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<form action="{{ route('withdraw_request.payment_store') }}" method="POST">

    @csrf

    <div class="modal-header">

    	<h5 class="modal-title h6">{{translate('Affiliate Withdraw Request')}}</h5>

    	<button type="button" class="close" data-dismiss="modal">

    	</button>

    </div>

    <div class="modal-body">

      <table class="table table-striped table-bordered" >

          <tbody>

              <tr>

                  <td>{{ translate('Paypal Email') }}</td>

                  <td>{{ $affiliate_user->paypal_email }}</td>

              </tr>

              <tr>

                  <td>{{ translate('Bank Information') }}</td>

                  <td>{{ $affiliate_user->bank_information }}</td>

              </tr>

          </tbody>

      </table>



      <input type="hidden" name="affiliate_user_id" value="{{ $affiliate_user->id }}">

      <input type="hidden" name="affiliate_withdraw_request_id" value="{{ $affiliate_withdraw_request->id }}">

      <div class="form-group row">

          <label class="col-sm-3 col-from-label" for="amount">{{translate('Amount')}}</label>

          <div class="col-sm-9">

              <input type="hidden" name="amount" value="{{$affiliate_withdraw_request->amount}}" class="form-control">

              <input type="number" value="{{$affiliate_withdraw_request->amount}}" class="form-control" disabled>

          </div>

      </div>



      <div class="form-group row">

          <label class="col-sm-3 col-from-label" for="payment_method">{{translate('Payment Method')}}</label>

          <div class="col-sm-9">

              <select name="payment_method" id="payment_method" class="form-control aiz-selectpicker" required>

                  <option value="">{{translate('Select Payment Method')}}</option>

                  <option value="Paypal">{{translate('Paypal')}}</option>

                  <option value="Bank">{{translate('Bank')}}</option>

              </select>

          </div>

      </div>

    </div>

    <div class="modal-footer">

      <button class="btn btn-sm btn-primary" type="submit">{{ translate('Pay')}}</button>

      <button type="button" class="btn btn-sm btn-light" data-dismiss="modal">{{translate('Cancel')}}</button>

    </div>

</form>