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

{% block seo_meta_title %}
	Distributor Registration | Become an Authorized Partner Today
{% endblock seo_meta_title %}

{% block seo_meta_description %}
	Register as an official distributor and get access to exclusive pricing, products, and support. Join our growing partner network today.
{% endblock seo_meta_description %}

{% block 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'] %}

	<div class="container">
		<div class="innerpage">
       		{% embed 'OfficeBrainCustomBundleThemeBundle:IdmeTheme:BaseUIElements/breadCrumb.html.twig' %}
				{% block bread_crumb_after_home %} <li><strong>{{ 'user.register.breadcrumb_heading'|trans }}</strong></li>{% endblock bread_crumb_after_home %}
			{% endembed %}
    		<h1 class="main-title register"><i class="fa fa-user"></i> {{ 'user.register.page_heading'|trans }}</h1>
        	<div class="row js-get-form">
        		<!-- SUBMIT FORM -->
        		<div class="ob-personal-info-mian-block">
						{{ form_start(form_user, { 'action': path('office_brain_userbundle_sign_up_register_post'), 'attr': {'novalidate':'true','id':'register_user', 'class': 'pfah-form'}}) }}
    					<div class="col-sm-12 col-md-12 col-lg-12 col-xs-12">
    							<div class="ob-personal-info-block">
                        			<div class="sub-form-box">
                            			<h2>{{ 'user.register.personal_info_heading'|trans }}</h2>
                            			<div class="row">
                                			{% if form_fields.fields.firstName.main == 1 %}
	                                			<div class="col-sm-6 col-xs-12">
	                                				<div class="form-group">
                                						{#{{ form_label(form_user.firstName, 'user.firstName.label'|trans({},'validators')) }}{% if 'firstName' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
		                                    			{% block first_name %}{% endblock first_name %}
	                                    			</div>
	                                			</div>
                                			{% endif %}

                                			{% if form_fields.fields.lastName.main == 1 %}
                                				<div class="col-sm-6 col-xs-12">
                                					<div class="form-group">
                                						{#{{ form_label(form_user.lastName, 'user.lastName.label'|trans({},'validators')) }}{% if 'lastName' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
	                                    				{% block last_name %}{% endblock last_name %}
                                    				</div>
                                				</div>
                                			{% endif %}

                                			{% if form_fields.fields.email.main == 1 %}
				                                <div class="col-sm-12 col-xs-12">
				                                	<div class="form-group">
                                						{# {{ form_label(form_user.email, 'user.email.label'|trans({},'validators')~' (ex. abc123@yahoo.com)') }}{% if 'email' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
					                                    {% block email %}{% endblock email %}
				                                    </div>
				                                    {% set login_link = '' %}
				                                    {% for key, value in registration_form %}
										            	{%  if key=='supplier' and value == 1 %}
										            		{% set login_link = path('office_brain_userbundle_sign_up_supplier_registration') %}
										            	{% elseif key=='distributor' and value == 1 %}
										            		{% set login_link = path('office_brain_userbundle_sign_up_distributor_registration') %}
										            	{% elseif key=='end_user' and value == 1 %}
										            		{% set login_link = path('office_brain_userbundle_sign_up_register') %}
										            	{% endif %}
										            {% endfor %}
				                                    <div class="login-inline">{{ 'user.register.account_exists'|trans }} <a href="{{ path('office_brain_userbundle_login_login') }}"> {{ 'user.register.login_link'|trans }}</a></div>
				                                </div>
			                                {% endif %}

         {#}                       			{% if form_fields.fields.middleName.main == 1 %}
                                				<div class="col-sm-6 col-xs-12">
                                					<div class="form-group">
                                						{{ form_label(form_user.middleName, 'user.middleName.label'|trans({},'validators')) }}{% if 'middleName' in form_fields.validations %}<span class="red">*</span>{% endif %}
                                						{% block middle_name %}{% endblock middle_name %}
                                    				</div>
                                				</div>
                                			{% endif %}
		#}
                            			</div>
	     {#}                       		<div class="row">
                                			{% if form_fields.fields.lastName.main == 1 %}
                                				<div class="col-sm-6 col-xs-12">
                                					<div class="form-group">
                                						{{ form_label(form_user.lastName, 'user.lastName.label'|trans({},'validators')) }}{% if 'lastName' in form_fields.validations %}<span class="red">*</span>{% endif %}
	                                    				{% block last_name %}{% endblock last_name %}
                                    				</div>
                                				</div>
                                			{% endif %}

