{% extends 'OfficeBrainCustomBundleThemeBundle:'~ app.request.get('project_setting').instance_theme ~':ContactUs/contactContentGuestLayout.html.twig'%}

{% block bread_crumb_after_home %}
       <li><strong>{{ 'cms.front.contact.bread_crumb' | trans }}</strong></li>
{% endblock bread_crumb_after_home %}

{% block page_main_content %}

{% set ob_city_dropdown = ob_project_setting['configuration_rule']['site_management']['option']['address']['option']['city']['option']['dropdown']['status'] %}
{% set ob_city_textbox = ob_project_setting['configuration_rule']['site_management']['option']['address']['option']['city']['option']['textbox']['status'] %}  
{% set ob_state_dropdown = ob_project_setting['configuration_rule']['site_management']['option']['address']['option']['state']['option']['dropdown']['status'] %}
{% set ob_state_textbox = ob_project_setting['configuration_rule']['site_management']['option']['address']['option']['state']['option']['textbox']['status'] %}
{% set ob_country_dropdown = ob_project_setting['configuration_rule']['site_management']['option']['address']['option']['country']['option']['dropdown']['status'] %}
{% set ob_country_textbox = ob_project_setting['configuration_rule']['site_management']['option']['address']['option']['country']['option']['textbox']['status'] %}

			         <form action="{{ path('office_brain_cmsbundle_contactus_postcontact')}}" method="post" id="contact_us_add" novalidate>
			              <div class="ob-contact-form-block">
			                 <div class="sub-form-box contact-us">
			                 {{ form_errors(contactUs) }}
                                <h2>How Can We Reach You?</h2>
                                     <div class="row">
                                        <div class="col-md-6 col-lg-6 col-sm-6 col-xs-12">
                                            <div class="form-group">
                                                  {% block name_block %}{% endblock name_block %}
                                            </div>
                                         </div>
                                         <div class="col-md-6 col-lg-6 col-sm-6 col-xs-12">
                                            <div class="form-group">
                                                {% block last_name_block %}{% endblock last_name_block %}
                                            </div>
                                         </div>
                                         <div class="col-md-12 col-lg-12 col-sm-12 col-xs-12">
                                            <div class="form-group">
                                                 {% block company_block %}{% endblock company_block %}
                                            </div>
                                        </div>
                                        <div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
                                            <div class="form-group">
                                                {% block street1_block %}{% endblock street1_block %}
                                            </div>
                                       </div>
                                       <div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
                                            <div class="form-group">
                                                {% block street2_block %}{% endblock street2_block %}
                                            </div>
                                       </div>
                                       <div class="clearfix"></div>
                                      {% if ob_city_dropdown %}
                                       <div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
                                            <div class="form-group inp-parts">
                                                {% block city_block %}{% endblock city_block %}
                                            </div>
                                      </div>
										{% endif %}
										{% if ob_city_textbox %}
										<div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
											<div class="form-group">
												{% block cityname_block %}{% endblock cityname_block %}
											</div>
										</div>
										{% endif %}
                                       
                                      {% if ob_country_textbox %}
                                            <div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
    											<div class="form-group">
    												{% block countryname_block %}{% endblock countryname_block %}
    											</div>
    										</div>
                                      {% elseif ob_country_dropdown %}
                                            <div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
                                                <div class="form-group inp-parts">
                                                    {% block country_block %}{% endblock country_block %}
                                                </div>
                                            </div>
                                      {% endif %}
                                      
                                      <div class="clearfix"></div>
                                      
										
										{% if ob_state_textbox %}
                                            <div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
    											<div class="form-group">
    												{% block statename_block %}{% endblock statename_block %}
    											</div>
    										</div>
                                        {% elseif ob_state_dropdown %}
                                            <div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
                                                <div class="form-group inp-parts">
                                                    {% block state_block %}{% endblock state_block %}
                                                </div>
                                            </div>
                                        {% endif %} 
										      
										<div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
                                            <div class="form-group">
                                                {% block zipcode_block %}{% endblock zipcode_block %}
                                            </div>
                                       </div>
                                       <div class="clearfix"></div>
                                       <div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
                                            <div class="form-group">
                                                {% block email_block %}{% endblock email_block %}
                                            </div>
                                       </div>
                                        <div class="col-md-6 col-lg-6 col-sm-12 col-xs-12">
                                            <div class="form-group">
                                                {% block phone_block %}{% endblock phone_block %}
                                            </div>
                                      </div>
                                 </div>
                                  <h2>Have you purchased from I.D. Me Promotions before?</h2>
    							<div class="col-sm-12">
    							{% block distributor_purchase_block %}
    							{% endblock distributor_purchase_block %}
    								
    							</div>
    							<div class="clearfix"></div>
    							<h2>How May We Help You?</h2>
    							<div class="row">
    								<div class="col-md-12 col-lg-12 col-sm-12 col-xs-12">
    									<div class="form-group">
    
    									 {% block subject_block %}{% endblock subject_block %}
    
    									</div>
    								</div>
    								<div class="col-md-12 col-lg-12 col-sm-12 col-xs-12">
                                         <div class="form-group">
    									   {% block message_block %}{% endblock message_block %}
    									 </div>
    								</div>
    							</div>
                                <div class="col-sm-12 row">
                                <div class="form-group">
                                  <div class="g-recaptcha" data-sitekey="6LdFSNYjAAAAAOygzOAbwDOOQPQaF5drYZ_cYJH-"></div>
                                 </div>
                            </div>

						     </div>
						 </div>
							<div class="hide">
								{{ form_rest(contactUs, {'display': 'hidden'}) }}
							</div>
                            						 <div class="btn-box-main ob-btn-reg-block">
                             <input type=submit value="{{ 'contact_us.button.label'|trans }}" class="btn btn-default">
                            {#} <input type="reset" value="{{ 'reset'|trans({},'goldstar') }}" class="btn btn-default js-reset-btn" />{#}
                         </div>
                            <div class="col-sm-12 col-md-12 col-lg-12 col-xs-12 text-center margin-top-15">
                                 <span class="required-field">* {{ 'cms.front.contact.required_fields'|trans }}</span>
                            </div>
			             
			         </form>
          </div> 
<script type="text/javascript">
/*$(document).ready(function(){
	$(".js-city").chosen();
	var city = "{{ 'contact_us.city.tooltip'|trans }}";
	var pr = $(".js-city").parent();
	$(".chosen-container", pr).tooltip({
	    placement: "bottom"
	}).attr('data-original-title', city);
});*/

</script> 
<script src='https://www.google.com/recaptcha/api.js' async defer></script>             
{% endblock page_main_content %}