templates/login/_requestAccessForm.html.twig line 1

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  1. {{ form_start(requestAccessForm, {'action': path('request_access')}) }}
  2. <div class="row">
  3.     <div class="col">
  4.         <label for="customerAccountName">Company Name *</label>
  5.         {{ form_widget(requestAccessForm.customerAccountName) }}
  6.     </div>
  7. </div>   <div class="row">
  8.     <div class="col">
  9.         <label for="IATANumber">IATA Number</label>
  10.         {{ form_widget(requestAccessForm.IATANumber) }}
  11.     </div>
  12. </div>
  13. <div class="row">
  14.     <div class="col">
  15.         <label for="contactFirstName">Contact First Name *</label>
  16.         {{ form_widget(requestAccessForm.contactFirstName) }}
  17.     </div>
  18. </div>
  19. <div class="row">
  20.     <div class="col">
  21.         <label for="contactLastName">Contact Last Name *</label>
  22.         {{ form_widget(requestAccessForm.contactLastName) }}
  23.     </div>
  24. </div>
  25. <div class="row">
  26.     <div class="col">
  27.         <label for="email">Email *</label>
  28.         {{ form_widget(requestAccessForm.email) }}
  29.     </div>
  30. </div>
  31. <div class="row">
  32.     <div class="form-group col-md-3">
  33.         <label for="website">Phone Code *</label>
  34.         {{ form_widget(requestAccessForm.phoneCountryCode) }}
  35.     </div>
  36.     <div class="form-group col-md-9">
  37.         <label for="website">Phone *</label>
  38.         {{ form_widget(requestAccessForm.phone) }}
  39.     </div>
  40. </div>
  42. <div class="row">
  43.     <div class="col">
  44.         <label for="website">Website</label>
  45.         {{ form_widget(requestAccessForm.website) }}
  46.     </div>
  47. </div>
  48. <div class="row">
  49.     <div class="col">
  50.         <label for="addressLine1">Address *</label>
  51.         {{ form_widget(requestAccessForm.addressLine1) }}
  52.     </div>
  53. </div>
  54. <div class="row">
  55.     <div class="col">
  56.         <label for="addressLine2">Unit/Suite/Apartment</label>
  57.         {{ form_widget(requestAccessForm.addressLine2) }}
  58.     </div>
  59. </div>
  60. <div class="row">
  61.     <div class="col">
  62.         <label for="language">Language</label>
  63.         {{ form_widget(requestAccessForm.language) }}
  64.     </div>
  65.     <div class="col">
  66.         <label for="customerAccount">{% if not app.session.get("customerAccountDomain") %}(*Optional){% endif%} Host / Agency Group{% if app.session.get("customerAccountDomain") %} *{% endif%}</label>
  67.         {{ form_widget(requestAccessForm.customerAccount) }}
  68.     </div>
  69. </div>
  70. <div class="flex">
  71.     {{ form_widget(requestAccessForm.ownershipLink) }}
  72.     {{ form_row(requestAccessForm._token) }}
  73.     <input id="submitBtn" type="submit" class="btn btn-primary" value="Request Access"/>
  74. </div>
  75. <input type="hidden" name="recaptcha_response" id="recaptchaResponse">
  76. {{ form_end(requestAccessForm) }}