leadsform

<!-- leads form -->
<div class="uk-grid">
    <div class="uk-width-1-1">

    <form ng-submit="submit(newlead)" class="uk-form uk-form-horizontal" id="newlead" name="newlead">
        <div id="wizard">


            <h1>Contact</h1>

            <div>
                <div class="uk-form-row ">
                    <label for="firstName" class="uk-form-label">First Name</label>
                    <div class="uk-form-controls">
                        <input placeholder="First Name" name="firstName" type="text" id="firstName" ng-model="newlead.firstName" class="required uk-form-width-medium">
                    </div>
            </div>
                <div class="uk-form-row">
                    <label for="lastName" class="uk-form-label">Last Name</label>
                    <div class="uk-form-controls">
                        <input placeholder="Last Name" name="lastName" type="text" id="lastName" ng-model="newlead.lastName" class="required uk-form-width-medium">
                    </div>
                </div>
                <div class="uk-form-row">
                    <label for="address1" class="uk-form-label">Address Line 1</label>
                    <div class="uk-form-controls">
                        <input placeholder="Address Line 2" name="address1" type="text" id="address1" ng-model="newlead.address1" class="uk-form-width-large">
                    </div>
                </div>
                <div class="uk-form-row">
                    <label for="address2" class="uk-form-label">Address Line 2</label>
                    <div class="uk-form-controls">
                        <input placeholder="Address Line 2" name="address2" type="text" id="address2" ng-model="newlead.address2" class="uk-form-width-medium">
                    </div>
                </div>
                <div class="uk-form-row">
                    <label for="country" class="uk-form-label">Country</label>
                    <div class="uk-form-controls">
                        <select class="uk-form-width-medium" name="country" id="country" ng-model="newlead.country"></select>
                    </div>

                </div>
                <div class="uk-form-row">
                    <label for="state" class="uk-form-label">State</label>
                    <div class="uk-form-controls">
                        <select class="uk-form-width-medium" name="state" id="state" ng-model="newlead.state"></select>
                    </div>
                </div>
                <div class="uk-form-row">
                    <label for="city" class="uk-form-label">City</label>
                    <div class="uk-form-controls">
                        <select class="uk-form-width-medium" name="city" id="city" ng-model="newlead.city"></select>
                    </div>
                </div>
                <div class="uk-form-row">
                    <label for="po_box" class="uk-form-label">Postal Code</label>
                    <div class="uk-form-controls">
                        <input placeholder="Postal Code" name="po_box" type="text" id="po_box" ng-model="newlead.po_box" class="uk-form-width-medium">
                    </div>
                </div>
                <div class="uk-form-row">
                    <label for="email" class="uk-form-label">Email</label>
                    <div class="uk-form-controls">
                        <input placeholder="Email" name="email" type="text" id="email" ng-model="newlead.email" class="uk-form-width-medium">

                    </div>
                </div>
                <div class="uk-form-row">
                    <label for="phone" class="uk-form-label">Phone</label>
                    <div class="uk-form-controls">
                        <input placeholder="Phone" name="phone" type="text" id="phone" ng-model="newlead.phone" class="required uk-form-width-medium">
                    </div>
                </div>
                <div class="uk-form-row">
                    <input name="password" type="hidden" id="password" value="default" ng-model="newlead.password" class="uk-form-width-medium">
                    <input name="fleet_office" type="hidden" id="fleet_office" value="1" ng-model="newlead.fleet_office" class="uk-form-width-medium">
                </div>
            </div>
            <h1>Contract Dates</h1>

            <div>
                <div class="uk-form-row">
                    <label for="start" class="uk-form-label">Start Date</label>
                    <div class="uk-form-controls">
                        <input id='start' name='start' type="text" data-uk-datepicker="{format:'YYYY-MM-DD'}"
                               class='required uk-form-width-medium' ng-model="newlead.start">
                    </div>
                </div>
                <div class="uk-form-row">
                    <label for="end" class="uk-form-label">End Date</label>
                    <div class="uk-form-controls">
                        <input id='end' name='end' type="text" data-uk-datepicker="{format:'YYYY-MM-DD'}"
                               class='required uk-form-width-medium' ng-model="newlead.end">
                    </div>
                </div>
                <div class="uk-form-row">
                    <label for="billing_cycle" class="uk-form-label">Billing Cycle</label>
                    <div class="required uk-form-controls">
                        <select name="billing_cycle" id="billing_cycle" ng-model="newlead.billing_cycle">
                            <option value="Daily">Daily</option>
                            <option value="Weekly">Weekly</option>
                            <option value="Monthly">Monthly</option>
                            <option value="Quarterly">Quarterly</option>
                            <option value="Semi-Annual">Semi-Annual</option>
                            <option value="Annual">Annual</option>
                        </select>
                    </div>

