{#This file is part of EC-CUBECopyright(c) EC-CUBE CO.,LTD. All Rights Reserved.http://www.ec-cube.co.jp/For the full copyright and license information, please view the LICENSEfile that was distributed with this source code.#}{% extends 'default_frame.twig' %}{% form_theme form 'Form/form_div_layout.twig' %}{% block javascript %} <script src="//yubinbango.github.io/yubinbango/yubinbango.js" charset="UTF-8"></script>{% endblock javascript %}{% block main %} <div class="ec-contactRole"> <div class="ec-pageHeader"> <h1 style ="font-size: calc(0.825rem + 1.5vw);font-weight:500;line-height:1.2;">{{ 'お問い合わせ/会員登録お申し込み'|trans }}</h1> </div> <div class="ec-off1Grid"> <div class="ec-off1Grid__cell"> <form method="post" action="{{ url('contact') }}" class="h-adr" novalidate> <span class="p-country-name" style="display:none;">Japan</span> {{ form_widget(form._token) }} <p class="ec-para-normal">{{ '会員登録のお申し込みにはご登録完了のご連絡まで2〜3営業日をいただきます。お急ぎの場合は、直接お電話にてお問い合わせください。'|trans|nl2br }}</p> <div style = "padding-left:12px;border-left:6px solid #ececec;"> <p>TEL.090-3082-8881(担当：鈴木)</p> <p style = "padding-top:0;">受付時間：10:00〜19:00</p> </div> <div class="ec-borderedDefs"> {# 会社名 #} <dl> <dt> {{ form_label(form.company_name, '会社名', { 'label_attr': { 'class': 'ec-label' }}) }} </dt> <dd> <div class="ec-halfInput{{ has_errors(form.company_name) ? ' error' }}"> {{ form_widget(form.company_name, {'attr': { 'placeholder': '会社名' }}) }} {{ form_errors(form.company_name) }} </div> </dd> </dl> {# 店舗名 #} <dl> <dt> {{ form_label(form.store_name, '店舗名', { 'label_attr': { 'class': 'ec-label' }}) }} </dt> <dd> <div class="ec-halfInput{{ has_errors(form.store_name) ? ' error' }}"> {{ form_widget(form.store_name, {'attr': { 'placeholder': '店舗名' }}) }} {{ form_errors(form.store_name) }} </div> </dd> </dl> <dl> <dt> {{ form_label(form.name, 'お名前(ご担当者)', { 'label_attr': { 'class': 'ec-label' }}) }} </dt> <dd> <div class="ec-halfInput{{ has_errors(form.name.name01, form.name.name02) ? ' error' }}"> {{ form_widget(form.name.name01, {'attr': { 'placeholder': '姓' }}) }} {{ form_widget(form.name.name02, {'attr': { 'placeholder': '名' }}) }} {{ form_errors(form.name.name01) }} {{ form_errors(form.name.name02) }} </div> </dd> </dl> <dl> <dt> {{ form_label(form.kana, 'お名前(ご担当者)(カナ)', {'label_attr': {'class': 'ec-label'}}) }} </dt> <dd> <div class="ec-halfInput{{ has_errors(form.kana.kana01, form.kana.kana02) ? ' error' }}"> {{ form_widget(form.kana.kana01, {'attr': { 'placeholder': 'セイ' }}) }} {{ form_widget(form.kana.kana02, {'attr': { 'placeholder': 'メイ' }}) }} {{ form_errors(form.kana.kana01) }} {{ form_errors(form.kana.kana02) }} </div> </dd> </dl> <dl> <dt> {{ form_label(form.address, '住所', { 'label_attr': { 'class': 'ec-label' }}) }} </dt> <dd> <div class="ec-zipInput{{ has_errors(form.postal_code) ? ' error' }}"> <span>{{ '〒'|trans }}</span> {{ form_widget(form.postal_code) }} <div class="ec-zipInputHelp"> <div class="ec-zipInputHelp__icon"> <div