File: /var/www/agighana.org_backup/3a24a1e18c43da5b647f7ec3cf91c008.php
<?php
use App\Models\{SectorActivity,Region,EmployeeSize,Turnover};
?>
<?php $__env->startSection('body'); ?>
<div class=" container">
<div class="card mb-5">
<div class="card-body shadow">
<form action="javascript:void(0)" id="saveForm" class="needs-validation" novalidate>
<div class="col-md-12">
<h5>Part A 1 - Company Address and Location</h5>
</div>
<div class="row">
<div class="col-md-12">
<label class=" form-label">Name of Organisation/Company*:</label>
<input type="text" name="company_name" class="form-control" id="" required>
</div>
</div>
<div class="row mt-3">
<div class="col-md-12">
<label class=" form-label">Postal Address:</label>
<input type="text" name="addr" class="form-control" placeholder="Address Line 1"
id="">
<input type="text" name="city" class="form-control mt-2" placeholder="City"
id="">
</div>
</div>
<div class="row mt-3">
<div class="col-md-6">
<label class=" form-label">Region*:</label>
<select class=" form-select" name="region" required id="">
<option value=""></option>
<?php $__currentLoopData = Region::all(); $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $item): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
<option value="<?php echo e($item->description); ?>"><?php echo e($item->description); ?></option>
<?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
</select>
</div>
<div class="col-md-6">
<label class=" form-label">Company Telephone::</label>
<input type="text" name="comp_phone" class="form-control" id="">
</div>
</div>
<div class="row mt-3">
<div class="col-md-6">
<label class=" form-label">Company Email:</label>
<input type="email" class=" form-control" name="comp_email" id="">
</div>
<div class="col-md-6">
<label class=" form-label">Company Website::</label>
<input type="text" name="comp_web" class="form-control" id="">
</div>
</div>
<div class="row mt-3">
<div class="col-md-6">
<label class=" form-label">Location Factory:</label>
<input type="text" class=" form-control" name="factory_loc" id="">
</div>
<div class="col-md-6">
<label class=" form-label">Digital Address:</label>
<input type="text" name="digital_add" class="form-control" id="">
</div>
</div>
<div class="row mt-3">
<div class="col-md-6">
<label class=" form-label">Passport size photo/Company Logo/Copy of Business
Certificate*:</label>
<input type="file" class=" form-control" name="comp_cert" id="">
</div>
</div>
<div class="row mt-3">
<div class="col-md-12">
<p>* Field with details not to be published and only for AGI purposes.</p>
</div>
</div>
<div class="col-md-12 mt-4">
<h5>Part A 2 – Chief Executive</h5>
</div>
<div class="row">
<div class="col-md-2">
<label class="form-label">Title*:</label>
<input type="text" class="form-control" placeholder="Title" name="ceo_title" id="">
</div>
<div class="col-md-5">
<label class="form-label">First name*:</label>
<input type="text" class="form-control" placeholder="First" name="ceo_fname" id="">
</div>
<div class="col-md-5">
<label class="form-label">Last name*:</label>
<input type="text" class="form-control" placeholder="Last" name="ceo_lname" id="">
</div>
</div>
<div class="row mt-4">
<div class="col-md-3">
<label class=" form-label">Position</label>
<input type="text" class=" form-control" name="ceo_position" id="">
</div>
<div class="col-md-3">
<label class=" form-label">Telephone Direct Line*:</label>
<input type="tel" class=" form-control" name="ceo_direct_tel_phone" id="">
</div>
<div class="col-md-3">
<label class=" form-label">Mobile*:</label>
<input type="text" class=" form-control" name="ceo_mobile" id="">
</div>
<div class="col-md-3">
<label class=" form-label">Email Address:</label>
<input type="tel" class=" form-control" name="ceo_email" id="">
</div>
</div>
<div class="row mt-4">
<div class="col-md-12">
<label class=" form-label">Personal Profile: (Not less than 300 words)*:</label>
<textarea name="ceo_personal_profile" id="" class=" form-control"></textarea>
