<?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();

$focus = encrypt('[ARTICLE_SUBMISSION]');
echo <<<EOJ
<noscript>Your browser doesn&rsquo;t support javascript. Please use another browser.</noscript>
<p class="noscript">Your browser doesn&rsquo;t support form script. Please use another browser.</p>
<form action="{$baseurl}{$filename}" method="post" name="articleform" class="form ajax-form" enctype="multipart/form-data">
	<input type="hidden" name="token" value="{$token}" autocomplete="off" readonly="readonly" />
	<input type="hidden" name="focus" value="{$focus}" autocomplete="off" readonly="readonly" />
	<input type="hidden" name="zipcode" value="" readonly />
	<div class="row">
		<div class="fl">
			<label class="flbl">Full Name<span>*</span></label>
			<input type="text" name="name" autocomplete="off" class="field" />
		</div>
		<div class="fr">
			<label class="flbl">Email<span>*</span></label>
			<input type="text" name="email" autocomplete="off" class="field" />
		</div>
	</div>
	<div class="row">
		<div class="fl">
			<label class="flbl">Country<span>*</span></label>
			<select name="country" class="field field-select" onchange="phonecode.value = this.value ? event.target.options[event.target.selectedIndex].dataset.phonecode : ''; pnvm.hidden = this.value !== 'India';">
				<option value="" selected="selected">Select country</option>
				{$countries}
			</select>
		</div>
		<div class="fr">
			<label class="flbl">WhatsApp Number <small id="pnvm" style="color:#f00;" hidden>(10 Digits Phone Number)</small><span>*</span></label>
			<div style="display:flex;clear:both;">
				<input type="text" name="phonecode" autocomplete="off" class="field" id="phonecode" style="width:60px;padding:0;text-align:center;" readonly />
				<input type="text" name="phone" autocomplete="off" class="field" onblur="if (this.value) { this.value = this.value.replace(/^0+/, ''); }" />
			</div>
		</div>
	</div>
	<div class="row">
		<label class="flbl">Institute Address<span>*</span></label>
		<textarea rows="5" cols="5" name="address" autocomplete="off" class="field field-textarea"></textarea>
	</div>
	<div class="row">
		<label class="flbl">Title of the submission<span>*</span></label>
		<input type="text" name="title" autocomplete="off" class="field" />
	</div>
	<div class="row">
		<label class="flbl">Article File<span>*</span></label>
		<div class="fluid flex">
			<input type="file" name="file[]" multiple="multiple" autocomplete="off" class="field field-file" />
			<input type="button" value="Add More Files" class="default addfield" />
		</div>
		<div class="fluid morefield"></div>
	</div>
	<div class="row">
		<input type="submit" name="submit" value="submit" disabled="disabled" class="button" />
		<div class="loader">Please Wait...</div>
	</div>
</form>
<div class="output"></div>
EOJ;
require_once('footer.php');
?>