                                			{% if form_fields.fields.gender.main == 1 %}
                                				<div class="col-sm-6 col-xs-12">
                                					<div class="form-group inp-parts">
                                						{{ form_label(form_user.gender, 'user.gender.label'|trans({},'validators')) }}{% if 'gender' in form_fields.validations %}<span class="red">*</span>{% endif %}
                                        				{% block gender %}{% endblock gender %}
                                    				</div>
                                				</div>
                                			{% endif %}
                            			</div>
		#}

                         			</div>
    							</div>

			    				<div class="ob-personal-info-block">
			                       <div class="sub-form-box">
			                        <h2>{{ 'user.register.login_heading'|trans }}</h2>
			                        	<div class="row">
			                                {% if form_fields.fields.username.main == 1 %}
			                                <div class="col-sm-6 col-xs-12">
			                                	<div class="form-group">
			                                		{{ form_label(form_user.loginUsername, 'user.username.label'|trans({},'validators')) }}{% if 'username' in form_fields.validations %}<span class="red">*</span>{% endif %}
				                                    {% block user_name %}{% endblock user_name %}
			                                    </div>
			                                </div>
			                                {% endif %}
			                        	</div>
			                        	<div class="row">
			                               {% if form_fields.fields.password.main == 1 %}
			                                	<div class="col-sm-6 col-xs-12">
			                                		<div class="form-group">
			                               				{#{{ form_label(form_user.password.first, 'user.password.label.first'|trans({},'validators')) }}{% if 'password' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
				                                    	{% block password_first %}{% endblock password_first %}
			                                    	</div>
			                                	</div>
			                                	<div class="col-sm-6 col-xs-12">
			                                		<div class="form-group">
				                                    	{#{{ form_label(form_user.password.second, 'user.password.label.second'|trans({},'validators')) }}{% if 'password' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
				                                    	{% block password_second %}{% endblock password_second %}
			                                    	</div>
			                                	</div>
			                               	{% endif %}
			                        	</div>
			                        	<div class="row">
	                            			{% if form_fields.fields.jobTitle.main == 1 %}
	                                			<div class="col-sm-6 col-xs-12">
	                                				<div class="form-group">
	                                					{{ form_label(form_user.jobTitle, 'user.jobTitle.label'|trans({},'validators')) }}{% if 'jobTitle' in form_fields.validations %}<span class="red">*</span>{% endif %}
		                                    			{% block job_title %}{% endblock job_title %}
	                                    			</div>
	                                			</div>
                                			{% endif %}
                                			{% if form_fields.fields.userCompany.main == 1 %}
                                				<div class="col-sm-6 col-xs-12" style="display: none;">
                                					<div class="form-group inp-parts">
                                					 	{{ form_label(form_user.userCompany, 'user.userCompany.label'|trans({},'validators')) }}{% if 'userCompany' in form_fields.validations %}<span class="red">*</span>{% endif %}
														{% block user_company %}{% endblock user_company %}
                                    				</div>
                                				</div>
                                			{% endif %}
                            			</div>
			                     	</div>
			    				</div>
			    				{% if form_fields.fields.companyNumber.main == 1 %}
			                		<div class="ob-contact-user">
			                    		<div class="sub-form-box">
			                            	<div class="radio" style="display:none">
 			                                	<label class="tab-label">
													<input type="radio" id="CompanyUser" value="ob_user_isCompany"  name="is_company" {% if form_user.isCompany.vars.value == 1 %}checked="checked"{% endif %}>
													<label for="CompanyUser" class="label-for-check">
			                                			{{ 'user.user.company'|trans({},'validators') }}
			                                		</label>
 			                                	</label>
			                            	</div>
{#			                                <div class="radio">
 			                                	<label class="tab-label">
												<input type="radio" id="PersonalUser" {% if form_user.isCompany.vars.value != 1 %}checked="checked"{% endif %}  value="ob_user_isIndividual" name="is_company">
													<label for="PersonalUser" class="label-for-check">
			                                    		{{ 'user.user.personal'|trans({},'validators') }}
			                                    	</label>
 			                                	</label>
			                            	</div>#}
			                            	<div class="clearfix"></div>
			                        		<div class="row">
			                        			<div class="col-xs-12">
				                            		{% if form_fields.fields.companyNumber.main == 1 %}
				                            			<div id="is_company_ob_user_isCompany" {% if form_user.isCompany.vars.value!= 1 %}style="display:none;"{% endif %} class="form-group tab-marging radio-form">
				                            	    		<div class="col-sm-6 col-xs-12">
 				                                    			<div class="form-group" >
				                                    				{{ form_label(form_user.companyNumber, 'user.companyNumber.label'|trans({},'validators')) }}{% if 'companyNumber' in form_fields.validations %}<span class="red">*</span>{% endif %}
				                                    				{% block company_number %}{% endblock company_number %}
 				                                    			</div>
				                                    		</div>
{# 				                                    		<div class="col-sm-6 col-xs-12">#}
{# 				                                    			<div class="form-group">#}
				                      {#}              				{{ form_label(form_user.companyName, 'user.companyName.label'|trans({},'validators')) }}{% if 'companyName' in form_fields.validations %}<span class="red">*</span>{% endif %}
				                                    				{% block company_name %}{% endblock company_name %}
				                      #}
{# 				                                    			</div>#}
{# 				                                    		</div>#}
				                                		</div>
				                                		<div class="clearfix"></div>
				                            		{% endif %}
				                            	</div>
											</div>
			                        	</div>
			                    	</div>
			               	{% endif %}
                </div>
                <div class="col-sm-12 col-md-12 col-lg-12 col-xs-12">
                	<div class="ob-contact-info-block ob-contact-user">
                    	<div class="sub-form-box">
                        	<h2>{{ 'user.register.contact_info_heading'|trans }}</h2>

