{% extends '::baseAjax.html.twig' %}
{% block ajax_body %}
	<div class="modal-dialog">
		<div class="modal-content">
            <a aria-label="Close" data-dismiss="modal" class="close" href="javascript:void(0);">&times;</a>
			<div class="modal-header">
				<h1 class="modal-title">{{ "request_quote.your_info"|trans }} </h1>
			</div>
			<div class="modal-body">
				<div class="row">
					<div class="col-sm-12">
					    <div class="info-popup product-section-box"> 
					    <form name='guestuser' id='guestuser' method='POST' action='{{path('office_brain_orderbundle_order_processaddgguestusersubmit')}}' novalidate>
                            <div class="row">
                                <div class="col-lg-6 col-md-8 col-sm-6 col-xs-12 radiobox shipping-col">
                                    <div class="row">
                                    	<div class="col-lg-4 col-md-4 col-sm-4 col-xs-12 padding-right-0">
                                    		{{ form_label(form.firstName,"request_quote.name"|trans) }} :    
                                        </div>                                       
                                        <div class="col-lg-8 col-md-8 col-sm-8 col-xs-12 shipping-select padding-left-0 ">
	                                        <div class="form-group"> 
	                                        	{% block order_add_guest_user_fname %}
												{% endblock order_add_guest_user_fname %}
	                                        </div>	
                                        </div>
                                    </div>
                                </div>    
                                <div class="col-lg-6 col-md-8 col-sm-6 col-xs-12 radiobox shipping-col">
                                    <div class="row">
                                        <div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
                                            {{ form_label(form.phone,"request_quote.phone"|trans) }} :  
                                        </div>                                       
                                        <div class="col-lg-8 col-md-8 col-sm-8 col-xs-12 shipping-select padding-left-0">
                                           <div class="form-group"> 
                                           		{% block order_add_guest_user_form_phone %}
												{% endblock order_add_guest_user_form_phone %}
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12 radiobox shipping-col">
                                    <div class="row">
                                        <div class="col-lg-2 col-md-2 col-sm-2 col-xs-12 padding-right-0">
                                            {{ form_label(form.email,"request_quote.email"|trans) }} :   
                                        </div>                                       
                                        <div class="col-lg-10 col-md-10 col-sm-10 col-xs-12 shipping-select padding-left-0">
                                           <div class="form-group"> 
                                           	{% block order_add_guest_user_form_email %}
											{% endblock order_add_guest_user_form_email %}
                                            </div>
                                        </div>
                                    </div>
                                </div>
                                <div class="col-lg-6 col-md-8 col-sm-6 col-xs-12 radiobox shipping-col">
                                    <div class="row">
                                        <div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
                                            {{ form_label(form.companyName,"request_quote.company"|trans) }} :    
                                        </div>                                       
                                        <div class="col-lg-8 col-md-8 col-sm-8 col-xs-12 shipping-select padding-left-0">
                                          <div class="form-group"> 
												{% block order_add_guest_user_company_name %}
													{{ form_widget(form.companyName,{'attr':{'class':'input','tabindex':'1'}}) }}
												{% endblock order_add_guest_user_company_name %}
                                            </div>
                                        </div>
                                    </div>
                                </div>    
                                <div class="col-lg-6 col-md-8 col-sm-6 col-xs-12 radiobox shipping-col">
                                    <div class="row">
                                        <div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
                                            {{ form_label(form.zipcode,"request_quote.zip_code"|trans) }} :   
                                        </div>                                       
                                        <div class="col-lg-8 col-md-8 col-sm-8 col-xs-12 shipping-select padding-left-0">
                                            <div class="form-group"> 
												{% block order_add_guest_user_form_zipcode %}
												{% endblock order_add_guest_user_form_zipcode %}
                                            </div>
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class="text-center">
                            	{% block order_add_guest_user_form_submit_request %}
                            	{% endblock order_add_guest_user_form_submit_request %}
                            </div>
                            {{ form_rest(form, {'display': 'hidden'}) }}
                           </form> 
                        </div>
					</div>
				</div>	
                
			</div>
		</div>
	</div>
	
		{% block order_add_guest_user_form_jquery %}    
		{% endblock order_add_guest_user_form_jquery %}
	{% endblock ajax_body %}