</div>
</div>
<div class="col-md-12 mt-4">
<h5>Part A 3 - Contact Person for AGI, if different from A2</h5>
</div>
<div class="row">
<div class="col-md-2">
<label class="form-label">Title*:</label>
<input type="text" class="form-control" placeholder="Title" name="contact_person_title"
id="">
</div>
<div class="col-md-5">
<label class="form-label">First name*:</label>
<input type="text" class="form-control" placeholder="First" name="contact_person_fname"
id="">
</div>
<div class="col-md-5">
<label class="form-label">Last name*:</label>
<input type="text" class="form-control" placeholder="Last" name="contact_person_lname"
id="">
</div>
</div>
<div class="row mt-4">
<div class="col-md-3">
<label class=" form-label">Position</label>
<input type="text" class=" form-control" name="contact_person_position" id="">
</div>
<div class="col-md-3">
<label class=" form-label">Telephone Direct Line*:</label>
<input type="tel" class=" form-control" name="contact_person_direct_tele_phone" id="">
</div>
<div class="col-md-3">
<label class=" form-label">Mobile*:</label>
<input type="text" class=" form-control" name="contact_person_mobile" id="">
</div>
<div class="col-md-3">
<label class=" form-label">Email Address:</label>
<input type="tel" class=" form-control" name="contact_person_email" id="">
</div>
</div>
<div class="col-md-12 mt-4">
<h5><b>Part B - Statistical</b> Data shall be treated strictly confidential and not made available
to third parties.</h5>
</div>
<div class="col-md-12 mt-4">
<h5>B1 - Company</h5>
</div>
<div class="row mt-4">
<div class="col-md-12">
<label class=" form-label">(1) Ownership Type:</label>
</div>
<div class="col-md-3">
<div class="form-check">
<input class="form-check-input" value="Sole Proprietorship" type="radio" name="ownership_type"
id="">
<label class="form-check-label" for="">
Sole Proprietorship
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-check">
<input class="form-check-input" type="radio" name="ownership_type"
id="" value="Partnership">
<label class="form-check-label" for="">
Partnership
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-check">
<input class="form-check-input" type="radio" name="ownership_type"
id="" value="Public Ltd">
<label class="form-check-label" for="">
Public Ltd
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-check">
<input class="form-check-input" type="radio" name="ownership_type"
id="" value="Private Ltd">
<label class="form-check-label" for="">
Private Ltd
</label>
</div>
</div>
</div>
<div class="row mt-4">
<div class="col-md-12">
<label class=" form-label">(2) Ownership Status:</label>
</div>
<div class="col-md-3">
<div class="form-check">
<input class="form-check-input" type="radio" name="ownership_status"
id="" value="Private">
<label class="form-check-label" for="">
Private
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-check">
<input class="form-check-input" type="radio" name="ownership_status"
id="" value="State">
<label class="form-check-label" for="">
State
</label>
</div>
</div>
<div class="col-md-3">
<div class="form-check">
<input class="form-check-input" type="radio" name="ownership_status"
id="" value="Mixed">
<label class="form-check-label" for="">
Mixed
</label>
</div>
</div>
<div class="col-md-12 mt-4">
<h6>(3) Please indicate (roughly) the percentage of the company that is owned by:</h6>
</div>
</div>
<div class="row mt-4">
<div class="col-md-4">
<label class="form-label">Ghanaian Private</label>
<input type="text" class=" form-control" name="gh_private" id="">
</div>
<div class="col-md-4">
<label class="form-label">Ghanaian State</label>
<input type="text" class=" form-control" name="gh_state" id="">
</div>
<div class="col-md-4">
<label class="form-label">Foreign Private</label>
<input type="text" class=" form-control" name="foreign_private" id="">
</div>
</div>
<div class="row mt-4">
<div class="col-md-4">
<label class=" form-label">(4) Year the company effectively started operations in