                        	{% block contact_info_type %}{% endblock contact_info_type %}

{#                         	<label class="tab-label"><input type="radio" name="billing" value="1" aria-label="Billing to this address" checked="checked">#}
{#                                 Business </label>#}
{#                             <label class="tab-label"><input type="radio" name="billing" value="2" aria-label="Billing to this address">#}
{#                                 Residential</label>    #}
                        	<div class="row">
                        		{% if form_fields.fields.companyName.main == 1 %}
	                            	<div class="col-sm-12 col-xs-12 col-lg-12 col-md-12">
				                    	<div class="form-group">
                        					{# {{ form_label(form_user.companyName, 'user.companyName.label'|trans({},'validators')) }}{% if 'companyName' in form_fields.validations %}<span class="red">*</span>{% endif %} #}
				                            {% block company_name %}{% endblock company_name %}
										</div>
									</div>
								{% endif %}
								{% if form_fields.fields.street1.main == 1 %}
                                	<div class="col-sm-8 col-xs-12 col-lg-8 col-md-8">
                                		<div class="form-group">
											{# {{ form_label(form_user.street1, 'user.street1.label'|trans({},'validators')) }}{% if 'street1' in form_fields.validations %}<span class="red">*</span>{% endif %} #}
	                                    	{% block street_1 %}{% endblock street_1 %}
                                    	</div>
                                	</div>
                               	{% endif %}
                                {% if form_fields.fields.street2.main == 1 %}
                                	<div class="col-sm-4 col-xs-12 col-lg-4 col-md-4">
                                		<div class="form-group">
                                			{# {{ form_label(form_user.street2, 'user.street2.label'|trans({},'validators')) }}{% if 'street2' in form_fields.validations %}<span class="red">*</span>{% endif %} #}
	                                    	{% block street_2 %}{% endblock street_2 %}
                                    	</div>
                                	</div>
                                {% endif %}
                                {% if ob_city_dropdown %}
	                                {% if form_fields.fields.cityId.main == 1 %}
	                                	<div class="col-sm-12 col-xs-12">
	                                		<div class="form-group inp-parts">
	{# 	                                    	{{ form_label(form_user.cityId, 'user.cityId.label'|trans({},'validators')) }}{% if 'cityId' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
		                                    	{% block city_id %}{% endblock city_id %}
	                                    	</div>
	                                	</div>
	                                {% endif %}
                                {% endif %}

                                {% if ob_city_textbox %}
	                                {% if form_fields.fields.cityName.main == 1 %}
	                                	<div class="col-sm-12 col-xs-12">
	                                		<div class="form-group">
		                                    	{% block city_name %}{% endblock city_name %}
	                                    	</div>
	                                	</div>
	                                {% endif %}
                                {% endif %}


