Personal info

Insert your personal details

Company Name

@if ($errors->has('company_name')) {{$errors->first('company_name')}} @endif

First Name

@if ($errors->has('first_name')) {{$errors->first('first_name')}} @endif

Last Name

@if ($errors->has('last_name')) Field required @endif

Email address

@if ($errors->has('email')) {{$errors->first('email')}} @endif

Phone number

@if ($errors->has('phone')) {{$errors->first('phone')}} @endif

Your Shipping Address

Insert your shipping address details

Your Address 1

@if ($errors->has('address_1')) {{$errors->first('address_1')}} @endif

Your Address 2

@if ($errors->has('address_2')) {{$errors->first('address_2')}} @endif

City

@if ($errors->has('city')) {{$errors->first('city')}} @endif

Zip Code

@if ($errors->has('zip_code')) {{$errors->first('zip_code')}} @endif

Country

@if ($errors->has('country')) {{$errors->first('country')}} @endif

@if($states_db && count($states_db) > 0)

State

@if ($errors->has('state')) {{$errors->first('state')}} @endif @else

State

@if ($errors->has('other_state')) {{$errors->first('other_state')}} @endif @endif

Check box if your billing address is different from your shipping address

Your Billing Address

Insert your billing address details

Your Address 1

@if ($errors->has('billing_address_1')) {{$errors->first('billing_address_1')}} @endif

Your Address 2

@if ($errors->has('billing_address_2')) {{$errors->first('billing_address_2')}} @endif

City

@if ($errors->has('billing_city')) {{$errors->first('billing_city')}} @endif

Zip Code

@if ($errors->has('billing_zip_code')) {{$errors->first('billing_zip_code')}} @endif

Country

@if ($errors->has('billing_country')) {{$errors->first('billing_country')}} @endif

@if($states_billing_db && count($states_billing_db) > 0)

State

@if ($errors->has('billing_state')) {{$errors->first('billing_state')}} @endif @else

State

@if ($errors->has('other_billing_state')) {{$errors->first('other_billing_state')}} @endif @endif