@if (is_null($record->index))
Use this utility to create a new student enrollment record. Click "Add" to save this record to your form.
@else
Use this utility to edit this existing student enrollment record. Click "Save" to save changes to your form.
@endif
{{ Form::open(array('url' => url('/forms/eligibility/' . $object->waiver->id . '/enrollment-records'),
'method' => 'POST',
'style' => 'font-size: 10pt;')) }}
{{ Form::hidden('redirect', url('/forms/eligibility/' . $object->waiver->id . '/edit')) }}
{{ Form::hidden('waiver_id', $object->waiver->id) }}
@if (!is_null($record->index))
{{ Form::hidden('index', $record->index) }}
@endif
{{ Form::label('school_year', 'School Year', array('style' => 'width: 125px;')) }}
{{ Form::select('school_year', $options['school_years'], $record->school_year, array('style' => '')) }}
Academic school year for this enrollment period.
{{ Form::label('grade', 'Grade', array('style' => 'width: 125px;')) }}
{{ Form::select('grade', $options['grades'], $record->grade, array('style' => '')) }}
Student's grade in school during this school year.
{{ Form::label('period', 'Grading Period', array('style' => 'width: 125px;')) }}
{{ Form::select('period', $options['periods'], $record->period, array('style' => '')) }}
Dates Attended
MM/DD/YYYY
{{ Form::label('first_date', 'First Date', array('style' => 'width: 125px;')) }}
{{ Form::text('first_date', (!Helpers::strIsEmpty($record->first_date)) ? date('m/d/Y', strtotime($record->first_date)) : null, array('style' => 'width: 100px; margin-right: 10px;')) }}
to
{{ Form::label('last_date', 'Last Date', array('style' => 'width: 125px;')) }}
{{ Form::text('last_date', (!Helpers::strIsEmpty($record->last_date)) ? date('m/d/Y', strtotime($record->last_date)) : null, array('style' => 'width: 100px;')) }}
When did the student attend school for this enrollment period?
{{ Form::label('school', 'School', array('style' => 'width: 125px;')) }}
{{ Form::text('school', $record->school, array('style' => 'width: 320px;',
'data-autocomplete' => true,
'data-source' => url('/forms/eligibility/' . $object->waiver->id . '/lookup/enrollment-school'))) }}
{{ Form::label('credits_earned', 'Number of Credits Earned', array('style' => 'width: 200px;')) }}
{{ Form::text('credits_earned', $record->credits_earned, array('style' => 'width: 50px;')) }}
For example, 3.5
{{ Form::label('classes_passed', 'Number of Classes Passed', array('style' => 'width: 200px;')) }}
{{ Form::text('classes_passed', $record->classes_passed, array('style' => 'width: 50px;', 'maxlength' => 2)) }}
For example, 6
{{ Form::close() }}