||||
RM21.20 | |||||
</td> | </td> | ||||
</tr> | </tr> | ||||
<tr><th colspan="2">OTC</th> | |||||
<td>{{ $otc }}</td> | |||||
@endif | |||||
<tr><th colspan="2">Total Charges</th> | |||||
<td><b>RM{{ $total_monthly }}</b></td> | |||||
</tr> | |||||
</tbody> | |||||
</table> | |||||
<hr><label><b>Upfront Charges</b></label> | |||||
<table class="table table-sm table-bordered"> | |||||
<tbody> | |||||
<tr> | |||||
<th>Description</th> | |||||
<th>Price exclude ST</th> | |||||
<th>With ST 6%</th> | |||||
</tr> | |||||
<tr><th>One Time Charges</th> | |||||
<td>RM{{ $otc }}</td> | |||||
<td>RM{{ $otc_st }}</td> | |||||
</tr> | |||||
<tr><th colspan="2">Deposit</th></th> | |||||
<td>RM{{ $deposit}}</td> | |||||
</tr> | </tr> | ||||
<tr><th colspan="2">Total Charges</th> | <tr><th colspan="2">Total Charges</th> | ||||
<td>{{ $total }}</td> | |||||
<td><b>RM{{ $upfront_total }}</b></td> | |||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
</table> | </table> | ||||
<small>All upfront charges will need to be paid prior installation. You will receive an email once your application has been processed.</small> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="photocopy" id="photocopy" value="24" required /> <p>Photocopy of NRIC(both side) or passport minimum (12 months validity) and visa minimum 6 months validity)</p> | |||||
<input type="checkbox" name="photocopy" id="photocopy" value="24" required /> <p>Photocopy of bothsides MyKad/Passport (for non-Malaysian)</p> | |||||
</label> | </label> | ||||
</div> | </div> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="formss" id="formss" value="24" required /> <p>Photocopy of Form 9, 24, 44 & 49 </p> | |||||
<input type="checkbox" name="formss" id="formss" value="24" required /> <p><small>Local Registered Company</small><br>Photocopy of Form 9/Form 13/Notice of Registration (Section 15)/Certificate of Incorporation (Section 17)/Section 28/Certificateof Practice issued by the relevant authority (NGO/Association /Cooperative) | |||||
<br><small>Foreign Registered Company</small><br>Form 79/Form 80/Form 80a/Form 83/Form 83a/Section 562(1)</p> | |||||
</label> | </label> | ||||
</div> | </div> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="consent" id="consent" value="24" required /> <p>I hereby consent to the collection, use, | <input type="checkbox" name="consent" id="consent" value="24" required /> <p>I hereby consent to the collection, use, | ||||
disclosure of my personal information in accordance with the <b> Privacy Policy </b> available one www.citybroadband.my.</p> | |||||
disclosure of my personal information in accordance with the <b><a href="https://www.citybroadband.my/privacy-policy-2/" > Privacy Policy</a></b> available one www.citybroadband.my.</p> | |||||
</label> | </label> | ||||
</div> | </div> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="declare" id="declare" value="24" required /> <p>I hereby declare that the above information, documents, and | <input type="checkbox" name="declare" id="declare" value="24" required /> <p>I hereby declare that the above information, documents, and | ||||
any appendices attached are true and valid. I have read and understood the contents of this form and agreed to be bound by <b> Terms & Condition </b> | |||||
any appendices attached are true and valid. I have read and understood the contents of this form and agreed to be bound by <b> <a href="https://www.citybroadband.my/terms-conditions/">Terms & Condition</a> </b> | |||||
as stated on the next page of this form which accompany the subscription of product(s) and/ or service(s). Allo Technology Sdn Bhd reserve the rights | as stated on the next page of this form which accompany the subscription of product(s) and/ or service(s). Allo Technology Sdn Bhd reserve the rights | ||||
to refuse any application at any given time should any of the information is incorrect. | to refuse any application at any given time should any of the information is incorrect. | ||||
</p> | </p> | ||||
<div class="col-md-6"> | <div class="col-md-6"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Front IC / Passport</b> <small style="color: red">*</small></label> | |||||
<label><b>MyKad / Passport (Front)</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="front_ic" name="front_ic" multiple onchange="validateImage1()" class="form-control" required /> | <input type="file" id="front_ic" name="front_ic" multiple onchange="validateImage1()" class="form-control" required /> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-6"> | <div class="col-md-6"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Rear IC/ Passport</b> <small style="color: red">*</small></label> | |||||
<label><b>MyKad/ Passport (Back)</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="back_ic" name="back_ic" multiple onchange="validateImage2()" class="form-control" required /> | <input type="file" id="back_ic" name="back_ic" multiple onchange="validateImage2()" class="form-control" required /> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<!-- <div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Front Visa</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="visaF" name="visaF" multiple onchange="validateImage5()" class="form-control" required /> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Rear Visa</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="visaB" name="visaB" multiple onchange="validateImage6()" class="form-control" required /> | |||||
