{% extends app.request.get('project_setting').instance_theme_path~':'~ app.request.get('project_setting').instance_theme ~':User/SignUp/registerLayout.html.twig' %}

{% block first_name %}
	{{ form_widget(form_user.firstName,{'attr':{'class':'input','data-original-title': 'user.firstName.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.firstName) }}
{% endblock first_name %}

{% block middle_name %}
	{{ form_widget(form_user.middleName,{'attr':{'class':'input','data-original-title': 'user.middleName.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.middleName) }}
{% endblock middle_name  %}

{% block last_name %}
	{{ form_widget(form_user.lastName,{'attr':{'class':'input','data-original-title': 'user.lastName.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.lastName) }}
{% endblock last_name  %}

{% block gender %}
	{{ form_widget(form_user.gender,{'placeholder': 'user.gender.select'|trans({},'validators'), 'empty_data':'','attr':{'class':'custom-select','data-original-title': 'user.gender.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.gender) }}
{% endblock gender %}

{% block user_company %}
	{{ form_widget(form_user.userCompany,{'placeholder': 'user.userCompany.select'|trans({},'validators'), 'empty_data':'','attr':{'class':'custom-select','data-original-title': 'user.userCompany.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.userCompany) }}
{% endblock user_company %}

{% block job_title %}
	{{ form_widget(form_user.jobTitle,{'attr':{'class':'input','data-original-title': 'user.jobTitle.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.jobTitle) }}
{% endblock job_title %}

{% block email %}
	{{ form_widget(form_user.email,{'attr':{'class':'input','data-original-title': 'user.email.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.email) }}
{% endblock email %}

{% block user_name %}
	{{ form_widget(form_user.loginUsername,{'attr':{'class':'input','data-original-title': 'user.username.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.loginUsername) }}
{% endblock user_name %}

{% block password_first %}
	{{ form_widget(form_user.password.first,{'attr':{'class':'input','data-original-title': 'user.password.label.first'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.password.first) }}
{% endblock password_first %}

{% block password_second %}
	{{ form_widget(form_user.password.second,{'attr':{'class':'input','data-original-title': 'user.password.label.second'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.password.second) }}
{% endblock password_second %}

{% block street_1 %}
	{{ form_widget(form_user.street1,{'attr':{'class':'input','data-original-title': 'user.street1.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.street1) }}
{% endblock street_1 %}

{% block street_2 %}
	{{ form_widget(form_user.street2,{'attr':{'class':'input','data-original-title': 'user.street2.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.street2) }}
{% endblock street_2 %}

{% block country_id %}
	{{ form_widget(form_user.countryId,{'placeholder': 'user.countryId.select'|trans({},'validators'), 'empty_data':'','attr':{'class':'custom-select js-country','data-original-title': 'user.countryId.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.countryId) }}
{% endblock country_id %}

{% block state_id %}
	{{ form_widget(form_user.stateId,{'placeholder': 'user.stateId.select'|trans({},'validators'), 'empty_data':'','attr':{'class':'custom-select  js-state','data-original-title': 'user.stateId.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.stateId) }}
{% endblock state_id %}

{% block city_id %}
	{{ form_widget(form_user.cityId,{'placeholder': 'user.cityId.select'|trans({},'validators'), 'empty_data':'','attr':{'class':'chosen-select js-city','data-original-title': 'user.cityId.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.cityId) }}
{% endblock city_id %}

{% block zip_id %}
	{{ form_widget(form_user.zipcode,{'attr':{'class':'input js-zipcode','data-original-title': 'user.zipcode.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.zipcode) }}
{% endblock zip_id %}

{% block phone %}
	{{ form_widget(form_user.phone,{'attr':{'class':'input js-phone','autocomplete':'off','data-original-title': 'user.phone.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.phone) }}
{% endblock phone %}

{% block mobile %}
	{{ form_widget(form_user.mobile,{'attr':{'class':'input js-phone','autocomplete':'off','data-original-title': 'user.mobile.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.mobile) }}
{% endblock mobile %}

{% block fax %}
	{{ form_widget(form_user.fax,{'attr':{'class':'input js-phone','autocomplete':'off','data-original-title': 'user.fax.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.fax) }}
{% endblock fax %}

{% block website %}
	{{ form_widget(form_user.website,{'attr':{'class':'input','data-original-title': 'user.website.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.website) }}
{% endblock website %}

