<div class="popup mb-5">
<form method="post">
<button type="submit" class="d-none"></button>
<div class="row">
<div class="col-md-6 order-1 order-md-0">
<div class="mt-3">
<label for="name">{{ "Name"|trans }}*</label>
<input required type="text" id="name" name="name">
</div>
<div class="mt-3">
<label for="email">{{ "E-Mail"|trans }}*</label>
<input required type="email" id="email" name="email">
</div>
<div class="row">
<div class="col-md-5">
<div class="mt-3">
<label for="plz">{{ "Postleitzahl"|trans }}</label>
<input type="text" id="plz" name="plz">
</div>
</div>
<div class="col-md-7">
<div class="mt-3">
<label for="city">{{ "Ort"|trans }}</label>
<input type="text" id="city" name="city">
</div>
</div>
</div>
<div class="row">
<div class="col-md-8">
<div class="mt-3">
<label for="street">{{ "Straße"|trans }}</label>
<input type="text" id="street" name="street">
</div>
</div>
<div class="col-md-4">
<div class="mt-3">
<label for="street_nr">{{ "Hausnummer"|trans }}</label>
<input type="text" id="street_nr" name="street_nr">
</div>
</div>
</div>
<div class="mt-3">
<label for="phone">{{ "Telefon"|trans }}</label>
<input type="text" id="phone" name="phone">
</div>
<div class="mt-3">
<label for="notes">{{ "Anfrage"|trans }} *</label>
<textarea required type="text" id="notes" name="notes" rows="6"></textarea>
</div>
<div class=" w-100">
<a href="javascript:void(0)" class="btn btn-default arrow grey mt-5 w-100 send-request">
{{ "Absenden"|trans }}
</a>
</div>
</div>
<div class="col-md-6 order-0 order-md-1">
<div class="mt-md-3">
<label for="">{{ "Ansprechpartner"|trans }}*</label>
<input type="hidden" name="ansprechpartner" id="ansprechpartner_input" value="Germany South">
<ul class="country-select">
<li><span>Germany South</span>
<ul style="display: none;">
<li class="">Asia</li>
<li class="">Austria</li>
<li class="">Belgien - Flandern</li>
<li class="">Belgien - Wallonien</li>
<li class="">Bosnia-Herzegovina</li>
<li class="">Croatia</li>
<li class="">Czech Republic</li>
<li class="">Denmark</li>
<li class="">Finland</li>
<li class="">France</li>
<li class="">Germany North-East</li>
<li class="">Germany North-West</li>
<li class="">Germany South</li>
<li class="">Great Britain</li>
<li class="">Hungary</li>
<li class="">Italy</li>
<li class="">Kosovo</li>
<li class="">Latvia</li>
<li class="">Lithuania</li>
<li class="">Luxemburg</li>
<li class="">Macedonia</li>
<li class="">Montenegro</li>
<li class="">Netherlands</li>
<li class="">Norway</li>
<li class="">Poland</li>
<li class="">Portugal</li>
<li class="">Romania</li>
<li class="">Serbia</li>
<li class="">Slovakia</li>
<li class="">Slovenia</li>
<li class="">South Africa</li>
<li class="">Spain</li>
<li class="">Sweden</li>
<li class="">Switzerland</li>
<li class="">Turkey</li>
<li class="">Ukraine</li>
</ul>
</li>
</ul>
<div class="mb-3 mb-md-0 ansprechpartner-container">
{% for c,tmp in countries %}
{% for machineType,a in tmp %}
<div class="ansprechpartner" data-country="{{ c }}" style="display: none;">
<div class="row">
{% for ap in a %}
<div class="{% if ap.getCountryImage() != null %}col-7{% else %}col-12{% endif %}">
<b>{% if machineType == "cutting" %}{{ "Stanzmaschinen"|trans }}{% elseif machineType == "shoes" %}{{ "Schuhmaschinen"|trans }}{% elseif machineType == "mold" %}{{ "Siebwerkstatt"|trans }}{% endif %}</b>
<br>
<br>
{{ ap.getTitel() }}
{% if ap.getCompany() %}
<br/>
{{ ap.getCompany() }}
{% endif %}
<br/><br/>
{% if ap.getPhone() %}
<div class="contact-phone"><a href="tel:{{ ap.getPhone() }}">{{ ap.getPhone() }}</a></div>
{% endif %}
{% if ap.getFax() %}
<div class="contact-fax"><a href="tel:{{ ap.getFax() }}">{{ ap.getFax() }}</a></div>
{% endif %}
{% if ap.getEmail() %}
<div class="contact-email">
<a href="mailto:{{ ap.getEmail() }}">{{ "E-Mail senden"|trans }}</a>
</div>
{% endif %}
{% if ap.getWeb() %}
<div class="contact-web mt-3">
<a href="http://{{ ap.getWeb() }}" target="_blank">{{ ap.getWeb() }}</a>
</div>
{% endif %}
</div>
{% if ap.getCountryImage() != null %}
<div class="col-5">
<a href="{{ ap.getCountryImage().getThumbnail("default") }}" data-fancybox="">
<img class="no-border mw-150" src="{{ ap.getCountryImage().getThumbnail("default") }}"/></a>
</div>
{% endif %}
{% endfor %}
</div>
</div>
{% endfor %}
{% endfor %}
</div>
</div>
</div>
</div>
</form>
<div class="message" style="display: none; font-weight: 500"></div>
</div>