<div class="page-content">
	<div class="page-header position-relative"></div>
	<!--/.page-header-->

	<div class="row-fluid">
		<div class="span12">
			<!--PAGE CONTENT BEGINS-->

			<div class="row-fluid">
				<div class="span12">
					<div class="widget-box">
						<div class="widget-header widget-header-blue widget-header-flat">
							<h4 class="lighter">Your Account</h4>


						</div>

						<div class="widget-body">
							<div class="widget-main">
								<div class="row-fluid">


									<div class="step-content row-fluid position-relative"
										id="step-container">
										<div class="step-pane active">

											<form class="form-horizontal" method="post" action=""
												enctype="multipart/form-data">

												<div class="control-group">
													<label class="control-label">Name Of Employee</label>
													<div class="controls">
														<input type="text" name="attendence[name]"
															value="<?php echo $name[0];?>">
													</div>
													<!-- /controls -->
												</div>
												<!-- /control-group -->

												<br>

												<div class="control-group">
													<label class="control-label">Type Of Leave</label>
													<div class="controls">

														<div class="span2">
															<input name="attendence[radio]" value="casual"
																type="radio"> <span class="lbl">Casual Leave</span>
														</div>

														<div class="span2">
															<input name="attendence[radio]" value="sick" type="radio">
															<span class="lbl">Sick Leave</span>
														</div>

														<div class="span2">
															<input name="attendence[radio]" value="maternity"
																type="radio"> <span class="lbl">Maternity Leave</span>
														</div>

														<div class="span2">
															<input name="attendence[radio]" value="other"
																type="radio"> <span class="lbl">other Leave</span>
														</div>
													</div>
													<!-- /controls -->
												</div>
												<!-- /control-group -->

												<br>
												<div class="control-group">
													<label class="control-label">Range Of Leave</label>
													<div class="controls">

														<div class="span2">
															<input name="attendence[firsthalf]" value="first"
																class="ace-checkbox-2" type="checkbox"> <span
																class="lbl"> First Half Leave</span>
														</div>

														<div class="span2">
															<input name="attendence[secondhalf]" value="second"
																class="ace-checkbox-2" type="checkbox"> <span
																class="lbl"> Second Half Leave</span>
														</div>

														<div class="span2">
															<input name="attendence[fullday]" value="full"
																class="ace-checkbox-2" type="checkbox"> <span
																class="lbl">Full Day Leave(s)</span>
														</div>

													</div>
													<!-- /controls -->
												</div>
												<!-- /control-group -->

												<br>
												<div class="control-group">
													<label class="control-label">Date Form:</label>
													<div class="controls">

														<input class="span4" type="text"
															name="attendence[mixdate]" id="id-date-range-picker-1" />
														<span class="add-on"> <i class="icon-calendar"></i>
														</span>


													</div>
													<!-- /controls -->
												</div>
												<!-- /control-group -->

												<br>

												<div class="control-group">
													<label class="control-label">Application Attachment</label>
													<div class="controls">
														<p>
															<input type="file" size="32" name="my_field[]" value="" />
														</p>


													</div>
												</div>

												<div class="control-group">

													<div class="controls">
														<span class="span12"> <input type="hidden" name="check"
															value="attendence"> <input type="hidden" name="action"
															value="multiple" />
															<button type="submit" name="submit"
																class="btn btn-small btn-primary">Save</button>
														</span>
													</div>
												</div>

											</form>


										</div>
									</div>



								</div>
							</div>
							<!--/widget-main-->
						</div>
						<!--/widget-body-->
					</div>
				</div>
			</div>

			<!--PAGE CONTENT ENDS-->
		</div>
		<!--/.span-->
	</div>
	<!--/.row-fluid-->
</div>
<!--/.page-content-->


</div>
<!--/.main-content-->