{% extends 'default_frame.twig' %}{% set body_class = 'registration_page' %}{% 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"> <ul class="breadcrumb p-none"> <li class="breadcrumb__item"> <a href="{{ url('homepage') }}" class="breadcrumb__item__link"> ホーム </a> </li> <li class="breadcrumb__item"> <p class="breadcrumb__item__arrow">＞</p> </li> <li class="breadcrumb__item"> <p class="breadcrumb__item__text">新規会員登録</p> </li> </ul> <div class="ec-pageHeader text-center"> <h1>{{ '新規会員登録フォーム'|trans }}</h1> </div> <div class="ec-contactRole__inner"> <form method="post" action="{{ url('entry_contact') }}" novalidate class="h-adr"> <span class="p-country-name" style="display:none;">Japan</span> {{ form_widget(form._token) }} <p class="ec-para-normal text-center text-normal">{{ '内容によっては回答をさしあげるのにお時間をいただくこともございます。 また、休業日は翌営業日以降の対応となりますのでご了承ください。 '|trans|nl2br }} </p> <div class="ec-borderedDefs"> <dl> <dt> {{ form_label(form.name, 'お名前', { '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(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.salon_name, 'サロン名', { 'label_attr': { 'class': 'ec-label' }}) }} </dt> <dd> <div class="ec-halfInput{{ has_errors(form.salon_name) ? ' error' }}"> {{ form_widget(form.salon_name) }} {{ form_errors(form.salon_name) }} </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' }}) }} </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.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, { 'attr': { 'placeholder': '例：ec-cube@example.com' }}) }} {{ form_errors(form.email) }} </div> </dd> </dl> </div> <div class="ec-registerRole__actions"> <div class="btn-size"> <button class="ec-blockBtn--action ec-yellow-btn" type="submit" name="mode" value="confirm">{{ '確認ページへ'|trans }}</button> </div> </div> </form> </div> </div>{% endblock %}