<?php /** @var \Autogedal\Retur\Block\ReturForm $block */ /** @var \Autogedal\Retur\ViewModel\UserDataProvider $viewModel */ $viewModel = $block->getViewModel(); ?> <form class="form retur" action="<?= $block->escapeUrl($block->getFormAction()) ?>" id="retur-form" method="post" data-hasrequired="<?= $block->escapeHtmlAttr(__('* Required Fields')) ?>" style="margin: auto 10%;" data-mage-init='{"validation":{}}'><input name="form_key" type="hidden" value="<?= /* @noEscape */ $block->getFormKey(); ?>" /><fieldset class="fieldset"><div class="field numar-comanda required"><label class="label" for="numar-comanda"><span><?= $block->escapeHtml(__('Numar Comanda')) ?></span></label> <div class="control"><input name="order_user_increment_id" id="numar-comanda" title="<?= $block->escapeHtmlAttr(__('Numar Comanda')) ?>" class="input-text" type="text" data-validate="{required:true}" placeholder="<?= $block->escapeHtmlAttr(__('Numar Comanda')) ?>" /></div></div><div class="field first-name required"><label class="label" for="first-name"><span><?= $block->escapeHtml(__('First Name')) ?></span></label> <div class="control"><input name="customer_firstname" id="first-name" title="<?= $block->escapeHtmlAttr(__('First Name')) ?>" value="<?= $block->escapeHtmlAttr($viewModel->getFirstName()) ?>" class="input-text" type="text" data-validate="{required:true}" placeholder="<?= $block->escapeHtmlAttr(__('Completeaza prenumele din comanda initiala')) ?>" /></div></div><div class="field last-name required"><label class="label" for="last-name"><span><?= $block->escapeHtml(__('Last Name')) ?></span></label> <div class="control"><input name="customer_lastname" id="last-name" title="<?= $block->escapeHtmlAttr(__('Last Name')) ?>" value="<?= $block->escapeHtmlAttr($viewModel->getLastName()) ?>" class="input-text" type="text" data-validate="{required:true}" placeholder="<?= $block->escapeHtmlAttr(__('Completeaza numele din comanda initiala')) ?>" /></div></div><div class="field telephone required"><label class="label" for="telephone"><span><?= $block->escapeHtml(__('Phone Number')) ?></span></label> <div class="control"><input name="telephone" id="telephone" title="<?= $block->escapeHtmlAttr(__('Phone Number')) ?>" value="<?= $block->escapeHtmlAttr($viewModel->getUserTelephone()) ?>" class="input-text" type="tel" data-validate="{required:true}" placeholder="<?= $block->escapeHtmlAttr(__('Completeaza numarul de telefon din comanda initiala')) ?>" /></div></div><div class="field email"><label class="label" for="email"><span><?= $block->escapeHtml(__('Adresa de e-mail')) ?></span></label> <div class="control"><input name="email" id="email" title="<?= $block->escapeHtmlAttr(__('Adresa de e-mail')) ?>" value="<?= $block->escapeHtmlAttr($viewModel->getUserEmail()) ?>" class="input-text" type="email" data-validate="{'validate-email':true}" data-mage-init='{"mage/trim-input":{}}' placeholder="<?= $block->escapeHtmlAttr(__('Te rugam sa ne lasi adresa de email pentru a te tine la curent cu stadiul returului.')) ?>" /></div></div><div class="field metoda-rambursare required"><label class="label" for="metoda-rambursare"><span><?= $block->escapeHtml(__('Metoda Rambursare / Inlocuire Produs')) ?></span></label> <div class="control"><select id="metoda-rambursare" name="metoda_rambursare" title="<?= $block->escapeHtml(__('Metoda Rambursare / Inlocuire Produs')) ?>" class="validate-select" data-validate="{required:true}" ><?php $options = $viewModel->getMetodeRambursare(); ?> <?php $metodaRambursare = $viewModel->getMetodaRambursare(); ?> <?php foreach ($options as $key => $option) : ?> <option value="<?= $block->escapeHtmlAttr($option['value']) ?>" <?= ($option['value'] == $metodaRambursare) ? ' selected="selected"' : '' ?>><?= $block->escapeHtml(__($option['label'])) ?></option><?php endforeach;?></select></div></div><div class="field iban required" style="display:none"><label class="label" for="iban"><span><?= $block->escapeHtml(__('IBAN')) ?></span></label> <div class="control"><input name="iban" id="iban" title="<?= $block->escapeHtmlAttr(__('IBAN')) ?>" value="<?= $block->escapeHtmlAttr($viewModel->getIban()) ?>" class="input-text" type="text" data-validate="{required:true}" placeholder="<?= $block->escapeHtmlAttr(__('Iban')) ?>" /></div></div><div class="field numar-awb"><label class="label" for="numar-awb"><span><?= $block->escapeHtml(__('Numar AWB si Firma de Curierat')) ?></span></label> <div class="control"><input name="awb_number" id="numar-awb" title="<?= $block->escapeHtmlAttr(__('Numar AWB si Firma de Curierat')) ?>" class="input-text" type="text" placeholder="<?= $block->escapeHtmlAttr(__('Daca ai expediat deja coletul, ajuta-ne cu nr. de awb si firma de curierat prin care ai expediat returul.')) ?>" /></div></div><div class="field comment"><label class="label" for="comment"><span><?= $block->escapeHtml(__('Motiv Retur / Detalii Suplimentare')) ?></span></label> <div class="control"><textarea
                    name="motiv_retur"
                    id="comment"
                    title="<?= $block->escapeHtmlAttr(__('Motiv Retur / Detalii Suplimentare')) ?>"
                    class="input-text"
                    cols="5"
                    rows="3"
                    placeholder="<?= $block->escapeHtmlAttr(__('Te rugam sa impartasesti cu noi motivul pentru care doresti sa returnezi produsul. Daca exista si alte detalii suplimentare, scrie-le aici.')) ?>"
                ><?= $block->escapeHtml($viewModel->getUserComment()) ?></textarea></div></div><div class="field required"><input type="checkbox" data-validate="{required:true}" id="retur_agreement" name="retur_agreement"><label> <?= __('Sunt de acord cu <a href="%1" target="_blank">termenii si conditiile</a>', $block->escapeUrl($block->getUrl('cms/termeni-conditii'))); ?></label></div></fieldset><div class="actions-toolbar"><div class="primary"><input type="hidden" name="hideit" id="hideit" value="" /><button type="submit" title="<?= $block->escapeHtmlAttr(__('Submit')) ?>" class="action submit primary"><span><?= $block->escapeHtml(__('Submit')) ?></span></button></div></div></form><script type="text/x-magento-init">
    {
        "*": {
            "Autogedal_Retur/js/block-submit-on-send": {
                "formId": "retur-form",
                "incUrl": "<?= $block->escapeHtml($viewModel->getIncUrl())?>"
            }
        }
    }</script>