{{ header }}{{ column_left }}
<div id="content">
  <div class="page-header">
    <div class="container-fluid">
      <div class="pull-right">
        <button type="submit" form="form-zone" data-toggle="tooltip" title="{{ button_save }}" class="btn btn-primary"><i class="fa fa-save"></i></button>
        <a href="{{ cancel }}" data-toggle="tooltip" title="{{ button_cancel }}" class="btn btn-default"><i class="fa fa-reply"></i></a></div>
      <h1>{{ heading_title }}</h1>
      <ul class="breadcrumb">
        {% for breadcrumb in breadcrumbs %}
        <li><a href="{{ breadcrumb.href }}">{{ breadcrumb.text }}</a></li>
        {% endfor %}
      </ul>
    </div>
  </div>
  <div class="container-fluid">
    {% if error_warning %}
    <div class="alert alert-danger alert-dismissible"><i class="fa fa-exclamation-circle"></i> {{ error_warning }}
      <button type="button" class="close" data-dismiss="alert">&times;</button>
    </div>
    {% endif %}
    <div class="panel panel-default">
      <div class="panel-heading">
        <h3 class="panel-title"><i class="fa fa-pencil"></i> {{ text_form }}</h3>
      </div>
      <div class="panel-body">
        <form action="{{ action }}" method="post" enctype="multipart/form-data" id="form-zone" class="form-horizontal">
          <div class="form-group required">
            <label class="col-sm-2 control-label" for="input-name">{{ entry_name }}</label>
            <div class="col-sm-10">
              <input type="text" name="name" value="{{ name }}" placeholder="{{ entry_name }}" id="input-name" class="form-control" />
              {% if error_name %}
              <div class="text-danger">{{ error_name }}</div>
              {% endif %}
            </div>
          </div>
          <div class="form-group">
            <label class="col-sm-2 control-label" for="input-code">{{ entry_code }}</label>
            <div class="col-sm-10">
              <input type="text" name="code" value="{{ code }}" placeholder="{{ entry_code }}" id="input-code" class="form-control" />
            </div>
          </div>
          <div class="form-group required">
            <label class="col-sm-2 control-label" for="input-slug">{{ entry_slug }}</label>
            <div class="col-sm-10">
              <input type="text" name="slug" value="{{ slug }}" placeholder="{{ entry_slug }}" id="input-slug" class="form-control" />
              {% if error_slug %}
              <div class="text-danger">{{ error_slug }}</div>
              {% endif %}
            </div>
          </div>
          <div class="form-group">
            <label class="col-sm-2 control-label" for="input-country">{{ entry_country }}</label>
            <div class="col-sm-10">
              <select name="country_id" id="input-country" class="form-control">
                {% for country in countries %}
                {% if country.country_id == country_id %}
                <option value="{{ country.country_id }}" selected="selected">{{ country.name }}</option>
                {% else %}
                <option value="{{ country.country_id }}">{{ country.name }}</option>
                {% endif %}
                {% endfor %}
              </select>
            </div>
          </div>
          <div class="form-group">
            <label class="col-sm-2 control-label" for="input-status">{{ entry_status }}</label>
            <div class="col-sm-10">
              <select name="status" id="input-status" class="form-control">
                {% if status %}
                <option value="1" selected="selected">{{ text_enabled }}</option>
                <option value="0">{{ text_disabled }}</option>
                {% else %}
                <option value="1">{{ text_enabled }}</option>
                <option value="0" selected="selected">{{ text_disabled }}</option>
                {% endif %}
              </select>
            </div>
          </div>
          <fieldset>
            <legend>{{ text_replacements }}</legend>
            <p class="text-muted">{{ help_replacements }}</p>
            {% for replacement_field in replacement_fields %}
            <div class="form-group required">
              <label class="col-sm-2 control-label" for="input-{{ replacement_field.name }}">{{ replacement_field.label }}</label>
              <div class="col-sm-10">
                <input type="text" name="{{ replacement_field.name }}" value="{{ replacement_field.value }}" placeholder="{{ replacement_field.label }}" id="input-{{ replacement_field.name }}" class="form-control" />
                {% if replacement_field.error %}
                <div class="text-danger">{{ replacement_field.error }}</div>
                {% endif %}
              </div>
            </div>
            {% endfor %}
          </fieldset>
          <fieldset>
            <legend>{{ text_contacts }}</legend>
            <p class="text-muted">{{ help_contacts }}</p>
            <div class="form-group">
              <label class="col-sm-2 control-label" for="input-contact-telephone">{{ entry_contact_telephone }}</label>
              <div class="col-sm-10">
                <input type="text" name="contact_telephone" value="{{ contact_telephone }}" placeholder="{{ entry_contact_telephone }}" id="input-contact-telephone" class="form-control" />
              </div>
            </div>
            <div class="form-group">
              <label class="col-sm-2 control-label" for="input-contact-email">{{ entry_contact_email }}</label>
              <div class="col-sm-10">
                <input type="text" name="contact_email" value="{{ contact_email }}" placeholder="{{ entry_contact_email }}" id="input-contact-email" class="form-control" />
                {% if error_contact_email %}
                <div class="text-danger">{{ error_contact_email }}</div>
                {% endif %}
              </div>
            </div>
            <div class="form-group">
              <label class="col-sm-2 control-label" for="input-contact-address">{{ entry_contact_address }}</label>
              <div class="col-sm-10">
                <textarea name="contact_address" rows="3" placeholder="{{ entry_contact_address }}" id="input-contact-address" class="form-control">{{ contact_address }}</textarea>
              </div>
            </div>
            <div class="form-group">
              <label class="col-sm-2 control-label" for="input-contact-geocode">{{ entry_contact_geocode }}</label>
              <div class="col-sm-10">
                <input type="text" name="contact_geocode" value="{{ contact_geocode }}" placeholder="{{ entry_contact_geocode }}" id="input-contact-geocode" class="form-control" />
              </div>
            </div>
            <div class="form-group">
              <label class="col-sm-2 control-label" for="input-contact-fax">{{ entry_contact_fax }}</label>
              <div class="col-sm-10">
                <input type="text" name="contact_fax" value="{{ contact_fax }}" placeholder="{{ entry_contact_fax }}" id="input-contact-fax" class="form-control" />
              </div>
            </div>
            <div class="form-group">
              <label class="col-sm-2 control-label" for="input-contact-open">{{ entry_contact_open }}</label>
              <div class="col-sm-10">
                <textarea name="contact_open" rows="3" placeholder="{{ entry_contact_open }}" id="input-contact-open" class="form-control">{{ contact_open }}</textarea>
              </div>
            </div>
            <div class="form-group">
              <label class="col-sm-2 control-label" for="input-contact-comment">{{ entry_contact_comment }}</label>
              <div class="col-sm-10">
                <textarea name="contact_comment" rows="3" placeholder="{{ entry_contact_comment }}" id="input-contact-comment" class="form-control">{{ contact_comment }}</textarea>
              </div>
            </div>
          </fieldset>
        </form>
      </div>
    </div>
  </div>
</div>
{{ footer }}
