<?
if(!defined("B_PROLOG_INCLUDED") || B_PROLOG_INCLUDED!==true)die();
?>
<?=$arResult["FORM_HEADER"]?>
<div class="popup popup_feedback new_abonent<?if ($arResult["isFormNote"] == "Y"):?> popup_is-active<?endif;?>">
<div class="popup__overlay"></div>
<div class="popup__container container">
<div class="popup__content">
<div class="popup__close"></div>
<?if ($arResult["isFormNote"] == "Y"):?>
<div class="popup__title">
<?=$arResult["FORM_NOTE"]?>
</div>
<script type="text/javascript">initPopups();</script>
<?else:?>
<form id="<?=$arResult['arForm']['SID']?>" action="<?=$APPLICATION->GetCurPage()?>" method="POST" enctype="multipart/form-data">
<div class="popup__title">
Форма обратной связи
</div>
<div class="popup__wrapper">
<div class="popup__wrap">
<input class="popup__input input input_theme_grey-line input_fio" required="required" type="text" name="form_text_1" placeholder="ФИО*">
<input class="popup__input input input_theme_grey-line input_phone" required="required" type="text" name="form_text_2" placeholder="Телефон*">
<input class="popup__input input input_theme_grey-line" type="text" name="form_text_3" placeholder="Email">
</div>
<div class="popup__wrap">
<input class="popup__input input input_theme_grey-line street" type="text" name="form_text_4" placeholder="Город и улица">
<input class="popup__input input input_theme_grey-line home" type="text" name="form_text_5" placeholder="дом и квартира">
<textarea class="popup__textarea textarea textarea_theme_grey-line" name="form_textarea_6" placeholder="Введите ваш комментарий"></textarea> <input type="hidden" name="form_hidden_7" class="selected_hidden_ultra_power"> <input type="hidden" name="form_hidden_8" class="monthly_pay"> <input type="hidden" name="form_hidden_9" class="equipment_pay"> <input type="hidden" name="form_hidden_10" class="final_pay"> <input type="hidden" name="form_hidden_11" class="adress_trtr"> <input type="hidden" name="form_hidden_12" value="<?=SITE_SERVER_NAME.'/'.$APPLICATION->GetCurPage()?>">
</div>
</div>
<div class="popup__footer">
<div class="popup__checkout">
<div class="input input_checkbox input_theme_green-checkbox">
<input class="input__source" required="required" type="checkbox" id="checkbox_deflt"> <label class="input__checkbox" for="checkbox_deflt"></label> <label class="input__text" for="checkbox_deflt">
Я согласен с условиями подключения, а также даю согласие на обработку персональных данных согласно <?if(!empty($arResult['FILE_ID'])):?> <a class="input__text" target="blank" href="<?=$arResult['FILE']?>">Федеральному закону «О персональных данных»</a>
<?else:?> Федеральному закону «О персональных данных» <?endif;?> </label>
</div>
</div>
<button type="submit" id="submit_form_1" name="web_form_apply" ga ('send', 'event', 'goal', 'order');yaCounter******.reachGoal('form_submit');value="Отправить" class="button button_size_medium button_theme_full-green">Отправить</button>
</div>
</form>
<?endif;?>
</div>
</div>
</div>
<?if ($arResult["isFormNote"] == "Y"):?>
<div class="popup__title">
<?=$arResult["FORM_NOTE"]?>
</div>
<script type="text/javascript">initPopups();</script>
<?else:?>