{% extends "public/content.html" %}

{% block headtitle %}Register{% endblock %}

{% block title %}
	<ul class="breadcrumb">
        <li><a href="/">Home</a></li>
        <li class="active">Become A Member</a></li>
    </ul>

	<h1>Become A Member</h1>

{% endblock %}

{% block content %}
	<div id="registration">
		{% if content_block %}
            {{ content_block.content|safe }}
		{% endif %}
		
		<form action="" method="POST" enctype="multipart/form-data" class="form form-horizontal">
			{% csrf_token %}
			
            <p>Fields marked with a <span class="required">*</span> are required</p>

            {% include "public/partials/form.html" with form=registration_form_member_rate %}

            <h2>Account Details</h2>
            {% include "public/partials/form.html" with form=registration_form_user %}
            {% include "public/partials/form.html" with form=registration_form_password %}

            <h2>Personal Details</h2>
            {% include "public/partials/form.html" with form=registration_form_personal %}
            {% include "public/partials/form.html" with form=registration_form_personal_address %}

            <h2>Work Details</h2>
            {% include "public/partials/form.html" with form=registration_form_hospital %}
            {% include "public/partials/form.html" with form=registration_form_work_skip %}
            
            <h2>Support of Application</h2>
            <p>Please either provide two current members to support your application or upload your CV and two letters of support from colleagues or peers.</p>
            {% include "public/partials/form.html" with form=registration_form_support %}
            
            <h2>Work Speciality Details</h2>
            <p>Please complete <strong>one box only</strong> to specify your specialist training:</p>
            {% include "public/partials/form.html" with form=registration_form_speciality checkboxes="true" %}
            
            {% include "public/partials/form.html" with form=registration_form_details %}
            
            <h2>Special Interest Groups</h2>
            <p>If you would like to join any of these SIGs, please tick the relevant box.</p>
            
		    {% include "public/partials/form.html" with form=registration_form_sig checkboxes="true" %}

            <h2>Donation</h2>
            <p>If you wish to make a donation, please tick the box below and enter the amount you wish to donate.</p>
            {% include "public/partials/form.html" with form=registration_form_donation %}
            
			{% include "public/partials/form.html" with form=registration_form_contact %}
						
    		<div class="form-group form-actions">
    			<div class="col-lg-4">
    				<input type="submit" class="btn btn-primary" value="Submit" />
    			</div>
    		</div>
		</form>
	</div>

{% endblock %}