Ghana*:</label>
<input type="date" class=" form-control" name="operation_date" id="" required>
</div>
<div class="col-md-4">
<label class=" form-label">(5) No of Employees (current status)*:</label>
<select name="no_of_employee" id="" class=" form-control" required>
<option value=""></option>
<?php $__currentLoopData = EmployeeSize::all(); $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $item): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
<option value="<?php echo e($item->description); ?>"><?php echo e($item->description); ?></option>
<?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
</select>
</div>
<div class="col-md-4">
<label class=" form-label">(6) Turnover (last financial year) FINANCIAL YEAR*:</label>
<select name="turnover" id="" class=" form-control" required>
<option value=""></option>
<?php $__currentLoopData = Turnover::all(); $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $item): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
<option value="<?php echo e($item->description); ?>"><?php echo e($item->description); ?></option>
<?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
</select>
</div>
</div>
<div class="row mt-4">
<div class="col-md-12">
<label class=" form-label">(7) Company Profile (Not less than 300 words)*</label>
<textarea name="company_profile" id="" class=" form-control"></textarea>
</div>
</div>
<div class="col-md-12 mt-4">
<h5>B2 Export</h5>
</div>
<div class="row mt-4">
<div class="col-md-6">
<label class="form-label">(1) Company exported over the last two years:</label>
<div class="row">
<div class="col-md-6">
<div class="form-check">
<input class="form-check-input" type="radio" name="exported_over_last_two"
id="" value="Yes">
<label class="form-check-label" for="">
Yes
</label>
</div>
</div>
<div class="col-md-6">
<div class="form-check">
<input class="form-check-input" type="radio" name="exported_over_last_two"
id="" value="No">
<label class="form-check-label" for="">
No
</label>
</div>
</div>
</div>
</div>
<div class="col-md-6">
<label class="form-label">(2) If yes:</label>
<div class="row">
<select name="yes_for_exported_last_two" class=" form-select" id="">
<option value=""></option>
<option value="">less than 10 times</option>
<option value="">10 times or more</option>
</select>
</div>
</div>
</div>
<div class="col-md-12 mt-4">
<label class="form-label">If (1) is yes, main export markets/destinations are:</label>
<div class="row">
<div class="col-md-1">
<div class="form-check">
<input class="form-check-input" type="checkbox" name="main_export_market"
id="" name="West Africa">
<label class="form-check-label" for="">
West Africa
</label>
</div>
</div>
<div class="col-md-2">
<div class="form-check">
<input class="form-check-input" type="checkbox" name="main_export_market"
id="" value="Other African Countries">
<label class="form-check-label" for="">
Other African Countries
</label>
</div>
</div>
<div class="col-md-2">
<div class="form-check">
<input class="form-check-input" type="checkbox" name="main_export_market"
id="" value="Europe (EU)">
<label class="form-check-label" for="">
Europe (EU)
</label>
</div>
</div>
<div class="col-md-2">
<div class="form-check">
<input class="form-check-input" type="checkbox" name="main_export_market"
id="" value="Europe (Non - EU)">
<label class="form-check-label" for="">
Europe (Non - EU)
</label>
</div>
</div>
<div class="col-md-1">
<div class="form-check">
<input class="form-check-input" type="checkbox" name="main_export_market"
id="" value="Asia">
<label class="form-check-label" for="">
Asia
</label>
</div>
</div>
<div class="col-md-2">
<div class="form-check">
<input class="form-check-input" type="checkbox" name="main_export_market"
id="" value="Middle East/Arabic Region">
<label class="form-check-label" for="">
Middle East/Arabic Region
</label>
</div>
</div>
<div class="col-md-2">
<div class="form-check">
<input class="form-check-input" type="checkbox" name="main_export_market"
