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


{# {% block modal_extra_class %}print-product{% endblock modal_extra_class %} #}
{# {% block modal_header_icon %}<i class="strip email-popup-strip"></i>{% endblock modal_header_icon %}  #}
{# {% block modal_header_title %}{{ 'email.order_sample'| trans({},"app") }}{% endblock modal_header_title %} #}
{% block modal_body_content %}
<style>
.modal-content .modal-header,
.modal-content > a.close {display: none;}

</style>
	{{ form_start(form) }}
	<button type="button" class="close" data-dismiss="modal" aria-label="Close"><span aria-hidden="true">&times;</span></button>
	<div class="products-box-modal">
	  <div class="product-img-modal">
		<img src="{{ product_detail.basic_information.default_image_url }}" alt="Product image" class="img-responsive">
	  </div>
	  <div class="product-info-box-modal">
		<div class="product-info-title-modal">
		  {{ product_detail.basic_information.title }}
		</div>
		<div class="product-info-sku-modal">
		  SKU: {{ product_detail.basic_information.sku_number }}
		</div>
		<div class="product-info-drip-modal">
		  Interested in this item? Give us a call at <strong>(888)-788-0101</strong> or submit the form below!
		</div>
	  </div>
	</div>
	<div class="product-forms-modal">
	  <div class="row">
		{% if form_type == "request_sample" %}
		<div class="col-xs-12">
		  <div class="form-group">
			<label for="recipient-name" class="control-label">Select Color <span>*</span></label>
			{% block email_color %}{% endblock email_color %}
		  </div>
		</div>
		{% endif %}
		{% if product_size|length>1 %}
		<div class="col-xs-12">
		  <div class="form-group">
			<label for="recipient-name" class="control-label">Select Size <span>*</span></label>
			{% block email_size %}{% endblock email_size %}
		  </div>
		</div>
		{% endif %}
		{% set hideclass='' %}
		{% if user_data.firstName is defined %}
		{% set hideclass='hide' %}
		{% endif %}
		<div class="col-md-6 col-xs-12 {{ hideclass }}">
		  <div class="form-group">
			<label for="recipient-name" class="control-label">First Name <span>*</span></label>
			{# <input type="text" class="form-control" id=""> #}
			{% block email_first_name %}{% endblock email_first_name %}
		  </div>
		</div>
		<div class="col-md-6 col-xs-12 {{ hideclass}}">
		  <div class="form-group">
			<label for="recipient-name" class="control-label">Last Name <span>*</span></label>
			{% block email_last_name %}{% endblock email_last_name %}
		  </div>
		</div>

		<div class="col-md-6 col-xs-12 {{ hideclass }}">
		  <div class="form-group">
			<label for="recipient-name" class="control-label">Email <span>*</span></label>
			{% block email_email %}{% endblock email_email %}
		  </div>
		</div>
		<div class="col-md-6 col-xs-12 {{ hideclass }}">
		  <div class="form-group">
			<label for="recipient-name" class="control-label">Phone Number <span>*</span></label>
			{% block email_phone %}{% endblock email_phone %}
		  </div>
		</div>

		<div class="col-md-12 col-xs-12 {{ hideclass }}">
		  <div class="form-group">
			<label for="recipient-name" class="control-label">Company Name</label>
			{% block email_company_name %}{% endblock email_company_name %}
		  </div>
		</div>

		{% if form_type != "request_sample" %}
		<div class="col-md-12 col-xs-12">
		  <div class="form-group">
			<label for="recipient-name" class="control-label">Comment/Question <span>*</span></label>
			{% block email_comment %}{% endblock email_comment %}
		  </div>
		</div>
		{% endif %}
		<div class="col-md-12 col-xs-12">
			<div class="form-group">
			<div class="g-recaptcha" data-sitekey="6LdFSNYjAAAAAOygzOAbwDOOQPQaF5drYZ_cYJH-"></div>
		</div>
		</div>
		<div class="col-xs-12">
			{% if form_type != "request_sample" %}
			<input type="submit" class="btn btn-primary virtual-modal-btn js-submit-btn" value="Submit">
			{% else %}
			<input type="submit" class="btn btn-primary virtual-modal-btn js-submit-btn" value="Request Sample">
		  	{% endif %}
		</div>

		<div class="col-xs-12 normal-text">
		  Samples will be blank or with a random imprint. We reserve the right to refuse sample requests for any reason. Samples over $10 may be subject to an additional charge. Shipping charges may apply.
		</div>
	  </div>
	</div>
	{{ form_rest(form, {'display': 'hidden'}) }}
	{{ form_end(form, {'render_rest': false,'render_submit':false}) }}
<script src='https://www.google.com/recaptcha/api.js' async defer></script>
	
{% endblock modal_body_content %}