</div> | |||||
</div> --> | |||||
<div class="col-md-6"> | |||||
<div class="col-md-12"> | |||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Company Form 24 / 49</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="form_24" name="form_24" multiple onchange="validateImage3()" class="form-control" required /> | |||||
<label><b>Form 9/Form 13/Notice of Registration (Section 15)/Certificate of Incorporation (Section 17)/Section 28/Certificateof Practice issued by the relevant authority (NGO/Association /Cooperative)</b> <small style="color: red">*Local Registered Company</small><br> | |||||
<b>Form 79/Form 80/Form 80a/Form 83/Form 83a/Section 562(1) </b ><small style="color: red">*Foreign Registered Company</small></label> | |||||
<input type="file" id="form9" name="form9" multiple onchange="validateImage4()" class="form-control" required /> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-6"> | |||||
<div class="col-md-12"> | |||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Company Form 9 & 44</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="form9" name="form9" multiple onchange="validateImage4()" class="form-control" required /> | |||||
<label><b>Upfront Payment Receipt</b></label> | |||||
<input type="file" id="payment_receipt" accept="image/*" capture="camera" name="payment_receipt" multiple="" onchange="validateImage5()" class="form-control" aria-required="true"> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
function validateImage5() { | function validateImage5() { | ||||
var formData = new FormData(); | var formData = new FormData(); | ||||
var file = document.getElementById("visaF").files[0]; | |||||
var file = document.getElementById("payment_receipt").files[0]; | |||||
formData.append("Filedata", file); | formData.append("Filedata", file); | ||||
var t = file.type.split('/').pop().toLowerCase(); | var t = file.type.split('/').pop().toLowerCase(); | ||||
if (t != "jpeg" && t != "jpg" && t != "pdf") { | |||||
alert('Only Accept jpg / jpeg / PDF Only!!'); | |||||
document.getElementById("visaF").value = ''; | |||||
if (t != "jpeg" && t != "jpg" && t !="png" && t != "pdf") { | |||||
alert('Accept jpg, jpeg, png and pdf only'); | |||||
document.getElementById("payment_receipt").value = ''; | |||||
return false; | return false; | ||||
} | } | ||||
return true; | return true; |
</div> | </div> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | |||||
<label> | |||||
<b>Street</b> | |||||
</label> | |||||
<div class="form-group"> | |||||
<label><b>Street</b></label> | |||||
<input type="text" name="street" placeholder="Enter your street" class="form-control"> | <input type="text" name="street" placeholder="Enter your street" class="form-control"> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>City</b> <small style="color: red">*</small></label> | |||||
<input name="city" id="city" placeholder="Enter city" class="form-control" type="text" required readonly="" > | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>State</b> <small style="color: red">*</small></label> | |||||
<input name="state" id="state" placeholder="Enter state" class="form-control" type="text" required readonly=""> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-12"> | |||||
<div class="form-group"> | |||||
<label><b>Postcode / Zip Code</b> <small style="color: red">*</small></label> | |||||
<input name="postcode" id="postcode" placeholder="90000" class="form-control" type="text" required readonly=""> | |||||
</div> | |||||
</div> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
$('footer').removeClass('reached-bottom'); | $('footer').removeClass('reached-bottom'); | ||||
} | } | ||||
}); | }); | ||||
$('#coverage').change(function(){ | |||||
$.ajax({ | |||||
type: "GET", | |||||
url: "{{ url('api/get-coverage-detail') }}"+"/"+$(this).val(), | |||||
success: function(result){ | |||||
$.each(result.data, function(i, d) { | |||||
$('#city').val(d.city); | |||||
$('#state').val(d.state); | |||||
$('#postcode').val(d.postcode); | |||||
}); | |||||
} | |||||
}); | |||||
}); | |||||
</script> | </script> | ||||
<style> | <style> | ||||
select { | select { |
<div> | <div> | ||||
<div class="inner-pane"> | <div class="inner-pane"> | ||||
<div class="row"> | |||||
<div class="row"> | |||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Type Application</b> <small style="color: red">*</small></label> | |||||
<label><b>Application Type</b> <small style="color: red">*</small></label> | |||||
<div> | <div> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="application" value="New" checked="">New | <input type="radio" name="application" value="New" checked="">New | ||||
<input type="radio" name="application" value="Upgrade">Upgrade | <input type="radio" name="application" value="Upgrade">Upgrade | ||||