                                	{% if form_fields.fields.countryId.main == 1 %}
    	                                <div class="col-sm-4 col-xs-12">
        	                            	<div class="form-group inp-parts">
    {# 											{{ form_label(form_user.countryId, 'user.countryId.label'|trans({},'validators')) }}{% if 'countryId' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
    											{% block country_id %}{% endblock country_id %}
                                        	</div>
                                 
                                    	</div>
                                {% endif %}

                                    {% if form_fields.fields.stateId.main == 1 %}
                                    	<div class="col-sm-4 col-xs-12">
                                    		<div class="form-group inp-parts">
    {# 	                                    	{{ form_label(form_user.stateId, 'user.stateId.label'|trans({},'validators')) }}{% if 'stateId' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
    	                                    	{% block state_id %}{% endblock state_id %}
                                        	</div>
                                        	
                                    	</div>
                                {% endif %}


                                {% if form_fields.fields.zipcode.main == 1 %}
                                	<div class="col-sm-4 col-xs-12">
                                		<div class="form-group js-zipcode-validate">
{# 	                                    	{{ form_label(form_user.zipcode, 'user.zipcode.label'|trans({},'validators')) }}{% if 'zipcode' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
	                                    	{% block zip_id %}{% endblock zip_id %}
                                    	</div>
                                	</div>
                                {% endif %}
                                {% if form_fields.fields.phone.main == 1 %}
                                	<div class="col-sm-12 col-xs-12">
                                		<div class="form-group">
{# 	                                    	{{ form_label(form_user.phone, 'user.phone.label'|trans({},'validators')) }}{% if 'phone' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
	                                    	{% block phone %}{% endblock phone %}
                                    	</div>
                                	</div>
                                {% endif %}
                                <div class="clearfix"></div>
                                {% if form_fields.fields.mobile.main == 1 %}
                                	<div class="col-sm-6 col-xs-12">
                                		<div class="form-group">
	                                    	{{ form_label(form_user.mobile, 'user.mobile.label'|trans({},'validators')) }}{% if 'mobile' in form_fields.validations %}<span class="red">*</span>{% endif %}
	                                    	{% block mobile %}{% endblock mobile %}
                                    	</div>
                                	</div>
                                {% endif %}
                                {% if form_fields.fields.fax.main == 1 %}
                                	<div class="col-sm-6 col-xs-12">
                                		<div class="form-group">
	                                    	{{ form_label(form_user.fax, 'user.fax.label'|trans({},'validators')) }}{% if 'fax' in form_fields.validations %}<span class="red">*</span>{% endif %}
	                                    	{% block fax %}{% endblock fax %}
                                    	</div>
                                	</div>
                                {% endif %}
                                {% if form_fields.fields.website.main == 1 %}
                                	<div class="col-sm-6 col-xs-12">
                                		<div class="form-group">
	                                    	{{ form_label(form_user.website, 'user.website.label'|trans({},'validators')) }}{% if 'website' in form_fields.validations %}<span class="red">*</span>{% endif %}
	                                    	{% block website %}{% endblock website %}
                                    	</div>
                                	</div>
                                {% endif %}
{#                                 <div class="col-sm-6 col-xs-12">#}
{#                                 	<div class="check-box-privacy">#}
{#     					  				<div class="checkbox check-block">#}
{#     					  					<input type="checkbox" id="checkbox-bill"  name="billing_address" value="1" tabindex="16" />#}
{# 											<label for="checkbox-bill">{{ 'user.address.billing'|trans({},'validators') }}</label>#}
{# 											{% block billing_address_check_box %}{% endblock billing_address_check_box %}										#}
{#     				                    </div>#}
{#     					  			</div>#}
{#                                 </div>#}
{#                                 <div class="col-sm-6 col-xs-12">#}
{#                                 	<div class="check-box-privacy">#}
{#     					  				<div class="checkbox check-block">#}
{#     				                        <input type="checkbox" id="checkbox-address" name="shipping_address" value="2" tabindex="16" />#}
{# 											<label for="checkbox-address">{{ 'user.address.shipping'|trans({},'validators') }}</label>#}
{#     				                        {% block shipping_address_check_box %}{% endblock shipping_address_check_box %}#}
