@section('content')

 	@if($errors->has())
    	<div class="alert alert-danger">
		@foreach ($errors->all() as $row)
	      {{ $row }}<br />
	  	@endforeach
        </div>
	@elseif (Session::has('success'))
	   <div class="alert alert-success"> An e-mail with the password reset has been sent.</div>
	@endif 
   	
    {{ Form::open(array('action' => 'AccountController@postForgot')) }}
   	<div class="black-form reset-pass">
		<a href="{{ URL::to('/') }}" class="banq-logo"></a>
		<div class="lock"></div>
		<p>PLEASE ENTER YOUR EMAIL ADDRESS</p>
		<div class="form-group">
			{{ Form::text('email', null, array('id' => 'email', 'class' => 'form-control', 'placeholder' => 'Email', 'required' => 'true')) }}
		</div>
        <p>PLEASE ENTER YOUR DATE OF BIRTH</p>
        <div class="form-group">
			{{ Form::text('month', null, array('id' => 'month', 'class' => 'form-control', 'placeholder' => 'MM', 'required' => 'true')) }}
            /
            {{ Form::text('day', null, array('id' => 'day', 'class' => 'form-control', 'placeholder' => 'DD', 'required' => 'true')) }}
            /
            {{ Form::text('year', null, array('id' => 'year', 'class' => 'form-control', 'placeholder' => 'YYYY', 'required' => 'true')) }}
        </div>
        <p>PLEASE ENTER YOUR SOCIAL SECURITY NUMBER</p>
        <div class="form-group">
        	{{ Form::text('ssn1', null, array('id' => 'ssn1', 'class' => 'form-control', 'placeholder' => 'XXX', 'required' => 'true')) }}
            -
            {{ Form::text('ssn2', null, array('id' => 'ssn2', 'class' => 'form-control', 'placeholder' => 'XX', 'required' => 'true')) }}
            -
            {{ Form::text('ssn3', null, array('id' => 'ssn3', 'class' => 'form-control', 'placeholder' => 'XXXX', 'required' => 'true')) }}
        </div>
		<button type="submit" class="btn">RESET PASSWORD</button>
		<p class="info">We are committed to maintaining the confidentiality, integrity and security of any personal information about our users. Please refer to our <a href="#">Security and Privacy Policy</a> for more information on our standards and practices.</p>
	</div>
    {{ Form::close() }}
@endsection