<?
require "proteger.php";
?>

<section class="block bloco">
	<nav class="mb-4" aria-label="breadcrumb">
		<ol class="breadcrumb">
			<li class="breadcrumb-item"><a href="./">Dashboard</a>
			<li class="breadcrumb-item"><a href="cupons/">Meus cupons</a>
			<li class="breadcrumb-item active" aria-current="page">Novo cupom</li>
		</ol>
	</nav>
	
	<form action="cupons_func.php" method="post" class="post" enctype="multipart/form-data">
		<div class="row">
			<div class="col-md-3 text-md-right mb-1">
				<p class="label i mb-0 mt-md-2">Código</p>
			</div>
			<div class="col-md-3">
				<input type="text" name="codigo" class="form-control no-enter" placeholder="Ex.: H3B7CX7275Y2" required style="text-transform: uppercase" autofocus>
			</div>
			<div class="col-md-3">
				<a href="" class="btn btn-block btn-outline-success validar">Validar código</a>
			</div>
		</div>
		<div id="frm" class="block hide">
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">CPF ou CNPJ</p>
				</div>
				<div class="col-md-3">
					<input type="tel" name="doc" class="form-control doc" required>
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 d-none d-md-inline"></div>
				<div class="col-md-7">
					<a href="" class="btn bnt-sm btn-outline-info auto-complete">Preencher dados abaixo com base no CPF/CNPJ do útlimo cupom que preenchi igual ao digitado acima</a>
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">Nome completo</p>
				</div>
				<div class="col-md-5">
					<input type="text" name="nome" class="form-control" required>
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label mb-0 mt-md-2">Telefone fixo</p>
				</div>
				<div class="col-md-3">
					<input type="tel" name="telefone" class="form-control telefone">
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">Celular</p>
				</div>
				<div class="col-md-3">
					<input type="tel" name="celular" class="form-control telefone" required>
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">Gênero</p>
				</div>
				<div class="col-md-3">
					<select name="genero" class="form-control" required>
						<option value=""></option>
						<option value="F">Feminino</option>
						<option value="M">Masculino</option>
					</select>
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">Data de nascimento</p>
				</div>
				<div class="col-md-2">
					<input type="tel" name="nascimento" class="form-control data" required>
				</div>
			</div>
			<div class="row divider">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">CEP</p>
				</div>
				<div class="col-md-2">
					<input type="tel" name="cep" class="form-control cep cepauto" required>
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">Endereço</p>
				</div>
				<div class="col-md-5">
					<input type="text" name="endereco" class="form-control" required>
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">Número</p>
				</div>
				<div class="col-md-2">
					<input type="text" name="endnum" class="form-control" required>
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label mb-0 mt-md-2">Complemento</p>
				</div>
				<div class="col-md-5">
					<input type="text" name="complemento" class="form-control">
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">Bairro</p>
				</div>
				<div class="col-md-5">
					<input type="text" name="bairro" class="form-control" required>
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">Cidade</p>
				</div>
				<div class="col-md-5">
					<input type="text" name="cidade" class="form-control" required>
				</div>
			</div>
			<div class="row">
				<div class="col-md-3 text-md-right mb-1">
					<p class="label i mb-0 mt-md-2">Estado</p>
				</div>
				<div class="col-md-5">
					<select name="uf" class="form-control" required>
						<option value=""></option>
						<?= estado() ?>
					</select>
				</div>
			</div>
			<div class="row mb-3 divider">
				<div class="col-md-3 d-none d-md-inline"></div>
				<div class="col">
					<label>
						<input type="checkbox" name="termos" value="1" required>
						<span class="text-dark">Li e aceito os <a href="" id="termos">termos do regulamento</a> desta campanha</span>
					</label>
				</div>
			</div>
			<div class="row mb-3 divider">
				<div class="col-md-3 d-none d-md-inline"></div>
				<div class="col">
					<label>
						<input type="checkbox" name="new" value="1" checked>
						<span class="text-dark">Ao salvar este cupom, voltar para adicionar novo</span>
					</label>
				</div>
			</div>
			<div class="row divider">
				<div class="col-md-3 d-none d-md-inline"></div>
				<div class="col">
					<input type="hidden" name="funcao" value="post">
					<input type="hidden" name="token">
					<button type="submit" class="btn btn-success"><i class="fa fa-hdd-o"></i> Salvar cupom</button>
				</div>
			</div>
		</div>
	</form>
</section>