app/template/default/PiaDocumentRequest/Resource/template/default/document_request/index.twig line 1

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  1. {% extends 'default_frame.twig' %}
  3. {% form_theme form 'Form/form_div_layout.twig' %}
  5. {% block javascript %}
  6.   <script src="//yubinbango.github.io/yubinbango/yubinbango.js" charset="UTF-8"></script>
  7.   <script>
  8.     $(function () {
  9.       $("div.chk label").each(function () {
  10.         $(this).after("<br>");
  11.       });
  12.       $("dt label").each(function () {
  13.         var html = $(this).html();
  14.         var result = html.replace(/（/g, "<br>（");
  15.         $(this).html(result);
  16.       });
  17.     });
  18.   </script>
  19.   <script src="https://www.google.com/recaptcha/api.js" async defer></script>
  20. {% endblock javascript %}
  22. {% block main %}
  23.   <style type="text/css">
  24.     .ec-borderedDefs input[type=radio] {
  25.       display: inline-block;
  26.       width: 20px;
  27.       height: 20px;
  28.       padding: 0;
  29.       vertical-align: sub;
  30.       border-radius: 50%;
  31.     }
  32.     .ec-borderedDefs input[type=radio]:checked {
  33.       border: 1px solid #8b98a5;
  34.       background-color: #1d9bf0;
  35.     }
  36.     .ec-borderedDefs input[type=radio]:checked::before {
  37.       content: "";
  38.       display: block;
  39.       position: relative;
  40.       left: 7.4px;
  41.       top: 1px;
  42.       width: 6px;
  43.       height: 12px;
  44.       border: solid white;
  45.       border-width: 0 3px 3px 0;
  46.       transform: rotate(45deg);
  47.     }
  48.     .ec-borderedDefs input[type=checkbox] {
  49.       display: inline-block;
  50.       width: 20px;
  51.       height: 20px;
  52.       padding: 0;
  53.       vertical-align: sub;
  54.     }
  55.     .ec-borderedDefs input[type="checkbox"]:checked {
  56.       border: 1px solid #8b98a5;
  57.       background-color: #1d9bf0;
  58.     }
  59.     .ec-borderedDefs input[type="checkbox"]:checked::before {
  60.       content: "";
  61.       display: block;
  62.       position: relative;
  63.       left: 7.4px;
  64.       top: 1px;
  65.       width: 6px;
  66.       height: 12px;
  67.       border: solid white;
  68.       border-width: 0 3px 3px 0;
  69.       transform: rotate(45deg);
  70.     }
  71.     div.chk{
  72.       line-height: 140%;
  73.     }
  74.     div.chk p{
  75.       margin: 0;
  76.       padding: 0;
  77.     }
  78.     label[for="pia_document_request_gold_3"],
  79.     label[for="pia_document_request_modern_2"],
  80.     label[for="pia_document_request_antique_2"] {
  81.       margin-bottom: 20px;
  82.     }
  83.   </style>
  84.   <div id="contents_wrap">
  85.     <div class="ec-contactRole">
  86.       <div class="kaso_h1title">
  87.         <p>Document request</p>
  88.         <h1>資料請求</h1>
  89.       </div>
  90.       <p class="wrap" style="margin: 30px auto auto auto"><img src="/user_data/common/img/doc_banar.jpg" alt="image" style="width: 100%; height: auto;" /></p>
  91.       <div id="formWrap">
  92.         <p>資料請求・お問い合わせ、どんな些細な事でもお気軽にお問い合わせください。<br>
  93.           確認後3日以内にご返信させて頂きます。</p>
  94.       </div>
  95.       <div class="ec-off1Grid">
  96.         <div class="ec-off1Grid__cell">
  97.           <form method="post" action="{{ url('document_request') }}" class="h-adr" novalidate>
  98.             <span class="p-country-name" style="display:none;">Japan</span>
  99.             {{ form_widget(form._token) }}
  100.             <div class="ec-borderedDefs">
  101.               <dl>
  102.                 <dt>
  103.                   {{ form_label(form.name, 'お名前', { 'label_attr': { 'class': 'ec-label' }}) }}
  104.                 </dt>
  105.                 <dd>
  106.                   <div class="ec-halfInput{{ has_errors(form.name.name01, form.name.name02) ? ' error' }}">
  107.                     {{ form_widget(form.name.name01, {'attr': { 'placeholder': '姓' }}) }}
  108.                     {{ form_widget(form.name.name02, {'attr': { 'placeholder': '名' }}) }}
  109.                     {{ form_errors(form.name.name01) }}
  110.                     {{ form_errors(form.name.name02) }}
  111.                   </div>
  112.                 </dd>
  113.               </dl>
  114.               <dl>
  115.                 <dt>
  116.                   {{ form_label(form.kana, 'お名前(カナ)', {'label_attr': {'class': 'ec-label'}}) }}
  117.                 </dt>
  118.                 <dd>
  119.                   <div class="ec-halfInput{{ has_errors(form.kana.kana01, form.kana.kana02) ? ' error' }}">
