Add Insurance Supervisor

Back to Supervisors

@if (session()->has('message'))

{{ session('message') }}

@endif

First Name @error('form_data.first_name')

{{ $message }}

@enderror

Last Name @error('form_data.last_name')

{{ $message }}

@enderror

Email Address

Phone Number

Username @error('form_data.username')

{{ $message }}

@enderror

Password @error('form_data.password')

{{ $message }}

@enderror

Confirm Password

Company Address

City

State

Postcode