class="ec-icon"><img src="{{ asset('assets/icon/question-white.svg') }}" alt=""> </div> </div><a href="https://www.post.japanpost.jp/zipcode/" target="_blank"><span>{{ '郵便番号検索'|trans }}</span></a> </div> {{ form_errors(form.postal_code) }} </div> <div class="ec-select{{ has_errors(form.address.pref) ? ' error' }}"> {{ form_widget(form.address.pref) }} {{ form_errors(form.address.pref) }} </div> <div class="ec-input{{ has_errors(form.address.addr01) ? ' error' }}"> {{ form_widget(form.address.addr01, { 'attr': { 'placeholder': '市区町村名(例：大阪市北区)' }}) }} {{ form_errors(form.address.addr01) }} </div> <div class="ec-input{{ has_errors(form.address.addr02) ? ' error' }}"> {{ form_widget(form.address.addr02, { 'attr': { 'placeholder': '番地・ビル名(例：西梅田1丁目6-8)' }}) }} {{ form_errors(form.address.addr02) }} </div> </dd> </dl> <dl> <dt> {{ form_label(form.phone_number, '電話番号', { 'label_attr': { 'class': 'ec-label' }}) }} <span style = "font-size:.8em;" >日中ご連絡が取れる番号</span> </dt> <dd> <div class="ec-telInput{{ has_errors(form.phone_number) ? ' error' }}"> {{ form_widget(form.phone_number) }} {{ form_errors(form.phone_number) }} </div> </dd> </dl> <dl> <dt> {{ form_label(form.mobile_number, '携帯電話番号', { 'label_attr': { 'class': 'ec-label' }}) }} <span style = "font-size:.8em;" >[任意]</span> </dt> <dd> <div class="ec-halfInput{{ has_errors(form.mobile_number) ? ' error' }}"> {{ form_widget(form.mobile_number, {'attr': { 'placeholder': '例：09012341234' }}) }} {{ form_errors(form.mobile_number) }} </div> </dd> </dl> <dl> <dt> {{ form_label(form.email, 'メールアドレス', { 'label_attr': { 'class': 'ec-label' }}) }} </dt> <dd> <div class="ec-input{{ has_errors(form.email) ? ' error' }}"> {{ form_widget(form.email) }} {{ form_errors(form.email) }} </div> </dd> </dl> <dl> <dt> {{ form_label(form.contents, 'お問い合わせ内容', { 'label_attr': { 'class': 'ec-label' }}) }} </dt> <dd> <div class="ec-input{{ has_errors(form.contents) ? ' error' }}"> {{ form_widget(form.contents) }} {{ form_errors(form.contents) }} </div> <p>{{ '新規会員登録のお客様は必ず「会員登録希望」とご記入下さい。'|trans }}</p> </dd> </dl> {# エンティティ拡張の自動出力 #} {% for f in form|filter(f => f.vars.eccube_form_options.auto_render) %} {% if f.vars.eccube_form_options.form_theme %} {% form_theme f f.vars.eccube_form_options.form_theme %} {{ form_row(f) }} {% else %} <dl> <dt> {% set label_class = f.vars.label_attr.class is defined ? f.vars.label_attr.class : '' %} {{ form_label(f, f.vars.label, { 'label_attr': {'class': label_class ~ ' ec-label' }}) }} </dt> <dd>「」 <div class="{{ f.vars.eccube_form_options.style_class }}{{ has_errors(f) ? ' error' }}"> {{ form_widget(f) }} {{ form_errors(f) }} </div> </dd> </dl> {% endif %} {% endfor %} </div> <div class="ec-RegisterRole__actions"> <div class="ec-off4Grid"> <div class="ec-off4Grid__cell"> <button type="submit" class="ec-blockBtn--action" name="mode" value="confirm">{{ '確認ページへ'|trans }} </button> </div> </div> </div> </form> </div> </div> </div>{% endblock %}