{{ Form::open(['route' => 'customer.referral.make', 'method' => 'POST', 'class' => 'form', 'role' => 'form' ]) }}

{{ Form::text('referred_customer_name', old('referred_customer_name'), [ 'class' => 'form-control', 'required' ]) }} {{ Form::label('referred_customer_name', 'Name') }}

{{ Form::text('referred_customer_org', old('referred_customer_org'), [ 'class' => 'form-control' ]) }} {{ Form::label('referred_customer_org', 'Organization Name') }}

{{ Form::email('referred_customer_email', old('referred_customer_email'), [ 'class' => 'form-control', 'required' ]) }} {{ Form::label('referred_customer_email', 'Email') }}

{{ Form::text('referred_customer_phone_1', old('referred_customer_phone_1'), [ 'class' => 'form-control', 'placeholder' => 'Mob.', 'required' ]) }} {{ Form::label('referred_customer_phone_1', 'Phone 1') }}

{{ Form::text('referred_customer_phone_2', old('referred_customer_phone_2'), [ 'class' => 'form-control', 'placeholder' => 'H.' ]) }} {{ Form::label('referred_customer_phone_1', 'Phone 2') }}

{{ Form::text('referred_customer_address', old('referred_customer_address'), [ 'class' => 'form-control' ]) }} {{ Form::label('referred_customer_address', 'Address') }}

{{ Form::text('referred_customer_website', old('referred_customer_website'), [ 'class' => 'form-control' ]) }} {{ Form::label('referred_customer_website', 'Website') }}

{{ Form::label('service_ids', 'Service') }}
@foreach($services as $slug => $service)

@endforeach

{{ Form::textarea('comment', old('comment'), [ 'class' => 'form-control', 'rows' => 5 ]) }} {{ Form::label('comment', 'Comment') }}