</label> | </label> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="application" value="Relocation">Relocation (Rm 150) | |||||
<input type="radio" name="application" value="Relocation">Relocation (RM 150) | |||||
</label> | </label> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Full Name</b> <small style="color: red">*</small></label> | |||||
<label><b>Full Name (as per MyKad/Passport)</b> <small style="color: red">*</small></label> | |||||
<input name="name" placeholder="Enter Full Name" class="form-control" type="text" required="" aria-required="true"> | <input name="name" placeholder="Enter Full Name" class="form-control" type="text" required="" aria-required="true"> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>NRIC / Passport</b> <small style="color: red">*</small></label> | |||||
<input name="nric_passport" placeholder="Enter NRIC / Passport Number" class="form-control" type="text" required="" aria-required="true"> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Email</b> <small style="color: red">*</small></label> | |||||
<input name="email" placeholder="Enter Email" class="form-control" type="email" required="" aria-required="true"> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="col-md-12"> | |||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Gender</b> <small style="color: red">*</small></label> | <label><b>Gender</b> <small style="color: red">*</small></label> | ||||
<select name="gender" id="gender" class="form-control"> | <select name="gender" id="gender" class="form-control"> | ||||
<option value="female">Female</option> | <option value="female">Female</option> | ||||
</select> | </select> | ||||
</div> | </div> | ||||
<small id="desc" style="color: red; display:none">A deposit of RM300 will be charge upfront prior installation.</small> | |||||
</div> | </div> | ||||
<div class="col-md-6"> | <div class="col-md-6"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Race</b> <small style="color: red">*</small></label> | |||||
<select name="race" id="race" class="form-control"> | |||||
<option value="malay">Malay</option> | |||||
<option value="chinese">Chinese</option> | |||||
<option value="indian">Indian</option> | |||||
<option value="others">Others</option> | |||||
</select> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Primary Contact No.</b> <small style="color: red">*</small></label> | |||||
<input name="contact_primary" placeholder="Enter Primary Contact Number" class="form-control" type="tel" required="" aria-required="true"> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Secondary Contact No.</b> </label> | |||||
<input name="contact_secondary" placeholder="Enter Secondary Contact Number" class="form-control" type="tel"> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-12"> | |||||
<div class="form-group"> | |||||
<label><b>Citizenship</b> <small style="color: red">*</small></label> | |||||
<label><b>Nationality (Malaysian/Non-Malaysian)</b> <small style="color: red">*</small></label> | |||||
<select name="citizenship" id="citizenship" onchange="citizen()" class="form-control"> | <select name="citizenship" id="citizenship" onchange="citizen()" class="form-control"> | ||||
<option value="Malaysian">Malaysian</option> | <option value="Malaysian">Malaysian</option> | ||||
<option value="Non">Non-Malaysian</option> | <option value="Non">Non-Malaysian</option> | ||||
</select> | </select> | ||||
<div> | |||||
<p id="list" style="display:none"> | |||||
<select name="citizenlist" id="citizenlist"class="form-control" > | |||||
<select id="list" name="citizenlist" id="citizenlist"class="form-control" style="display:none"> | |||||
<option value="" selected="selected">Select Country</option> | <option value="" selected="selected">Select Country</option> | ||||
<option value="United States">United States</option> | <option value="United States">United States</option> | ||||
<option value="United Kingdom">United Kingdom</option> | <option value="United Kingdom">United Kingdom</option> | ||||
<option value="Zambia">Zambia</option> | <option value="Zambia">Zambia</option> | ||||
<option value="Zimbabwe">Zimbabwe</option> | <option value="Zimbabwe">Zimbabwe</option> | ||||
</select> | </select> | ||||
</p> | |||||
</div> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>MyKad / Passport</b> <small style="color: red">*</small></label> | |||||
<input id="nric1" name="nric_passport1" placeholder="Enter NRIC / Passport Number" class="form-control" type="text" required="" aria-required="true" style="display:block"> | |||||
<textarea rows="3" id="nric2" name="nric_passport2" placeholder="Enter NRIC / Passport Number" class="form-control" type="text" required="" aria-required="true" style="display:none"></textarea> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Contact Number (Primary) </b> <small style="color: red">*</small></label> | |||||
<input name="contact_primary" placeholder="Enter Primary Contact Number" class="form-control" type="tel" required="" aria-required="true"> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Contact Number (Secondary)</b> </label> | |||||