id="" value="North America">
<label class="form-check-label" for="">
North America
</label>
</div>
</div>
<div class="col-md-12 mt-3">
<label class="form-label">Other</label>
<textarea name="other_markets" id="" class=" form-control"></textarea>
</div>
</div>
</div>
<div class="col-md-12">
<h5>B3 Trade Fairs</h5>
</div>
<div class="row mt-4">
<div class="col-md-6">
<label class="form-label">(1) The Company is interested to participate at AGI Trade
Fairs:</label>
<div class="row">
<div class="col-md-3">
<input class="form-check-input" type="radio" name="intrested_in_agi_fair"
id="" value="Yes">
<label class="form-check-label" for="">
Yes
</label>
</div>
<div class="col-md-3">
<input class="form-check-input" type="radio" name="intrested_in_agi_fair"
id="" value="No">
<label class="form-check-label" for="">
No
</label>
</div>
<div class="col-md-6">
<input class="form-check-input" type="radio" name="intrested_in_agi_fair"
id="" value="Undecided">
<label class="form-check-label" for="">
Undecided
</label>
</div>
</div>
</div>
<div class="col-md-6">
<label class="form-label">(2) If yes:</label>
<div class="row">
<div class="col-md-6">
<input class="form-check-input" type="radio" name="if_interested_agi_fair"
id="" value="In Ghana">
<label class="form-check-label" for="">
In Ghana
</label>
</div>
<div class="col-md-6">
<input class="form-check-input" type="radio" name="if_interested_agi_fair"
id="">
<label class="form-check-label" for="">
In ECOWAS Countries
</label>
</div>
</div>
</div>
</div>
<div class="row mt-4">
<div class="col-md-6">
<h4>B 4 Imports: Company imports about:</h4>
<input type="text" class=" form-control" name="company_inports_about" id="">
</div>
<div class="col-md-6">
<h4>B5 The Company is already member of:</h4>
<div class="row">
<div class="col-md-4">
<input class="form-check-input" type="radio" name="already_member_of"
id="" value="Ghana Employers Association (GEA)">
<label class="form-check-label" for="">
Ghana Employers Association (GEA)
</label>
</div>
<div class="col-md-4">
<input class="form-check-input" type="radio" name="already_member_of"
id="" value="Ghana Notional Chamber of Commerce & Industry (GNCCI)">
<label class="form-check-label" for="">
Ghana National Chamber of Commerce & Industry (GNCCI)
</label>
</div>
<div class="col-md-4">
<input class="form-check-input" type="radio" name="already_member_of"
id="" value="Federation of Ghanaian Exporters (FAGE)">
<label class="form-check-label" for="">
Federation of Ghanaian Exporters (FAGE)
</label>
</div>
<div class="col-md-12">
<label class="form-label">Other</label>
<input type="text" class=" form-control" placeholder="Other" name="already_member_of_other"
id="">
</div>
</div>
</div>
</div>
<div class="col-md-12 mt-4">
<p><b>Part C - Data will be used for AGI Publications (Membership Directory, Buyers Guide, website,
etc.)</b> Your company will be listed in alphabetical order with full details of A1, C2 and
C3 under the General Listing. Company’s name will also be listed under respective sector(s) in
the appropriate Sector Listing. If you require further information, please contact the AGI
Secretariat.</p>
</div>
<div class="col-md-12 mt-4">
<p><b>C1 - Please select the sector(s) of your companies’ main business activity. If more than one
applies, tick up to three major areas.</b></p>
<p><b>Please do not tick more than three (3)!</b></p>
<div class="row">
<?php $__currentLoopData = SectorActivity::all(); $__env->addLoop($__currentLoopData); foreach($__currentLoopData as $item): $__env->incrementLoopIndices(); $loop = $__env->getLastLoop(); ?>
<div class="col-md-4 mb-2">
<input class="form-check-input" type="checkbox" name="sector_activity"
id="" value="<?php echo e($item->description); ?>">
<label class="form-check-label" for="">
<?php echo e($item->description); ?>
</label>
</div>
<?php endforeach; $__env->popLoop(); $loop = $__env->getLastLoop(); ?>
<div class="col-md-4">
<label for="">Other</label>