{#     				                    </div>#}
{#     					  			</div>#}
{#                                 </div>#}
                        	</div>
                     	</div>
                	</div>
             	</div>
             	<div class="clearfix"></div>
                {% if form_fields.fields.locatedDistributorId.main == 1 %}
                	<div class="col-lg-6 col-sm-6 col-md-6 col-xs-12">
						<div class="ob-select-distributer">
                        	<div class="sub-form-box">
                            	<div class="row">
                            		<div class="col-lg-12">
                            			<label class="tab-label">{{ 'user.register.select_pref_dist'|trans }}</label>
                            		</div>
                            		<div class="clearfix"></div>
                                	<div class="col-sm-6 col-xs-12">
                                		<div class="form-group inp-parts">
                                        	<label for="distributor_state" class="checkout-label">{{ 'user.state.label'|trans({},'validators') }}</label>
                                        	<select name="distributor_state" id="distributor_state" class="custom-select js-distributor-state" data-placement="top" data-toggle="tooltip">
{#                                         		<option value="">{{ 'user.state.label'|trans({},'validators') }}</option>#}
                                            	{% block distributor_state %}{% endblock distributor_state %}
                                        	</select>
                                    	</div>
                                	</div>
                                	<div class="col-sm-6 col-xs-12">
                                    	<div class="form-group inp-parts">
                                        <label for="locate_distributor" class="checkout-label">{{ 'user.locatedDistributorId.label'|trans({},'validators') }}{% if 'locatedDistributorId' in form_fields.validations %}<span class="red">*</span>{% endif %}</label>
                                        	<select name="locate_distributor" id="locate_distributor" class="custom-select js-locate-distributor" data-placement="top" data-toggle="tooltip">
                                            	<option data-state="default" value="">{{ 'user.locatedDistributorId.label'|trans({},'validators') }}</option>
                                            	{% block locate_distributor %}{% endblock locate_distributor %}
                                        	</select>
                                    	</div>
                                	</div>
                            	</div>
                        	</div>
                		</div>
	  				</div>
	  			{% endif %}
	  			<div class="col-sm-12 col-md-12 col-lg-12 col-xs-12 hide">
	  				<div class="ob-membership-info">
	  					<div class="sub-form-box">
	  						<h2>{{ 'user.register.member_info'|trans }}</h2>
	  						<p>{{ 'user.register.member_info_text'|trans }} <a href="{{ url("office_brain_cmsbundle_contactus_contact") }}">{{ 'user.register.click_link'|trans }}.</a></p>
{# 	  						<div class="form-group">#}
{# 								<label class="required" for="membershipinfo">Enter Atleast one fields</label>#}
{# 							</div>#}
	  						<ul>
{# 	  							{% if form_fields.fields.membershipNumber1.main == 1 %}#}
                                	<li>
                                		<div class="form-group">
                                			<label class="tab-label">
                                				<input type="radio" class="js-radio-value" name="billing" value="1" aria-label="Billing to this address" checked="checked"> {{ 'user.membershipNumber1.label'|trans({},'validators') }}
                                			</label>
{# 	                                    	{{ form_label(form_user.membershipNumber1, 'user.membershipNumber1.label'|trans({},'validators')) }}{% if 'membershipNumber1' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
{# 	                                    	{% block membership_number_1 %}{% endblock membership_number_1 %}#}
                                    	</div>
                                	</li>
{#                                 {% endif %}#}
{#                                 {% if form_fields.fields.membershipNumber2.main == 1 %}#}
                                	<li>
                                		<div class="form-group">
                                			<label class="tab-label">
                                				<input type="radio" class="js-radio-value" name="billing" value="2" aria-label="Billing to this address" checked="checked"> {{ 'user.membershipNumber2.label'|trans({},'validators') }}
                                			</label>
{# 	                                    	{{ form_label(form_user.membershipNumber2, 'user.membershipNumber2.label'|trans({},'validators')) }}{% if 'membershipNumber2' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
{# 	                                    	{% block membership_number_2 %}{% endblock membership_number_2 %}#}
                                    	</div>
                                	</li>
{#                                 {% endif %}#}
{#                                 {% if form_fields.fields.membershipNumber3.main == 1 %}#}
                                	<li>
                                		<div class="form-group">
                                			<label class="tab-label">
                                				<input type="radio" class="js-radio-value" name="billing" value="3" aria-label="Billing to this address" checked="checked"> {{ 'user.membershipNumber3.label'|trans({},'validators') }}