<input name="contact_secondary" placeholder="Enter Secondary Contact Number" class="form-control" type="tel"> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-12"> | |||||
<div class="form-group"> | |||||
<label><b>Email</b> <small style="color: red">*</small></label> | |||||
<input name="email" placeholder="Enter Email" class="form-control" type="email" required="" aria-required="true"> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<!-- </a> --> | <!-- </a> --> | ||||
</div> | </div> | ||||
<!-- <div class="pull-left"> | |||||
<a href="{{url('/application-form/residential/address/step1')}}"> | |||||
<div class="pull-left"> | |||||
<a href="javascript:history.back()"> | |||||
<input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | <input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | ||||
</a> | </a> | ||||
</div> --> | |||||
</div> | |||||
<div class="clearfix"></div> | <div class="clearfix"></div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
var val = $( "#citizenship" ).val(); | var val = $( "#citizenship" ).val(); | ||||
if (val =='Non') { | if (val =='Non') { | ||||
document.getElementById("list").style.display="block"; | document.getElementById("list").style.display="block"; | ||||
document.getElementById("race").value="others"; // show the list if non selected | |||||
document.getElementById("nric2").style.display="block"; | |||||
document.getElementById("nric1").style.display="none"; | |||||
document.getElementById("desc").style.display="block"; | |||||
}else{ | }else{ | ||||
document.getElementById("list").style.display="none"; | document.getElementById("list").style.display="none"; | ||||
document.getElementById("race").value="malay"; | |||||
document.getElementById("nric2").style.display="none"; | |||||
document.getElementById("nric1").style.display="block"; | |||||
document.getElementById("desc").style.display="none"; | |||||
} | } | ||||
} | } | ||||
</script> | </script> |
<div class="tracking-process" ></div> | <div class="tracking-process" ></div> | ||||
<div> | <div> | ||||
<div class="inner-pane"> | |||||
<div class="inner-pane"> | |||||
<div class="row"> | <div class="row"> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<label>You have selected:</label> | |||||
<p>Resident package - {{ $pg }}</p> | |||||
<label>City Broadband Package:</label> | |||||
<p>{{ $product->package_name }} RM{{ $product->retail_price }}/month</p> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
<!-- Contract --> | <!-- Contract --> | ||||
<div class="row"> | <div class="row"> | ||||
<div class="col-md-6"> | |||||
<div class="col-md-12"> | |||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Subscription / Contract Period </b> <small style="color: red">*</small></label> | <label><b>Subscription / Contract Period </b> <small style="color: red">*</small></label> | ||||
<div> | <div> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="subscription" value="12">12 Months (Rm 300) | |||||
<input id="subscription1" type="radio" name="subscription" value="12">12 Months | |||||
</label> | </label> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="subscription" value="24" checked="">24 Months | |||||
<input id="subscription2" type="radio" name="subscription" value="24" checked="">24 Months | |||||
</label> | </label> | ||||
</div> | |||||
</div> | |||||
</div> | |||||
<div class="col-md-6"> | |||||
<div class="form-group"> | |||||
<label><b>Billing Cycle</b> <small style="color: red">*</small></label> | |||||
<div> | |||||
@if ($a['package'] != "1Gbps") | |||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="billing" value="monthly" checked="" readonly="">Monthly | |||||
<input type="checkbox" id="10off" checked=""> <small id="10off1">RM10 off every month for 24 months</small> | |||||
</label> | </label> | ||||
@endif | |||||
</div> | </div> | ||||
<small id="OTC" style="color:blue; display:none">A one-time charge of RM300 applies for 12 months subscription.</small> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
@if($citizen != 'Malaysian') | @if($citizen != 'Malaysian') | ||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p>Would you like to subscribe for Voice ( Rm 20) ?<br><small style="color:red">Deposit RM100 is required for foreigner - new activation voice</small></p> | |||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p>Add on Voice Home Plan at RM20/month<br><small style="color:red">A one-time-charge of RM100 is required for new voice activation tied to 12 months contract</small></p> | |||||
@else | @else | ||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p>Would you like to subscribe for Voice ( Rm 20) ?</p> | |||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p>Add on Voice Home Plan at RM20/month</p> | |||||
@endif | @endif | ||||
</label> | </label> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<!-- RFS --> | <!-- RFS --> | ||||
<div class="row"> | <div class="row"> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Checking and Evaluation, Date</b> <small style="color: red">*</small></label> | |||||
<label><b>Preferred appointment date</b> <small style="color: red">*</small></label> | |||||