<input class=" form-control" type="text" name="sector_activity_other" id="">
</div>
</div>
</div>
<div class="col-md-12">
<h5>Other Industry</h5>
<div class="row">
<div class="col-md-3">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Mining & Quarrying">
<label class="form-check-label" for="">
Mining & Quarrying
</label>
</div>
<div class="col-md-3">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Oil & Gas Extraction">
<label class="form-check-label" for="">
Oil & Gas Extraction
</label>
</div>
<div class="col-md-3">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Electricity, Gas & Water">
<label class="form-check-label" for="">
Electricity, Gas & Water
</label>
</div>
<div class="col-md-3">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Construction">
<label class="form-check-label" for="">
Construction
</label>
</div>
</div>
</div>
<div class="col-md-12">
<h5>Services</h5>
<div class="row">
<div class="col-md-4">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Engineering">
<label class="form-check-label" for="">
Engineering
</label>
</div>
<div class="col-md-4">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Banking, Financial Services Incl. Insurances">
<label class="form-check-label" for="">
Banking, Financial Services Incl. Insurances
</label>
</div>
<div class="col-md-4">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Telecommunication">
<label class="form-check-label" for="">
Telecommunication
</label>
</div>
<div class="col-md-4">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Business Services">
<label class="form-check-label" for="">
Business Services
</label>
</div>
<div class="col-md-4">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Computer & Software Industries">
<label class="form-check-label" for="">
Computer & Software Industries
</label>
</div>
<div class="col-md-4">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Logistics & Transport">
<label class="form-check-label" for="">
Logistics & Transport
</label>
</div>
<div class="col-md-4">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Tourism & Hospitality">
<label class="form-check-label" for="">
Tourism & Hospitality
</label>
</div>
<div class="col-md-4">
<input class="form-check-input" type="checkbox" name="other_industry"
id="" value="Wholesale, Retail, Ex- and Import">
<label class="form-check-label" for="">
Wholesale, Retail, Ex- and Import
</label>
</div>
<div class="col-md-4">
<label class="form-label">
Other
</label>
<input type="text" class=" form-control" name="other_industry_other" id="">
</div>
</div>
</div>
<div class="col-md-12 mt-3">
<h5>C2 - Our main area of business is:</h5>
<textarea name="" id="" class=" form-control"></textarea>
</div>
<div class="col-md-12 mt-3">
<h5>C3 - Our five (5) main products or services:</h5>
<textarea name="main_area_business" id="" class=" form-control"></textarea>
</div>
<div class="col-md-6 mt-3">
<h5>To submit your form, click in the checkbox provided below.*</h5>
<input class="form-check-input" type="checkbox" value="Yes" name="agree_policy" id="">
<label class="form-check-label" for="">
I agree that the information I have provided may be used by AGI
</label>
</div>
<div class="mt-4">
<button type="submit" class=" btn btn-primary" id="btnSubmit">Submit</button>
<span><div class="spinner-border" role="status" style="display: none" id="spinner">
<span class="visually-hidden">Loading...</span>
</div></span>
</div>
</form>
</div>
</div>
</div>
<?php $__env->stopSection(); ?>
<?php $__env->startSection('scripts'); ?>
<script src="<?php echo e(asset('assets/js/self/register.js')); ?>"></script>
<script>$('.navRegister').addClass('active')</script>
<?php $__env->stopSection(); ?>
<?php echo $__env->make('layouts.app', \Illuminate\Support\Arr::except(get_defined_vars(), ['__data', '__path']))->render(); ?><?php /**PATH /var/www/html/agi/public_html/newagi.agighana.org/resources/views/member/register.blade.php ENDPATH**/ ?>