{% block is_company %} 
	<input type="radio" value="ob_user_isCompany" name="is_company" {% if form_user.isCompany.vars.value == 1 %}checked="checked"{% endif %}>	
{% endblock is_company %}

{% block is_individual %}
	<input type="radio" {% if form_user.isCompany.vars.value != 1 %}checked="checked"{% endif %}  value="ob_user_isIndividual" name="is_company">	
{% endblock is_individual %}

{% block company_number %}
	{{ form_widget(form_user.companyNumber,{'attr':{'class':'input','data-original-title': 'user.companyNumber.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.companyNumber) }}
{% endblock company_number %}

{% block company_name %}
	{{ form_widget(form_user.companyName,{'attr':{'class':'input','data-original-title': 'user.companyName.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.companyName) }}
{% endblock company_name %}

{% block distributor_state %}
	<option value="">{{ 'user.state.label'|trans({},'validators') }}</option>
    {% for stId,stName in states %}
    	<option value="{{ stId }}">{{ stName }}</option>
	{% endfor %}
{% endblock distributor_state %}

{% block locate_distributor %}
	{% for dist in distributors %}
    	<option value="{{ dist.id }}" data-state="{{ dist.stateId }}">{{ dist.firstName~' '~dist.lastName }}</option>
	{% endfor %}
{% endblock locate_distributor %}

{% block membership_number_1 %}
	{{ form_widget(form_user.membershipNumber1,{'attr':{'class':'input','data-original-title': 'user.membershipNumber1.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.membershipNumber1) }}
{% endblock membership_number_1 %}

{% block membership_number_2 %}
	{{ form_widget(form_user.membershipNumber2,{'attr':{'class':'input','data-original-title': 'user.membershipNumber2.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.membershipNumber2) }}
{% endblock membership_number_2 %}

{% block membership_number_3 %}
	{{ form_widget(form_user.membershipNumber3,{'attr':{'class':'input','data-original-title': 'user.membershipNumber3.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.membershipNumber3) }}
{% endblock membership_number_3 %}

{% block membership_number_4 %}
	{{ form_widget(form_user.membershipNumber4,{'attr':{'class':'input','data-original-title': 'user.membershipNumber4.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.membershipNumber4) }}
{% endblock membership_number_4 %}

{% block membership_number_5 %}
	{{ form_widget(form_user.membershipNumber5,{'attr':{'class':'input','data-original-title': 'user.membershipNumber5.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
    {{ form_errors(form_user.membershipNumber5) }}
{% endblock membership_number_5 %}

{% block membership_number_6 %}
	{{ form_widget(form_user.membershipNumber6,{'attr':{'class':'input','data-original-title': 'user.membershipNumber6.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.membershipNumber6) }}
{% endblock membership_number_6 %}

{% block ob_customer_id %}
	{{ form_widget(form_user.obCustomerId,{'attr':{'class':'input','data-original-title': 'user.obCustomerId.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.obCustomerId) }}
{% endblock ob_customer_id %}

{% block captcha %}
{#}
  	{{ form_widget(form_user.recaptcha) }}
    {{ form_errors(form_user.recaptcha) }}
 {#} 
	{{ form_widget(form_user.captcha,{'attr':{'class':'input captcha-input','data-original-title': 'user.captcha.label'|trans({},'validators'), 'data-placement':'bottom', 'data-toggle':'tooltip' }}) }}
	{{ form_errors(form_user.captcha) }}
	
	
{% endblock captcha %}

{% block newsletters_subscription %}
	{{ form_widget(form_user.newslettersUnsubscription) }}	
{% endblock newsletters_subscription %}


{% block footer_js %}
    {{ parent() }}    
    {% javascripts '@OfficeBrainPageBundle/Resources/public/js/form-validation.min.js'
        		   '@OfficeBrainPageBundle/Resources/public/js/validation-bootstrap.min.js'
    			   '@OfficeBrainPageBundle/Resources/public/js/bundle/billing_block.js'
    			   '@OfficeBrainUserBundle/Resources/public/js/signup.js'
    			   output='js/SupplierTheme/project_libraries_register.js' 
    %}
    <script src="{{ asset_url }}" type='text/javascript'></script>
    {% endjavascripts %}    
    <script type="text/javascript" src="{{ asset(ob_project_assets_base_url ~ 'js/easyResponsiveTabs.js') }}"></script>
{% endblock footer_js %}