<div class="input-group date" id="sDate"> | <div class="input-group date" id="sDate"> | ||||
<input type="text" name="thedate" id="thedate" class="form-control" required="" aria-required="true"> | <input type="text" name="thedate" id="thedate" class="form-control" required="" aria-required="true"> | ||||
<label><b>Notes: </b></label> | <label><b>Notes: </b></label> | ||||
<div class="text"> | <div class="text"> | ||||
<p class="text">1. Standard contract period is 24 months unless otherwise stated.</p> | <p class="text">1. Standard contract period is 24 months unless otherwise stated.</p> | ||||
<p class="text">2. Checking and Evaluation date is subject to the availability of required infrastructure and/ or equipment.</p> | |||||
<p class="text">2. Preferred appointment date is subject to the availability of required infrastructure and/ or equipment.</p> | |||||
<p class="text">3. Early termination will subject to RM500 penalty.</p> | <p class="text">3. Early termination will subject to RM500 penalty.</p> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<!-- </a> --> | <!-- </a> --> | ||||
</div> | </div> | ||||
<!-- <div class="pull-left"> | |||||
<a href="{{url('/application-form/residential/address/step1')}}"> | |||||
<input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | |||||
</a> | |||||
</div> --> | |||||
<div class="pull-left"> | |||||
<a href="javascript:history.back()"> | |||||
<input type="button" class="btn btn-previous" name="previous" value="Previous" style="background-color: grey;"> | |||||
</a> | |||||
</div> | |||||
<div class="clearfix"></div> | <div class="clearfix"></div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
$('footer').removeClass('reached-bottom'); | $('footer').removeClass('reached-bottom'); | ||||
} | } | ||||
}); | }); | ||||
$('#subscription1').change(function(){ | |||||
if(document.getElementById('subscription1').checked){ | |||||
$('#OTC').show(); | |||||
document.getElementById('10off').checked = false; | |||||
$('#10off').hide(); | |||||
$('#10off1').hide(); | |||||
} | |||||
}); | |||||
$('#subscription2').change(function(){ | |||||
if(document.getElementById('subscription2').checked){ | |||||
$('#OTC').hide(); | |||||
document.getElementById('10off').checked = true; | |||||
$('#10off').show(); | |||||
$('#10off1').show(); | |||||
} | |||||
}); | |||||
</script> | </script> | ||||
<style> | <style> | ||||
select { | select { |
<input type="hidden" name="city" value="{{ $coverage->city }}"> | <input type="hidden" name="city" value="{{ $coverage->city }}"> | ||||
<input type="hidden" name="state" value="{{ $coverage->state }}"> | <input type="hidden" name="state" value="{{ $coverage->state }}"> | ||||
<input type="hidden" name="deposit" value="{{ $deposit }}"> | <input type="hidden" name="deposit" value="{{ $deposit }}"> | ||||
<input type="hidden" name="otc" value="{{ $otc }}"> | |||||
<input type="hidden" name="otc" value="{{ $otc_st }}"> | |||||
<input type="hidden" name="gst" value="{{ $gst }}"> | <input type="hidden" name="gst" value="{{ $gst }}"> | ||||
<input type="hidden" name="total" value="{{ $total }}"> | |||||
<input type="hidden" name="promo_st" value="{{ $promo_st }}"> | |||||
<input type="hidden" name="total_monthly" value="{{ $total_monthly }}"> | |||||
<div class="tracking-process"></div> | <div class="tracking-process"></div> | ||||
<label><b>Subscription Details</b></label> | <label><b>Subscription Details</b></label> | ||||
<table class="table table-sm table-bordered"> | <table class="table table-sm table-bordered"> | ||||
<tbody> | <tbody> | ||||
<tr><th width="50%">Type Application</th> | |||||
<tr><th width="50%">Application Type</th> | |||||
<td>{{$a['application']}}</td> | <td>{{$a['application']}}</td> | ||||
</tr> | </tr> | ||||
<tr><th width="50%">Residential Package</th> | |||||
<td>{{$a['package']}}</td> | |||||
<tr><th width="50%">Package</th> | |||||
<td>City Broadband Residential {{$a['package']}}</td> | |||||
</tr> | </tr> | ||||
@if ($a['subscription']==24 && ($a['package']=='50Mbps' || $a['package']=='100Mbps' || $a['package']=='300Mbps' || $a['package']=='500Mbps')) | |||||
<tr><th width="50%">Promotion</th> | |||||
<td>RM10 off for 24 months</td> | |||||
</tr> | |||||
@endif | |||||
<tr><th width="50%">Contract Term</th> | <tr><th width="50%">Contract Term</th> | ||||
<td>{{$a['subscription']}}Months</td> | |||||
<td>{{$a['subscription']}} Months</td> | |||||
</tr> | </tr> | ||||
<tr><th width="50%">Checking and Evaluation, Date</th> | |||||
<tr><th width="50%">Preferred Installation Date</th> | |||||
<td>{{$a['thedate']}}</td> | <td>{{$a['thedate']}}</td> | ||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
<hr><label><b>Add-On(s)</b></label> | <hr><label><b>Add-On(s)</b></label> | ||||
<table class="table table-sm table-bordered"> | <table class="table table-sm table-bordered"> | ||||
<tbody> | <tbody> | ||||
<tr><th width="50%">Subscribe for Voice</th> | |||||
<tr><th width="50%">Home Voice Plan</th> | |||||
<td>{{$a['voice']}}</td> | <td>{{$a['voice']}}</td> | ||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
