<% content_for :title, "Complete Application" %>

Where can we find You?

<%= form_with(model: @customer, local: true) do |form| %> <% if @customer.errors.any? %>

<%= pluralize(@customer.errors.count, "error") %> prohibited this customer from being saved:

    <% @customer.errors.full_messages.each do |message| %>
  • <%= message %>
  • <% end %>
<% end %> <% if @customer.customer_type_id == 1 %> <%= form.hidden_field :redirect_action, value: "employer_details" %> <% else %> <%= form.hidden_field :redirect_action, value: "banker_details" %> <% end %> <%= form.hidden_field :redirect_error, value: "contact_details" %>
<%= form.label :address_1,"Street Address *", :class=>"lead g-font-size-16--xs" %> <%= form.text_field :address_1, required: true, :class=>"form-control" %>
<%= form.label :address_2,"Location *", :class=>"lead g-font-size-16--xs" %> <%= form.text_field :address_2, required: true, :class=>"form-control" %>
<%= form.label :city, "City *", :class=>"lead g-font-size-16--xs" %> <%= form.text_field :city, required: true, :class=>"form-control" %>
<%= form.label :country, "Country of Origin *", :class=>"lead g-font-size-16--xs" %> <%= form.text_field :country, required: true, :class=>"form-control" %>

How can we contact You?

<%= form.label :mobile_1, "Mobile Number *", :class=>"lead g-font-size-16--xs" %> <%= form.text_field :mobile_1, required: true, :class=>"form-control" %>
<%= form.label :mobile_2, :class=>"lead g-font-size-16--xs" %> <%= form.text_field :mobile_2, :class=>"form-control" %>
<%= form.label :email, "Email Address *", :class=>"lead g-font-size-16--xs" %> <%= form.email_field :email, required: true, :class=>"form-control" %>
<%= form.label :district, "District *", :class=>"lead g-font-size-16--xs" %> <%= form.text_field :district, required: true, :class=>"form-control" %>
<%= form.label :province, "Province *", :class=>"lead g-font-size-16--xs" %> <%= form.text_field :province, required: true, :class=>"form-control" %>
<%= submit_tag "Update & Proceed", :class => "text-uppercase s-btn s-btn--md btn-success g-radius--50 g-padding-x-70--xs g-margin-b-20--xs" %>
<% end %>