<div class="modal" id="modal_callback" tabindex="-1" role="dialog"> <div class="modal-dialog"> <div class="modal-content"> <div class="modal-header"> <button type="button" class="close" data-dismiss="modal"><span aria-hidden="true">×</span><span class="sr-only">Close</span></button> <div class="h4"><i class=" icon-mail-2"></i> {{ labels.get('modal-callback-1')|raw }} </div> </div> <div class="modal-body"> <form id="order-callback" method="post" action="{{ path('callback') }}"> <input type="hidden" name="code" value="" class="g-code" id="g-code"> <div class="form-group" id="callback-form-name"> <label for="recipient-name2" class="control-label">{{ labels.get('modal-callback-2')|raw }}</label> <input class="form-control" id="recipient-name2" placeholder="{{ labels.get('modal-callback-6')|raw }}" data-placement="top" data-trigger="manual" data-content="Must be at least 3 characters long, and must only contain letters." type="text" name="name"> </div> <div class="form-group" id="callback-form-phone"> <label for="recipient-Phone-Number2" class="control-label">{{ labels.get('modal-callback-3')|raw }}</label> <input type="text" maxlength="60" class="form-control" id="recipient-Phone-Number2" placeholder="{{ labels.get('modal-callback-7')|raw }}" name="phone"> </div> <div class="form-group"> <p class="pull-left text-danger hide" id="callback-form-error"> {{ labels.get('modal-callback-4')|raw }} </p> </div> </form> </div> <div class="modal-footer"> <button type="button" class="btn btn-default" data-dismiss="modal" id="sendclose2">{{ labels.get('modal-callback-5')|raw }}</button> <input type="submit" class="btn btn-callback pull-right" id="sendcallback" value="{{ labels.get('modal-callback-8')|raw }}"> </div> </div> </div></div>