<td>{{$a['nric_passport']}}</td> | <td>{{$a['nric_passport']}}</td> | ||||
</tr> | </tr> | ||||
<tr><th width="50%">Gender</th> | <tr><th width="50%">Gender</th> | ||||
<td>{{$a['gender']}}</td> | |||||
<td>{{ucfirst($a['gender'])}}</td> | |||||
</tr> | </tr> | ||||
<tr><th width="50%">Nationality</th> | <tr><th width="50%">Nationality</th> | ||||
<td>{{$a['citizenship']}}</td> | <td>{{$a['citizenship']}}</td> | ||||
<td>{{$coverage->building_name}}</td> | <td>{{$coverage->building_name}}</td> | ||||
</tr> | </tr> | ||||
<tr><th width="50%">Street</th> | <tr><th width="50%">Street</th> | ||||
<td>{{$a['street']}}</td> | |||||
<td>{{ucwords($a['street'])}}</td> | |||||
</tr> | </tr> | ||||
<tr><th width="50%">Postcode</th> | <tr><th width="50%">Postcode</th> | ||||
<td>{{$coverage->postcode}}</td> | <td>{{$coverage->postcode}}</td> | ||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
</table> | </table> | ||||
<hr><label><b>Montly Recurring Fee</b></label> | |||||
<hr><label><b>Montly Recurring Charges</b></label> | |||||
@if($a['package']!='1Gbps' && $a['subscription']=='24') | |||||
<br><small> Promotion: RM10 off for 24 months</small> | |||||
@endif | |||||
<table class="table table-sm table-bordered"> | <table class="table table-sm table-bordered"> | ||||
<tbody> | <tbody> | ||||
<tr> | <tr> | ||||
<th>Description</th> | <th>Description</th> | ||||
<th>Price excl. ST</th> | |||||
<th>With ST (6%)</th> | |||||
<th>Price exclude ST</th> | |||||
<th>With ST 6%</th> | |||||
</tr> | </tr> | ||||
<tr><th>Broadband Fee</th> | |||||
@if($product->promotion_price == '0') | |||||
<td>{{ $product->retail_price }}</td> | |||||
@elseif($product->promotion_price != '0' && $a['subscription'] == '24') | |||||
<td><span style="text-decoration: line-through;">{{ $product->retail_price }}</span> {{ $product->promotion_price }}</td> | |||||
@endif | |||||
<td>{{ $gst }}</td> | |||||
<tr><th>City Broadband Residential - {{$a['package']}}</th> | |||||
@if($a['package']!='1Gbps' && $a['subscription']=='24') | |||||
<td><span style="text-decoration: line-through;">RM{{ $product->retail_price }}</span> RM{{ $promo_price}}</td> | |||||
<td>RM{{ $promo_st }}</td> | |||||
@else | |||||
<td>RM{{ $product->retail_price }}</td> | |||||
<td>RM{{ $gst }}</td> | |||||
@endif | |||||
</tr> | </tr> | ||||
<tr><th colspan="2">Deposit</th> | |||||
@if($a['voice']=='Yes') | |||||
<tr><th>Voice Home Plan</th> | |||||
<td> | |||||
RM20 | |||||
</td> | |||||
<td> | <td> | ||||
{{ $deposit }} | |||||
RM21.20 | |||||
</td> | </td> | ||||
</tr> | </tr> | ||||
<tr><th colspan="2">OTC</th> | |||||
<td>{{ $otc }}</td> | |||||
@endif | |||||
<tr><th colspan="2">Total Charges</th> | |||||
<td><b>RM{{ $total_monthly }}</b></td> | |||||
</tr> | |||||
</tbody> | |||||
</table> | |||||
<hr><label><b>Upfront Charges</b></label> | |||||
<table class="table table-sm table-bordered"> | |||||
<tbody> | |||||
<tr> | |||||
<th>Description</th> | |||||
<th>Price exclude ST</th> | |||||
<th>With ST 6%</th> | |||||
</tr> | |||||
<tr><th>One Time Charges</th> | |||||
<td>RM{{ $otc }}</td> | |||||
<td>RM{{ $otc_st }}</td> | |||||
</tr> | |||||
<tr><th colspan="2">Deposit</th></th> | |||||
<td>RM{{ $deposit}}</td> | |||||
</tr> | </tr> | ||||
<tr><th colspan="2">Total Charges</th> | <tr><th colspan="2">Total Charges</th> | ||||
<td>{{ $total }}</td> | |||||
<td><b>RM{{ $upfront_total }}</b></td> | |||||
</tr> | </tr> | ||||
</tbody> | </tbody> | ||||
</table> | </table> | ||||
<small>All upfront charges will need to be paid prior installation. You will receive an email once your application has been processed.</small> | |||||
</div> | </div> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="photocopy" id="photocopy" value="24" required="" aria-required="true"> <p>Photocopy of NRIC(both side) or passport minimum (12 months validity) and visa minimum 6 months validity)</p> | |||||
</label> | |||||
</div> | |||||
<div class="checkbox"> | |||||
<label> | |||||
<input type="checkbox" name="consent" id="consent" value="24" required="" aria-required="true"> <p>I hereby consent to the collection, use, | <input type="checkbox" name="consent" id="consent" value="24" required="" aria-required="true"> <p>I hereby consent to the collection, use, | ||||
disclosure of my personal information in accordance with the <b> Privacy Policy </b> available one www.citybroadband.my.</p> | |||||
disclosure of my personal information in accordance with the <b> <a href="https://www.citybroadband.my/privacy-policy-2/" >Privacy Policy</a> </b> available one www.citybroadband.my.</p> | |||||
</label> | </label> | ||||
</div> | </div> | ||||
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
<input type="checkbox" name="declare" id="declare" value="24" required="" aria-required="true"> <p>I hereby declare that the above information, documents, and | <input type="checkbox" name="declare" id="declare" value="24" required="" aria-required="true"> <p>I hereby declare that the above information, documents, and | ||||
any appendices attached are true and valid. I have read and understood the contents of this form and agreed to be bound by <b> Terms & Condition </b> | |||||