  120.                     {{ form_widget(form.kana.kana01, {'attr': { 'placeholder': 'セイ' }}) }}
  121.                     {{ form_widget(form.kana.kana02, {'attr': { 'placeholder': 'メイ' }}) }}
  122.                     {{ form_errors(form.kana.kana01) }}
  123.                     {{ form_errors(form.kana.kana02) }}
  124.                   </div>
  125.                 </dd>
  126.               </dl>
  127.               <dl>
  128.                 <dt>
  129.                   {{ form_label(form.address, '住所', { 'label_attr': { 'class': 'ec-label' }}) }}
  130.                 </dt>
  131.                 <dd>
  132.                   <div class="ec-zipInput{{ has_errors(form.postal_code) ? ' error' }}">
  133.                     <span>{{ '〒'|trans }}</span>
  134.                     {{ form_widget(form.postal_code) }}
  135.                     <div class="ec-zipInputHelp">
  136.                       <div class="ec-zipInputHelp__icon">
  137.                         <div class="ec-icon"><img
  138.                             src="{{ asset('assets/icon/question-white.svg') }}" alt="">
  139.                         </div>
  140.                       </div><a href="https://www.post.japanpost.jp/zipcode/" target="_blank"><span>{{ '郵便番号検索'|trans }}</span></a>
  141.                     </div>
  142.                     {{ form_errors(form.postal_code) }}
  143.                   </div>
  144.                   <div class="ec-select{{ has_errors(form.address.pref) ? ' error' }}">
  145.                     {{ form_widget(form.address.pref) }}
  146.                     {{ form_errors(form.address.pref) }}
  147.                   </div>
  148.                   <div class="ec-input{{ has_errors(form.address.addr01) ? ' error' }}">
  149.                     {{ form_widget(form.address.addr01, { 'attr': { 'placeholder': '市区町村名(例：大阪市北区)' }}) }}
  150.                     {{ form_errors(form.address.addr01) }}
  151.                   </div>
  152.                   <div class="ec-input{{ has_errors(form.address.addr02) ? ' error' }}">
  153.                     {{ form_widget(form.address.addr02,  { 'attr': { 'placeholder': '番地・ビル名(例：西梅田1丁目6-8)' }}) }}
  154.                     {{ form_errors(form.address.addr02) }}
  155.                   </div>
  156.                 </dd>
  157.               </dl>
  158.               <dl>
  159.                 <dt>
  160.                   {{ form_label(form.phone_number, '電話番号', { 'label_attr': { 'class': 'ec-label' }}) }}
  161.                 </dt>
  162.                 <dd>
  163.                   <div class="ec-telInput{{ has_errors(form.phone_number) ? ' error' }}">
  164.                     {{ form_widget(form.phone_number) }}
  165.                     {{ form_errors(form.phone_number) }}
  166.                   </div>
  167.                 </dd>
  168.               </dl>
  169.               <dl>
  170.                 <dt>
  171.                   {{ form_label(form.email, 'メールアドレス', { 'label_attr': { 'class': 'ec-label' }}) }}
  172.                 </dt>
  173.                 <dd>
  174.                   <div class="ec-input{{ has_errors(form.email) ? ' error' }}">
  175.                     {{ form_widget(form.email) }}
  176.                     {{ form_errors(form.email) }}
  177.                   </div>
  178.                 </dd>
  179.               </dl>
  180.               <dl>
  181.                 <dt>
  182.                   {{ form_label(form.sex, '性別', { 'label_attr': { 'class': 'ec-label' }}) }}
  183.                 </dt>
  184.                 <dd>
  185.                   <div class="ec-input{{ has_errors(form.sex) ? ' error' }}">
  186.                     {{ form_widget(form.sex,  {'label_attr': {'class': 'radio-inline'}}) }}
  187.                     {{ form_errors(form.sex) }}
  188.                   </div>
  189.                 </dd>
  190.               </dl>
  191.               <dl>
  192.                 <dt>
  193.                   {{ form_label(form.how_about, 'サイトを知ったきっかけ（複数選択可）', { 'label_attr': { 'class': 'ec-label' }}) }}
  194.                 </dt>
  195.                 <dd>
  196.                   <div class="chk ec-input{{ has_errors(form.how_about) ? ' error' }}">
  197.                     {{ form_widget(form.how_about) }}
  198.                     {{ form_errors(form.how_about) }}
  199.                   </div>
  200.                 </dd>
  201.               </dl>
  202.               <dl>
  203.                 <dt>
  204.                   {{ form_label(form.purpose, '目的（複数選択可）', { 'label_attr': { 'class': 'ec-label' }}) }}
  205.                 </dt>
  206.                 <dd>
