<?php

include("includes/header.php"); 
include("includes/sidebar.php"); 

 ?>
 <div class="main-content app-content">
<div class="container">
                            
                            <!--Modal: order-modal-->
                           
                                <h5 class="text-uppercase">
        Loan Application</h5>
    <div class="row settings mt-3">
       
        <div class="col-xl-12">
            <div id="settingmenuContent">
                
                                <div id="editprofile">
                    <div class="row mb-5">
                        <div class="col-12">
                            <div class="card border-0 box-shadow">
                                <div class="card-body pb-0">
                                    <div class="d-flex align-items-center mb-3">
                                        <h5 class="text-uppercase">Apply for a Loan</h5>
                                    </div>
                                    <form method="POST"
                                        action=""
                                        enctype="multipart/form-data">
                                        <input type="hidden" name="_token" value="xzK0d1n2eIf3u6XdzjKWVvVUTx7gOZ9hY40Uw4si">                                        <div class="row">
                                            <div class="form-group col-sm-6">
                                                <label class="form-label">Name<span
                                                        class="text-danger"> * </span></label>
                                                <input type="text" class="form-control" name="name"
                                                    value="RealzBoutique"
                                                    placeholder="Name" required>

                                            </div>
                                            <div class="form-group col-sm-6">
                                                <label class="form-label">Email<span
                                                        class="text-danger"> * </span></label>
                                                <input type="email" class="form-control" name="email"
                                                    value="marcdouglas961@gmail.com"
                                                    placeholder="Email" required>

                                            </div>
                                            <div class="form-group col-sm-4">
                                                <label class="form-label"
                                                    for="mobile">Mobile<span
                                                        class="text-danger"> * </span></label>
                                                <input type="text" class="form-control mobile-number" name="mobile"
                                                    id="mobile" value="07823827621"
                                                    placeholder="Mobile" required>

                                            </div>
                                            <div class="form-group col-sm-4">
                                                <label class="form-label">Image</label>
                                                <input type="file" class="form-control" name="profile">
                                   
                                            </div>
                                                   

                                                    <div class="form-group col-sm-4">
                                                <label class="form-label">Image</label>
                                                <input type="file" class="form-control" name="profile">
                                   
                                            </div>
                                                                                                                                                
                                                                                                            
                                                    

                                                                                                                                                                                        <div class="form-group col-md-6">
                                                    <label for="country"
                                                        class="form-label">City<span
                                                            class="text-danger"> * </span></label>
                                                    <select name="country" class="form-select" id="country" required>
                                                        <option value="">-- Select --</option>
                                                                                                                    <option value="1"
                                                                selected>
                                                                Nigeria
                                                            </option>
                                                                                                                    <option value="2"
                                                                >
                                                                Others
                                                            </option>
                                                                                                            </select>
                                                </div>
                                                <div class="form-group col-md-6">
                                                    <label for="city"
                                                        class="form-label">Area<span
                                                            class="text-danger">
                                                            * </span></label>
                                                    <select name="city" class="form-select" id="city" required>
                                                        <option value="">-- Select --</option>
                                                    </select>
                                                </div>
                                                                                        <div class="form-group text-end">
                                                                                            <br>
                                                <button
                                                    class="btn btn-secondary  "
                                                     type="submit" name="updateprofile" value="1" >Apply</button>
                                            </div>
                                        </div>
                                    </form>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
                

                          
                    </div>
                  
                               

            </div>
        </div>
    </div>
    
    
                        </div>
                    </div>
                </div>
  <?php

include("includes/footer.php"); 
 ?>