any appendices attached are true and valid. I have read and understood the contents of this form and agreed to be bound by <b> <a href="https://www.citybroadband.my/terms-conditions/">Terms & Condition </a> </b> | |||||
as stated on the next page of this form which accompany the subscription of product(s) and/ or service(s). Allo Technology Sdn Bhd reserve the rights | as stated on the next page of this form which accompany the subscription of product(s) and/ or service(s). Allo Technology Sdn Bhd reserve the rights | ||||
to refuse any application at any given time should any of the information is incorrect. | to refuse any application at any given time should any of the information is incorrect. | ||||
</p> | </p> | ||||
</div> | </div> | ||||
<h3>Upload Documents</h3> | <h3>Upload Documents</h3> | ||||
<small><b>Acceptable formats: jpg , jpeg </b></small> | |||||
<small><b>Acceptable formats: jpg , jpeg , png </b></small> | |||||
<div class="row"> | <div class="row"> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Front IC / Passport</b> <small style="color: red">*</small></label> | |||||
<label><b>MyKad/Passport (Front)</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="front_ic" accept="image/*" capture="camera" name="front_ic" multiple="" onchange="validateImage1()" class="form-control" required="" aria-required="true"> | <input type="file" id="front_ic" accept="image/*" capture="camera" name="front_ic" multiple="" onchange="validateImage1()" class="form-control" required="" aria-required="true"> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Rear IC / Passport</b> <small style="color: red">*</small></label> | |||||
<label><b>MyKad/Passport (Back)</b> <small style="color: red">*</small></label> | |||||
<input type="file" id="back_ic" accept="image/*" capture="camera" name="back_ic" multiple="" onchange="validateImage2()" class="form-control" required="" aria-required="true"> | <input type="file" id="back_ic" accept="image/*" capture="camera" name="back_ic" multiple="" onchange="validateImage2()" class="form-control" required="" aria-required="true"> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Front Visa</b> <small style="color: red">* Non-Malaysia</small></label> | |||||
<label><b>Visa (Front)</b> <small style="color: red">* Non-Malaysian</small></label> | |||||
<input type="file" id="visaF" accept="image/*" capture="camera" name="visaF" multiple="" onchange="validateImage3()" class="form-control" aria-required="true"> | <input type="file" id="visaF" accept="image/*" capture="camera" name="visaF" multiple="" onchange="validateImage3()" class="form-control" aria-required="true"> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-12"> | <div class="col-md-12"> | ||||
<div class="form-group"> | <div class="form-group"> | ||||
<label><b>Rear Visa</b> <small style="color: red">* Non-Malaysia</small></label> | |||||
<label><b>Visa (Back)</b> <small style="color: red">* Non-Malaysian</small></label> | |||||
<input type="file" id="visaB" accept="image/*" capture="camera" name="visaB" multiple="" onchange="validateImage4()" class="form-control" aria-required="true"> | <input type="file" id="visaB" accept="image/*" capture="camera" name="visaB" multiple="" onchange="validateImage4()" class="form-control" aria-required="true"> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-12"> | |||||
<div class="form-group"> | |||||
<label><b>Upfront Payment Receipt</b></label> | |||||
<input type="file" id="payment_receipt" accept="image/*" capture="camera" name="payment_receipt" multiple="" onchange="validateImage5()" class="form-control" aria-required="true"> | |||||
</div> | |||||
</div> | |||||
</div> | </div> | ||||
<!-- Signature --> | <!-- Signature --> | ||||
<script src="{{url('js/signature_pad.ums.js')}}" type="text/javascript"></script> | <script src="{{url('js/signature_pad.ums.js')}}" type="text/javascript"></script> | ||||
<script type="text/javascript"> | <script type="text/javascript"> | ||||
function validateImage1() { | |||||
function validateImage1() { | |||||
var formData = new FormData(); | var formData = new FormData(); | ||||
var file = document.getElementById("front_ic").files[0]; | var file = document.getElementById("front_ic").files[0]; | ||||
formData.append("Filedata", file); | formData.append("Filedata", file); | ||||
var t = file.type.split('/').pop().toLowerCase(); | var t = file.type.split('/').pop().toLowerCase(); | ||||
if (t != "jpeg" && t != "jpg") { | |||||
alert('Only Accept jpg / jpeg Only!!'); | |||||
if (t != "jpeg" && t != "jpg" && t !="png") { | |||||
alert('Accept jpg, jpeg, png and pdf only'); | |||||
document.getElementById("front_ic").value = ''; | document.getElementById("front_ic").value = ''; | ||||
return false; | return false; | ||||
} | } | ||||
formData.append("Filedata", file); | formData.append("Filedata", file); | ||||
var t = file.type.split('/').pop().toLowerCase(); | var t = file.type.split('/').pop().toLowerCase(); | ||||
if (t != "jpeg" && t != "jpg") { | |||||
alert('Only Accept jpg / jpeg'); | |||||
if (t != "jpeg" && t != "jpg" && t !="png") { | |||||