                                			</label>
{# 	                                    	{{ form_label(form_user.membershipNumber3, 'user.membershipNumber3.label'|trans({},'validators')) }}{% if 'membershipNumber3' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
{# 	                                    	{% block membership_number_3 %}{% endblock membership_number_3 %}#}
                                    	</div>
                                	</li>
{#                                 {% endif %}#}
{#                                 {% if form_fields.fields.membershipNumber4.main == 1 %}#}
                                	<li>
                                		<div class="form-group">
                                			<label class="tab-label">
                                				<input type="radio" class="js-radio-value" name="billing" value="4" aria-label="Billing to this address" checked="checked"> {{ 'user.membershipNumber4.label'|trans({},'validators') }}
                                			</label>
{# 	                                    	{{ form_label(form_user.membershipNumber4, 'user.membershipNumber4.label'|trans({},'validators')) }}{% if 'membershipNumber4' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
{# 	                                    	{% block membership_number_4 %}{% endblock membership_number_4 %}#}
                                    	</div>
                                	</li>
{#                                 {% endif %}#}
{#                                 {% if form_fields.fields.membershipNumber5.main == 1 %}#}
                                	<li>
                                		<div class="form-group">
                                			<label class="tab-label">
                                				<input type="radio" class="js-radio-value" name="billing" value="5" aria-label="Billing to this address" checked="checked"> {{ 'user.membershipNumber5.label'|trans({},'validators') }}
                                			</label>
{# 	                                    	{{ form_label(form_user.membershipNumber5, 'user.membershipNumber5.label'|trans({},'validators')) }}{% if 'membershipNumber5' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
{# 	                                    	{% block membership_number_5 %}{% endblock membership_number_5 %}#}
                                    	</div>
                                	</li>
{#                                 {% endif %}#}
{#                                 {% if form_fields.fields.membershipNumber6.main == 1 %}#}
                                	<li>
                                		<div class="form-group">
                                			<label class="tab-label">
                                 				<input type="radio" class="js-radio-value" name="billing" value="6" aria-label="Billing to this address" checked="checked"> {# {{ 'user.membershipNumber6.label'|trans({},'validators') }} #} Distributor Central
                                			</label>
{# 	                                    	{{ form_label(form_user.membershipNumber6, 'user.membershipNumber6.label'|trans({},'validators')) }}{% if 'membershipNumber6' in form_fields.validations %}<span class="red">*</span>{% endif %}#}
{# 	                                    	{% block membership_number_6 %}{% endblock membership_number_6 %}#}
                                    	</div>
                                	</li>
{#                                 {% endif %}#}
									<li>
		  								<div class="form-group">
		                                   <label class="tab-label"><input type="radio" name="billing" value="7" aria-label="Billing to this address" checked="checked"> Other </label>
	                                    </div>
                                    </li>
                           	</ul>
                           	<div class="clearfix"></div>
							<div class="row">
                                {% if form_fields.fields.obCustomerId.main == 1 %}
                                	<div class="col-sm-3 col-md-3 col-lg-3 col-xs-12">
                                    	<div class="form-group">
                                        	{{ form_label(form_user.obCustomerId, 'user.obCustomerId.label'|trans({},'validators')) }}{% if 'obCustomerId' in form_fields.validations %}<span class="red">*</span>{% endif %}
                                        	{% block ob_customer_id %}{% endblock ob_customer_id %}
                                    	</div>
                                	</div>
                                {% endif %}
                           	</div>
						</div>
						<div class="col-sm-6 col-xs-12 col-lg-4 col-md-4 padding-left-0">
							<div class="form-group">
								<input type="text" name="membership_id" id="ob_user_membership_id" placeholder="* Membership ID#" class="input" tabindex="9" data-toggle="tooltip" data-placement="bottom" title="" data-original-title=""  required="required" value="{%if membership_value is defined and membership_value != '' %}{{ membership_value }}{% else %}{{'00001'}}{% endif %}">
								{% if membership_value is defined and membership_value == '' %}
								<ul><li style="display:block;">Enter Membership ID</li></ul>
								{% endif %}
                            </div>
						</div>
					</div>
				</div>
{# 	  			<div class="col-sm-12 col-md-12 col-lg-12 col-xs-12">#}
{# 	               <span class="required-field">* {{ 'req_fields'|trans({},'app') }}</span>#}
{# 	            </div>#}