                </div>
                <div class="uk-form-row">
                    <label for="budget" class="uk-form-label">Budget</label>
                    <div class="uk-form-controls">
                        <input placeholder="Budget" name="budget" type="text" id="budget" ng-model="newlead.budget" class="required uk-form-width-medium">
                    </div>

                </div>
                <input name="dirtyasset" type="hidden" id="dirtyasset" ng-model="newlead.dirtyasset" class="uk-form-width-medium">
                <input name="dirtypackage" type="hidden" id="dirtypackage" ng-model="newlead.dirtypackage" class="uk-form-width-medium">
                <input name="dirtystart" type="hidden" id="dirtystart" ng-model="newlead.dirtystart" class="uk-form-width-medium">
                <input name="dirtyend" type="hidden" id="dirtyend" ng-model="newlead.dirtyend" class="uk-form-width-medium">


                <div id="lead-confirm"></div>
                <div id="contract-confirm"></div>
            </div>

            <h1>Vehicle Selection</h1>
            <div>

                <div id="assets"></div>
                <input name="procureasset" value='false' type="hidden" id="procureasset" ng-model="newlead.procureasset" class="uk-form-width-medium">
                <input name="cancelcontract" value='false' type="hidden" id="cancelcontract" ng-model="newlead.cancelcontract" class="uk-form-width-medium">
                <input name="modifycontract" value='false' type="hidden" id="modifycontract" ng-model="newlead.modifycontract" class="uk-form-width-medium">
                <input name="dirtyvehicle" value='false' type="hidden" id="dirtyvehicle" ng-model="newlead.dirtyvehicle" class="uk-form-width-medium">
            </div>


<!--            <h1>Package</h1>-->
<!---->
<!--            <div>-->
<!--                <div id="packages">-->
<!--                </div>-->
<!--            <input name="chosen_pack" type="hidden" id="chosen_pack" ng-model="newlead.chosen_pack" class="uk-form-width-medium">-->
<!--            </div>-->
            <h1>Summary</h1>

            <div>
                <div class="uk-grid">
                    <div class="uk-width-1-2">
                        <div class="uk-form-row">
                            <label for="firstName" class="uk-form-label">First Name</label>: <span
                                class="first_name"></span></div>
                        <div class="uk-form-row">
                            <label for="lastName" class="uk-form-label">Last Name</label>: <span
                                class="last_name"></span></div>
                        <div class="uk-form-row">
                            <label for="email" class="uk-form-label">Email</label>: <span
                                class="email"></span></div>
                        <div class="uk-form-row">
                            <label for="mobile" class="uk-form-label">Mobile</label>: <span
                                class="phone"></span></div>
                    </div>
                    <div class="uk-width-1-2">
                        <div class="uk-form-row">
                            <label for="start" class="uk-form-label">Contract Start Date</label>: <span
                                class="start"></span></div>
                        <div class="uk-form-row">
                            <label for="end" class="uk-form-label">Contract End Date</label>: <span
                                class="end"></span></div>
                        <div class="uk-form-row">
                            <label for="package" class="uk-form-label">Package</label>: <span
                                class="pack_name"></span></div>
                        <div class="uk-form-row">
                            <input name="billingCycle" type="hidden" id="billingCycle" ng-model="newlead.billingCycle" class="uk-form-width-medium">
                            <label for="billingCycle" class="uk-form-label">Billing Cycle</label>: <span
                                class="billing_cycle"></span></div>
                        <div class="uk-form-row">
                            <label for="selectasset" class="uk-form-label">Asset</label>: <span
                                class="selectasset"></span></div>
                        <div class="uk-form-row">
                            <label for="assetstatus" class="uk-form-label">Condition</label>: <span
                                class="assetstatus"></span></div>
                        <div class="uk-form-row">
                            <input name="chosen_asset" value='false' type="hidden" id="chosen_asset" ng-model="newlead.chosen_asset" class="uk-form-width-medium">
                            <input name="chosen_package" value='false' type="hidden" id="chosen_package" ng-model="newlead.chosen_package" class="uk-form-width-medium">
                            <input name="chosen_contract" value='false' type="hidden" id="chosen_contract" ng-model="newlead.chosen_contract" class="uk-form-width-medium">
                        </div>
                    </div>
                    <div class="uk-width-1-2"></div>
                <table class="uk-table">
                </table>
                    <div class="uk-form-row ">
                        <label for="handle_lead" class="uk-form-label">Save Lead</label>
                        <div class="uk-form-controls">
                            <input type="radio" id="savelead" name="handle_lead" value="lead" checked="checked" />
                    </div>
                    <div class="uk-form-row ">
                        <label for="handle_lead" class="uk-form-label">Convert to contract</label>
                        <div class="uk-form-controls">
                            <input type="radio" id="savecontract" name="handle_lead" value="contract" />
                        </div>
                    </div>
                        <div class="uk-form-row ">
                                <input class="uk-button-primary" type="submit" value="Submit">
                            </div>
                        </div>
                </div>
        </div>
    </div>
        </form>

    </div>
</div>