extends /templates/base-flat
block content

  #learn-more-modal.modal.fade
    .modal-dialog.modal-sm
      .modal-content.style-flat
        .modal-header
          .button.close(type="button", data-dismiss="modal", aria-hidden="true") ×
        .modal-body(data-i18n="teachers_quote.learn_more_modal")

  .container
    form
      .row.text-center
        .col-md-offset-2.col-md-8
          h3.m-t-3(data-i18n="teachers_quote.convert_account_title")
          h4(data-i18n="[html]teachers_quote.create_account_subtitle")
          .alert.alert-info.m-y-2
            div
              span.spr(data-i18n="teachers_quote.not")
              strong= me.broadName()
              | ?
              a.spl#logout-link(data-i18n="login.log_out")
            if me.get('role') === 'student'
              div#conversion-warning.m-t-2
                span.spr(data-i18n="[html]teachers_quote.conversion_warning")
                a(data-i18n="new_home.learn_more" data-toggle="modal" data-target="#learn-more-modal")

      .row.m-y-2
        .col-md-offset-2.col-md-4.col-sm-6
          .form-group
            label.control-label(data-i18n="general.username")
            input.form-control(disabled=true value=me.get('name'))

        .col-md-4.col-sm-6
          #email-form-group.form-group
            label.control-label(data-i18n="general.email")
            input.form-control(name='email' disabled=true value=me.get('email'))

      .row.m-y-2
        .col-md-offset-2.col-md-4.col-sm-6
          .form-group
            label.control-label(data-i18n="general.first_name")
            input.form-control(name="firstName" value=me.get('firstName') || '')

        .col-md-4.col-sm-6
          .form-group
            label.control-label(data-i18n="general.last_name")
            input.form-control(name="lastName" value=me.get('lastName') || '')

      .row.m-y-2
        .col-md-offset-2.col-md-4.col-sm-6
          .form-group
            label.control-label
              span(data-i18n="teachers_quote.phone_number")
              span.spl.text-muted(data-i18n="signup.optional")
            .help-block.small
              em.text-info(data-i18n="teachers_quote.phone_number_help")
            input.form-control(name="phoneNumber")

        .col-md-4.col-sm-6
          .form-group
            label.control-label(data-i18n="teachers_quote.primary_role_label")
            .help-block.small
              em.text-info(data-i18n="teachers_quote.role_help")
            select.form-control(name="role")
              option(data-i18n="teachers_quote.role_default", , value='')
              option(data-i18n="courses.teacher", value="Teacher")
              option(data-i18n="teachers_quote.tech_coordinator", value="Technology coordinator")
              option(data-i18n="teachers_quote.advisor", value="Advisor")
              option(data-i18n="teachers_quote.principal", value="Principal")
              option(data-i18n="teachers_quote.superintendent", value="Superintendent")
              option(data-i18n="teachers_quote.parent", value="Parent")

      #form-school-info
        .row.m-y-2
          .col-md-offset-2.col-md-4.col-sm-6
            .form-group
              label.control-label(data-i18n="teachers_quote.organization_label")
              input.form-control#organization-control(name="organization")

          .col-md-4.col-sm-6
            .form-group
              label.control-label(data-i18n="teachers_quote.city")
              input.form-control(name="city")

        .row.m-y-2
          .col-md-offset-2.col-md-4.col-sm-6
            .form-group
              label.control-label(data-i18n="teachers_quote.state")
              input.form-control(name="state")

          .col-md-4.col-sm-6
            .form-group
              label.control-labellabel.control-label(data-i18n="teachers_quote.country")
              input.form-control(name="country")

      #form-students-info
        .row.m-y-2
          .col-md-offset-2.col-md-4
            .form-group
              label.control-label(data-i18n="courses.number_programming_students")
              .help-block.small
                em.text-info(data-i18n="teachers_quote.num_students_help")
              select.form-control(name="numStudents")
                option(data-i18n="teachers_quote.num_students_default", value='')
                option 1-10
                option 11-50
                option 51-100
                option 101-200
                option 201-500
                option 501-1000
                option 1000+

          .col-md-4.col-sm-6
            .form-group
              label.control-label
                span(data-i18n="courses.number_total_students")
                span.spl.text-muted(data-i18n="signup.optional")
              select.form-control(name="numStudentsTotal")
                option(data-i18n="teachers_quote.num_students_default", value='')
                option 1-500
                option 500-1,000
                option 1,000-5,000
                option 5,000-10,000
                option 10,000+

        .form-group
          .row.m-y-2
            .col-md-offset-2.col-md-10
              label.control-label(data-i18n="teachers_quote.education_level_label")
              .help-block.small
                em.text-info(data-i18n="teachers_quote.education_level_help")
            .col-md-offset-2.col-md-5
              .checkbox
                label
                  input(type="checkbox" name="educationLevel" value="Elementary")
                  span(data-i18n="teachers_quote.elementary_school")
              .checkbox
                label
                  input(type="checkbox" name="educationLevel" value="Middle")
                  span(data-i18n="teachers_quote.middle_school")
              .checkbox
                label
                  input(type="checkbox" name="educationLevel" value="High")
                  span(data-i18n="teachers_quote.high_school")
              .checkbox
                label
                  input(type="checkbox" name="educationLevel" value="College+")
                  span(data-i18n="teachers_quote.college_plus")
              .checkbox
                label
                  input#other-education-level-checkbox(type="checkbox")
                  span(data-i18n="nav.other").spr
                  span(data-i18n="teachers_quote.please_explain")
              input#other-education-level-input.form-control

      #anything-else-row.row.m-y-2
        .col-md-offset-2.col-md-8
          label.control-label
            span(data-i18n="teachers_quote.anything_else")
            span.spl.text-muted(data-i18n="signup.optional")
          textarea.form-control(rows=8, name="notes")
          input(type="hidden" name="nces_id")
          input(type="hidden" name="nces_name")
          input(type="hidden" name="nces_district")
          input(type="hidden" name="nces_district_id")
          input(type="hidden" name="nces_district_schools")
          input(type="hidden" name="nces_district_students")
          input(type="hidden" name="nces_students")
          input(type="hidden" name="nces_phone")
      #buttons-row.row.m-y-2.text-center
        input#create-account-btn.btn.btn-lg.btn-primary(type="submit" data-i18n="[value]teachers_quote.convert_account_title")