  207.                   <div class="chk ec-input{{ has_errors(form.purpose) ? ' error' }}">
  208.                     {{ form_widget(form.purpose) }}
  209.                     {{ form_errors(form.purpose) }}
  210.                   </div>
  211.                 </dd>
  212.               </dl>
  213.               <dl>
  214.                 <dt>
  215.                   {{ form_label(form.coin, '興味のコイン（複数選択可）', { 'label_attr': { 'class': 'ec-label' }}) }}
  216.                 </dt>
  217.                 <dd>
  218.                   <div class="chk ec-input{{ has_errors(form.coin) ? ' error' }}">
  219.                     {{ form_widget(form.coin) }}
  220.                     {{ form_errors(form.coin) }}
  221.                   </div>
  222.                 </dd>
  223.               </dl>
  224.               <dl>
  225.                 <dt>
  226.                   {{ form_label(form.seminar, 'セミナー', { 'label_attr': { 'class': 'ec-label' }}) }}
  227.                 </dt>
  228.                 <dd>
  229.                   <div class="chk ec-input{{ has_errors(form.seminar) ? ' error' }}">
  230.                     {{ form_widget(form.seminar) }}
  231.                     {{ form_errors(form.seminar) }}
  232.                   </div>
  233.                 </dd>
  234.               </dl>
  235.               <dl>
  236.                 <dt>
  237.                   {{ form_label(form.show_room, 'ショールーム', { 'label_attr': { 'class': 'ec-label' }}) }}
  238.                 </dt>
  239.                 <dd>
  240.                   <div class="chk ec-input{{ has_errors(form.show_room) ? ' error' }}">
  241.                     {{ form_widget(form.show_room) }}
  242.                     {{ form_errors(form.show_room) }}
  243.                   </div>
  244.                 </dd>
  245.               </dl>
  246.               <dl>
  247.                 <dt>
  248.                   {{ form_label(form.gold, '金地金（ゴールドバー）（シルバーバー）', { 'label_attr': { 'class': 'ec-label' }}) }}
  249.                 </dt>
  250.                 <dd>
  251.                   <div id="gold_area" class="chk ec-input{{ has_errors(form.gold) ? ' error' }}">
  252.                     {{ form_widget(form.gold) }}
  253.                     {{ form_errors(form.gold) }}
  254.                   </div>
  255.                 </dd>
  256.               </dl>
  257.               <dl>
  258.                 <dt>
  259.                   {{ form_label(form.antique, 'アンティークコイン', { 'label_attr': { 'class': 'ec-label' }}) }}
  260.                 </dt>
  261.                 <dd>
  262.                   <div class="chk ec-input{{ has_errors(form.antique) ? ' error' }}">
  263.                     <p>所有している</p>
  264.                     {{ form_widget(form.antique) }}
  265.                     {{ form_errors(form.antique) }}
  266.                   </div>
  267.                 </dd>
  268.               </dl>
  269.               <dl>
  270.                 <dt>
  271.                   {{ form_label(form.modern, 'モダンコイン', { 'label_attr': { 'class': 'ec-label' }}) }}
  272.                 </dt>
  273.                 <dd>
  274.                   <div class="chk ec-input{{ has_errors(form.modern) ? ' error' }}">
  275.                     <p>所有している</p>
  276.                     {{ form_widget(form.modern) }}
  277.                     {{ form_errors(form.modern) }}
  278.                   </div>
  279.                 </dd>
  280.               </dl>
  281.               <dl>
  282.                 <dt>
  283.                   {{ form_label(form.contents, 'お問い合わせ内容', { 'label_attr': { 'class': 'ec-label' }}) }}
  284.                 </dt>
  285.                 <dd>
  286.                   <div class="ec-input{{ has_errors(form.contents) ? ' error' }}">
  287.                     {{ form_widget(form.contents) }}
  288.                     {{ form_errors(form.contents) }}
  289.                   </div>
  290.                 </dd>
  291.               </dl>
  292.             </div>
  293.             <div class="g-recaptcha" data-sitekey="{{ recaptcha_site_key }}" style="margin: 1rem auto; width: fit-content;"></div>
  294.             <div class="ec-RegisterRole__actions">
  295.               <div class="ec-off4Grid">
  296.                 <div class="ec-off4Grid__cell">
  297.                   <button type="submit" class="ec-blockBtn--action" name="mode" value="confirm">{{ '確認ページへ'|trans }}
  298.                   </button>
  299.                 </div>
  300.               </div>
  301.             </div>
  302.           </form>
  303.         </div>
  304.       </div>
  305.     </div>
  306.   </div>
  307. {% endblock %}