<?php
require_once('header.php');
echo $page_content;

$countries = '';
$stmt = $mysqli->prepare("SELECT nicename, phonecode FROM country WHERE phonecode != '0' ORDER BY nicename");
$stmt->execute();
$stmt->store_result();
$stmt->bind_result($nicename, $phonecode);
while($stmt->fetch()):
	$countries .= '<option value="' . $nicename . '" data-phonecode="+' . $phonecode . '">' . $nicename . '</option>';
endwhile;
$stmt->close();

echo <<<EOJ
<form action="{$baseurl}{$filename}" method="post" name="submissionform" class="grey lighten-3 form ajax" enctype="multipart/form-data">
	<input type="hidden" name="{$token_id}" value="{$token_value}" readonly />
	<input type="hidden" name="focus" value="{$en->encrypt('[ARTICLE_SUBMISSION]')}" readonly />
	<input type="hidden" name="zipcode" value="" readonly />
	<div class="progress grey lighten-2"><div class="indeterminate blue accent-4"></div></div>
	<div class="row">
		<div class="col s12 m6 l6">
			<label for="name">Name<span class="red-text right">*</span></label>
			<input type="text" name="name" id="name" />
		</div>
		<div class="col s12 m6 l6">
			<label for="email">Email<span class="red-text right">*</span></label>
			<input type="text" name="email" id="email" />
		</div>
	</div>
	<div class="row">
		<div class="col s12 m6 l6">
			<label for="country">Country</label>
			<select name="country" class="browser-default" onchange="phonecode.value = this.value ? event.target.options[event.target.selectedIndex].dataset.phonecode : ''; pnvm.hidden = this.value !== 'India';">
				<option value="" selected="selected">Select country</option>
				{$countries}
			</select>
		</div>
		<div class="col s12 m6 l6">
			<label for="phone">WhatsApp Number <small id="pnvm" style="color:#f00;" hidden>(10 Digits Phone Number)</small></label>
			<div style="display:flex;clear:both;">
				<input type="text" name="phonecode" id="phonecode" style="width:50px;padding:0;text-align:center;background:#eee;" readonly />
				<input type="text" name="phone" id="phone" onblur="if (this.value) { this.value = this.value.replace(/^0+/, ''); }" />
			</div>
		</div>
	</div>
	<div class="row">
		<div class="col s12 m12 l12">
			<label for="address">Institute Address<span class="red-text right">*</span></label>
			<textarea rows="5" cols="5" name="address" id="address" class="materialize-textarea"></textarea>
		</div>
	</div>
	<div class="row">
		<div class="col s12 m12 l12">
			<label for="title">Title of the Submission<span class="red-text right">*</span></label>
			<input type="text" name="title" id="title" />
		</div>
	</div>
	<div class="row">
		<div class="col s12 m12 l12">
			<label for="file">Choose File<span class="red-text right">*</span></label>
			<div class="file-field left" style="width:100%">
				<div class="btn grey lighten-1 z-depth-0"><span>article file</span><input type="file" name="file[]" id="file" multiple /></div>
				<div class="file-path-wrapper">
					<input type="text" name="file" placeholder="Choose one or more files" class="file-path" />
				</div>
			</div>
		</div>
	</div>
	<div class="row">
		<div class="col s12 m12 l12">
			<label for="sourcelist"><span class="red-text right">*</span></label>
			<select name="sourcelist" id="sourcelist" class="browser-default" onchange="if(this.value == 'Other') { $('.source').val('').show(0); } else { $('.source').val(this.value).hide(0); }">
				<option value="" selected>How do you know about this journal</option>
				<option value="Online Search">Online Search</option>
				<option value="Email">Email</option>
				<option value="Friend">Friend</option>
				<option value="Letter">Letter</option>
				<option value="Other">Other</option>
			</select>
			<input type="text" name="source" autocomplete="off" class="source" style="margin-top:10px;display:none" />
		</div>
	</div>
	<div class="row">
		<div class="col s12 m12 l12">
			<button type="submit" name="submit" class="waves-effect btn-flat blue accent-4 white-text right" disabled>Submit</button>
		</div>
	</div>
</form>
<div class="smsg center-align"></div>
EOJ;
require_once('footer.php');
?>