{% extends 'D2CustomerBusinessBundle::layout.html.twig' %}

{% block head_script_extra %} 
<script type="text/javascript" src="{{ asset('bundles/d2customerbusiness/js/portal-common.js') }}"></script>
{% endblock head_script_extra %}

{% block page_header %}
<div class="row">
	<div class="col-md-12">
		<div class="pull-right">
			<a href="{{ path('home_page') }}" class="btn btn-sm btn-default">Back</a>
		</div>
		<div>
			Add your new <code>Account</code> details.
		</div>
	</div>
</div>
{% endblock %}

{% block content %}
<div class="row" style="margin-top:20px">
	<div class="col-md-offset-2 col-md-8">
		<form action="{{ path('customer_portal_company_create', { 'type': account_type }) }}" method="post" {{ form_enctype(form) }} class="form-general" id="data_form">
			<div id="d2_billingbundle_accounttype">
				{{ form_errors(form) }}
				<table>
					<tr style="vertical-align:top">
						<td>
							<h3>Company Details</h3>
							<table>
								<tr>
									<td>{{ form_label(form.company_name) }}</td>
									<td>{{ form_errors(form.company_name) }}</td>
									<td>{{ form_widget(form.company_name) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.trading_as) }}</td>
									<td>{{ form_errors(form.trading_as) }}</td>
									<td>{{ form_widget(form.trading_as, { 'attr': {'onclick': 'TradingAs()','onBlur': 'TradingAs()'} }) }}</td>
								</tr>
								<tr id="invoice_name">
									<td>{{ form_label(form.invoice_name) }}</td>
									<td>{{ form_errors(form.invoice_name) }}</td>
									<td>{{ form_widget(form.invoice_name, { 'attr': {'onclick': 'TradingAs()','onBlur': 'TradingAs()'} }) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.vat_number) }}</td>
									<td>{{ form_errors(form.vat_number) }}</td>
									<td>{{ form_widget(form.vat_number) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.ck_number) }}</td>
									<td>{{ form_errors(form.ck_number) }}</td>
									<td>{{ form_widget(form.ck_number) }}</td>
								</tr>
							</table>
						</td>
						<td>
							<h3>Contact Details</h3>
							<table>
								<tr>
									<td>{{ form_label(form.email) }}</td>
									<td>{{ form_errors(form.email) }}</td>
									<td>{{ form_widget(form.email) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.tel) }}</td>
									<td>{{ form_errors(form.tel) }}</td>
									<td>{{ form_widget(form.tel, { 'attr': {'maxlength': '16'} }) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.fax) }}</td>
									<td>{{ form_errors(form.fax) }}</td>
									<td>{{ form_widget(form.fax, { 'attr': {'maxlength': '16'} }) }}</td>
								</tr>
							</table>
						</td>
					</tr>
					<tr style="vertical-align:top">
						<td>
							<h3>Physical Address</h3>
							<table>
								<tr>
									<td>{{ form_label(form.physical_address_street) }}</td>
									<td>{{ form_errors(form.physical_address_street) }}</td>
									<td>{{ form_widget(form.physical_address_street) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.physical_address_suburb) }}</td>
									<td>{{ form_errors(form.physical_address_suburb) }}</td>
									<td>{{ form_widget(form.physical_address_suburb) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.physical_address_city) }}</td>
									<td>{{ form_errors(form.physical_address_city) }}</td>
									<td>{{ form_widget(form.physical_address_city) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.physical_address_province) }}</td>
									<td>{{ form_errors(form.physical_address_province) }}</td>
									<td>{{ form_widget(form.physical_address_province) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.physical_address_country) }}</td>
									<td>{{ form_errors(form.physical_address_country) }}</td>
									<td>{{ form_widget(form.physical_address_country) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.physical_address_code) }}</td>
									<td>{{ form_errors(form.physical_address_code) }}</td>
									<td>{{ form_widget(form.physical_address_code) }}</td>
								</tr>
							</table>
						</td>
						<td>
							<h3>Postal Address</h3>
							<table>
								<tr>
									<td>{{ form_label(form.postal_address_street) }}</td>
									<td>{{ form_errors(form.postal_address_street) }}</td>
									<td>{{ form_widget(form.postal_address_street) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.postal_address_suburb) }}</td>
									<td>{{ form_errors(form.postal_address_suburb) }}</td>
									<td>{{ form_widget(form.postal_address_suburb) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.postal_address_city) }}</td>
									<td>{{ form_errors(form.postal_address_city) }}</td>
									<td>{{ form_widget(form.postal_address_city) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.postal_address_provice) }}</td>
									<td>{{ form_errors(form.postal_address_provice) }}</td>
									<td>{{ form_widget(form.postal_address_provice) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.postal_address_country) }}</td>
									<td>{{ form_errors(form.postal_address_country) }}</td>
									<td>{{ form_widget(form.postal_address_country) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.postal_address_code) }}</td>
									<td>{{ form_errors(form.postal_address_code) }}</td>
									<td>{{ form_widget(form.postal_address_code) }}</td>
								</tr>
								<tr>
									<td>{{ form_label(form.postal_as_physical) }}</td>
									<td>{{ form_errors(form.postal_as_physical) }}</td>
									<td>{{ form_widget(form.postal_as_physical, { 'attr': {'onclick': 'AddressAutoFill1()','id': 'address_auto_fill'} }) }}</td>
								</tr>
							</table>
						</td>
					</tr>
				</table>

				{{ form_rest(form) }}
			</div>
			<div>
				<input class="btn btn-lg btn-default pull-right" type="submit" value="Create" />
			</div>
		</form>
	</div>
</div>
{% endblock content %}