alert('Accept jpg, jpeg, png and pdf only'); | |||||
document.getElementById("back_ic").value = ''; | document.getElementById("back_ic").value = ''; | ||||
return false; | return false; | ||||
} | } | ||||
formData.append("Filedata", file); | formData.append("Filedata", file); | ||||
var t = file.type.split('/').pop().toLowerCase(); | var t = file.type.split('/').pop().toLowerCase(); | ||||
if (t != "jpeg" && t != "jpg") { | |||||
alert('Only Accept jpg / jpeg'); | |||||
if (t != "jpeg" && t != "jpg" && t !="png") { | |||||
alert('Accept jpg, jpeg, png and pdf only'); | |||||
document.getElementById("visaF").value = ''; | document.getElementById("visaF").value = ''; | ||||
return false; | return false; | ||||
} | } | ||||
formData.append("Filedata", file); | formData.append("Filedata", file); | ||||
var t = file.type.split('/').pop().toLowerCase(); | var t = file.type.split('/').pop().toLowerCase(); | ||||
if (t != "jpeg" && t != "jpg") { | |||||
alert('Only Accept jpg / jpeg'); | |||||
if (t != "jpeg" && t != "jpg" &&t !="png") { | |||||
alert('Accept jpg, jpeg, png and pdf only'); | |||||
document.getElementById("visaB").value = ''; | document.getElementById("visaB").value = ''; | ||||
return false; | return false; | ||||
} | } | ||||
return true; | return true; | ||||
} | } | ||||
function validateImage5() { | |||||
var formData = new FormData(); | |||||
var file = document.getElementById("payment_receipt").files[0]; | |||||
formData.append("Filedata", file); | |||||
var t = file.type.split('/').pop().toLowerCase(); | |||||
if (t != "jpeg" && t != "jpg" && t !="png" && t != "pdf") { | |||||
alert('Accept jpg, jpeg, png and pdf only'); | |||||
document.getElementById("payment_receipt").value = ''; | |||||
return false; | |||||
} | |||||
return true; | |||||
} | |||||
$(document).ready(function(){ | $(document).ready(function(){ | ||||
<input type="radio" name="application" value="Upgrade">Upgrade | <input type="radio" name="application" value="Upgrade">Upgrade | ||||
</label> | </label> | ||||
<label class="radio-inline"> | <label class="radio-inline"> | ||||
<input type="radio" name="application" value="Relocation">Relocation (Rm 150) | |||||
<input type="radio" name="application" value="Relocation">Relocation (RM 150) | |||||
</label> | </label> | ||||
</div> | </div> | ||||
</div> | </div> |
<div class="checkbox"> | <div class="checkbox"> | ||||
<label> | <label> | ||||
@if($citizen != 'Malaysian') | @if($citizen != 'Malaysian') | ||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p>Add on Voice Home Plan at RM20/month<br><small style="color:red">A deposit of RM100 is required for new voice activation tied to 12 months contract</small></p> | |||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p>Add on Voice Home Plan at RM20/month<br><small style="color:red">A one-time-charge of RM100 is required for new voice activation tied to 12 months contract</small></p> | |||||
@else | @else | ||||
<input type="checkbox" name="voice" id="voice" value="Yes"> <p>Add on Voice Home Plan at RM20/month</p> | <input type="checkbox" name="voice" id="voice" value="Yes"> <p>Add on Voice Home Plan at RM20/month</p> | ||||
@endif | @endif |
<td>RM{{ $otc }}</td> | <td>RM{{ $otc }}</td> | ||||
<td>RM{{ $otc_st }}</td> | <td>RM{{ $otc_st }}</td> | ||||
</tr> | </tr> | ||||
<tr><th>Deposit</th></th> | |||||
<td colspan="2">RM{{ $deposit}}</td> | |||||
<tr><th colspan="2">Deposit</th></th> | |||||
<td>RM{{ $deposit}}</td> | |||||
</tr> | </tr> | ||||
<tr><th colspan="2">Total Charges</th> | <tr><th colspan="2">Total Charges</th> | ||||
<td><b>RM{{ $upfront_total }}</b></td> | <td><b>RM{{ $upfront_total }}</b></td> | ||||
<input type="file" id="visaB" accept="image/*" capture="camera" name="visaB" multiple="" onchange="validateImage4()" class="form-control" aria-required="true"> | <input type="file" id="visaB" accept="image/*" capture="camera" name="visaB" multiple="" onchange="validateImage4()" class="form-control" aria-required="true"> | ||||
</div> | </div> | ||||
</div> | </div> | ||||
<div class="col-md-12"> | |||||
<div class="form-group"> | |||||
<label><b>Upfront Payment Receipt</b></label> | |||||
<input type="file" id="payment_receipt" accept="image/*" capture="camera" name="payment_receipt" multiple="" onchange="validateImage5()" class="form-control" required="" aria-required="true"> | |||||
</div> | |||||
</div> | |||||
</div> | </div> | ||||
<!-- Signature --> | <!-- Signature --> | ||||
return true; | return true; | ||||
} | } | ||||
function validateImage5() { | |||||
var formData = new FormData(); | |||||
var file = document.getElementById("payment_receipt").files[0]; | |||||
formData.append("Filedata", file); | |||||
var t = file.type.split('/').pop().toLowerCase(); | |||||
if (t != "jpeg" && t != "jpg" && t !="png" && t != "pdf") { | |||||
alert('Accept jpg, jpeg, png and pdf only'); | |||||
document.getElementById("payment_receipt").value = ''; | |||||
return false; | |||||
} | |||||
return true; | |||||
} | |||||
$(document).ready(function(){ | $(document).ready(function(){ | ||||
var needV = "{{ $a['citizenship'] }}"; | var needV = "{{ $a['citizenship'] }}"; |