{!! Former::open('/bluevine/signup')->id('bluevineSignup') !!}
{!! trans('texts.bluevine_modal_text') !!}
{!! trans('texts.bluevine_create_account') !!}
{!! Former::text('name')->id('bluevine_name')->placeholder(trans('texts.name'))->value($user->first_name . ' ' . $user->last_name)->required() !!}
{!! Former::text('email')->id('bluevine_email')->placeholder(trans('texts.email'))->value($user->email)->required() !!}
{!! Former::text('phone')->id('bluevine_phone')->placeholder(trans('texts.phone'))->value(!empty($user->phone) ? $user->phone : '')->maxlength(10)->required() !!}
{!! Former::number('fico_score')->min(300)->max(850)->placeholder(trans('texts.fico_score'))->required() !!}
{!! Former::text('business_inception')->append('
')->placeholder(trans('texts.business_inception'))->required() !!}
{!! Former::number('annual_revenue')->prepend('$')->append('.00')->placeholder(trans('texts.annual_revenue'))->value(floor($usdLast12Months))->required() !!}
{!! Former::number('average_bank_balance')->prepend('$')->append('.00')->placeholder(trans('texts.average_bank_balance'))->required() !!}
{!! Former::checkboxes('quote_types')
->onchange('bluevineQuoteTypesChanged()')
->required()
->checkboxes([
trans('texts.invoice_factoring') => ['value' => 'invoice_factoring', 'name' => 'quote_type_factoring', 'id'=>'quote_type_factoring'],
trans('texts.line_of_credit') => ['value' => 'line_of_credit', 'name' => 'quote_type_loc', 'id'=>'quote_type_loc'],
]) !!}
{!! Former::number('desired_credit_limit_factoring')
->id('desired_credit_limit_factoring')
->name('desired_credit_limit[invoice_factoring]')
->prepend('$')->append('.00')
->value(5000)
->required()
->placeholder(trans('texts.desired_credit_limit'))
->label(trans('texts.desired_credit_limit_factoring'))!!}
{!! Former::number('desired_credit_limit_loc')
->id('desired_credit_limit_loc')
->name('desired_credit_limit[line_of_credit]')
->prepend('$')->append('.00')
->value(5000)
->required()
->placeholder(trans('texts.desired_credit_limit'))
->label(trans('texts.desired_credit_limit_loc'))!!}
{!! Former::close() !!}