Password* Confirm Password*

8 or more letters

atleast 1 capital letter

at least 1 number

at least 1 special character

Address 1* {!! Form::text('address_1',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'100']) !!}

Address 2 {!! Form::text('address_2',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'100']) !!}

City* {!! Form::text('city',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'45']) !!}

State* {!! Form::text('state',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'45']) !!}

Zip code* {!! Form::text('zipcode',null,['class'=>'form-control js-number','autocomplete'=>'nope','maxlength'=>'11']) !!}

Country* {!! Form::select('country', array(''=>'Select')+$country,null,['class'=>'form-control','id'=>'country']) !!}

Phone*

{!! Form::text('code',null,['class'=>'form-control js-number','autocomplete'=>'nope','maxlength'=>'3','style'=>'width:60px']) !!}

{!! Form::text('phone',null,['class'=>'form-control js-number','autocomplete'=>'nope','maxlength'=>'10']) !!}

Academy Name {!! Form::text('music_academy',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'100']) !!}

Music Stream {!! Form::text('music_stream',null,['class'=>'form-control','autocomplete'=>'nope','maxlength'=>'100']) !!}

Is Academy {!! Form::select('is_academy', array('1'=>'Yes','0'=>'No'),null,['class'=>'form-control','id'=>'status-column']) !!}

Status {!! Form::select('status', array('1'=>'Activte','Inactive'=>'Deactivate'),null,['class'=>'form-control','id'=>'status-column']) !!}