                            		{#}<div class="col-sm-12 col-md-12 col-lg-12 col-xs-12">
                                		<div class="form-group">
											{% block captcha %}{% endblock captcha %}
                                    	</div>
   									</div>{#}

	  			{% if form_fields.fields.newslettersUnsubscription.main == 1 %}
	  				<div class="col-sm-12 col-md-12 col-lg-12 col-xs-12">
		  				<div class="check-box-privacy">
		  					<div class="checkbox check-block">
								{% block newsletters_subscription %}{% endblock newsletters_subscription %}
								{{ form_label(form_user.newslettersUnsubscription, 'user.register.newsletter_text'|trans({},'validators')) }}
	                    	</div>
		  				</div>
	  				</div>
	  			{% endif %}
	            <div class="clearfix"></div>

	            <div class="col-sm-12 col-md-12 col-lg-12 col-xs-12">
	        		<div class="btn-box-main ob-btn-reg-block">
	        	    	<input type="hidden" name="userType" value="{{ userType }}" />
	                	<input type="submit" value="{{ 'submit'|trans({},'app') }}" class="btn btn-default js-submit-button "/>
{# 	                	<input type="reset" class="btn btn-default js-reset-register-form" value="{{ 'reset'|trans({},'app') }}" >#}
	            	</div>
	            </div>
	            <div class="col-sm-12 col-md-12 col-lg-12 col-xs-12 text-center">
	            	<span class="required-field">* {{ 'user.contact_book.add_contact_book.required_field'|trans }} </span>
	            </div>
	            
					{{ form_rest(form_user, {'display': 'hidden'}) }}

    		{{ form_end(form_user) }}
    		</div>
    	</div>
    </div>
</div>
{% endblock main_content %}

{% block footer_js %}
    {{ parent() }}
    <script type="text/javascript" src="{{ asset(ob_project_assets_base_url ~ 'js/easyResponsiveTabs.js') }}"></script>
    {% javascripts '@OfficeBrainPageBundle/Resources/public/js/bundle/billing_block.js'
                   '@OfficeBrainUserBundle/Resources/public/js/signup.js' %}
    	<script src="{{ asset_url }}" type='text/javascript'></script>
    {% endjavascripts %}
    
    {% javascripts '@OfficeBrainUserBundle/Resources/public/js/jquery-input-mask-phone-number.js'
     %}
    	<script src="{{ asset_url }}" type='text/javascript'></script>
    {% endjavascripts %}
    <script type="text/javascript">
    	$('#ob_user_phone').usPhoneFormat({
            format: '(xxx) xxx-xxxx',
        });
    </script>

    <script type="text/javascript">
$(document).ready(function(){
  var rdVaule=$("input[name='billing']:checked").val();
	$('.js-radio-value').on('click',function(){
	rdVaule=$(this).val();
	$('#ob_user_membershipNumber'+rdVaule).val($('#ob_user_membership_id').val());
	setTimeout(function(){ $('#ob_user_membership_id').blur(); }, 1500);
	});
	$("#ob_user_membership_id").blur(function(){
  $('#ob_user_membershipNumber'+rdVaule).val($(this).val());
   });
  $('#ob_user_newslettersUnsubscription').prop('checked', true);
	$('ul li input[type=radio]').on('click', function(){
		set_membership_val();
	});
	$('#membership_id').on('change', function(){
		set_membership_val();
	});
	$('#ob_user_contactInfoType').addClass('radio');
	$('#ob_user_contactInfoType label').addClass('tab-label');
	/**For Coutry name in DB**/
	$('#ob_user_countryId').on('change', function()
	{
		if($(this).find(":selected").val() != ""){
			var selectedCountry=$(this).find(":selected").text();
			$(".js_country_name").val(selectedCountry);
		}
		else{
			$(".js_country_name").val("");
		}

	});

	$('#ob_user_stateId').on('change', function()
	{
		if($(this).find(":selected").val() != ""){
			var selectedState=$(this).find(":selected").text();
			$(".js_state_name").val(selectedState);
		}
		else{
			$(".js_state_name").val("");
		}
		//$("#ob_user_stateId option:selected").val(selectedState);

	});


});

function set_membership_val(){
	$('#ob_user_membershipNumber1').val('');
	$('#ob_user_membershipNumber2').val('');
	$('#ob_user_membershipNumber3').val('');
	$('#ob_user_membershipNumber4').val('');
	$('#ob_user_membershipNumber5').val('');
	$('#ob_user_membershipNumber6').val('');
	$('#ob_user_membershipNumber'+$('ul li input[type=radio]:checked').val()).val($('#membership_id').val());
}
</script>
{% endblock footer_js %}