<div class="offer-placeholder">
    <form action="<?php echo URL::route('offerForm.process'); ?>" method="post" id="offer-form">
        <input type="hidden" name="formname" id="hiddenRow" value="offer-form">

        <span class="error-log <?php echo ($errors->has('first_name')? 'active' :''); ?>"><?php echo $errors->first('first_name'); ?></span>
        <span class="error-log <?php echo ($errors->has('last_name')? 'active' :''); ?>"><?php echo $errors->first('last_name'); ?></span>

        <div class="name-row">
            <div><label for="first_name"><?php echo \Illuminate\Support\Facades\Lang::get('offer.first-name'); ?><em>*</em></label><input class="required" id="first_name"
                                                                                 type="text" name="first_name"></div>
            <div><label for="last_name"><?php echo \Illuminate\Support\Facades\Lang::get('offer.sur-name'); ?><em>*</em></label><input class="required" id="last_name" type="text"
                                                                             name="last_name"></div>
        </div>
        <label for="email"><?php echo \Illuminate\Support\Facades\Lang::get('offer.email'); ?><em>*</em></label>
        <span class="error-log <?php echo ($errors->has('email')? 'active' :''); ?>"><?php echo $errors->first('email'); ?></span>
        <input class="required" id="email" type="email" name="email">

        <label for="phone"><?php echo \Illuminate\Support\Facades\Lang::get('offer.phone'); ?></label>
        <span class="error-log <?php echo ($errors->has('phone')? 'active' :''); ?>"><?php echo $errors->first('phone'); ?></span>
        <input id="phone" type="text" name="phone">

        <?php /*<label for="address"><?php echo \Illuminate\Support\Facades\Lang::get('offer.adres'); ?><em>*</em></label>*/ ?>
        <?php /*<span class="error-log <?php echo ($errors->has('address')? 'active' :''); ?>"><?php echo $errors->first('address'); ?></span>*/ ?>
        <?php /*<input class="required" id="address" type="text" name="address">*/ ?>

        <?php /*<span class="error-log <?php echo ($errors->has('zip_code')? 'active' :''); ?>"><?php echo $errors->first('zip_code'); ?></span>*/ ?>
        <?php /*<span class="error-log <?php echo ($errors->has('city')? 'active' :''); ?>"><?php echo $errors->first('city'); ?></span>*/ ?>
        <?php /*<div class="adres-row">*/ ?>
            <?php /*<div><label for="zip_code"><?php echo \Illuminate\Support\Facades\Lang::get('offer.zip-code'); ?><em>*</em></label><input class="required" id="zip_code"*/ ?>
                                                                             <?php /*type="text" name="zip_code"></div>*/ ?>
            <?php /*<div><label for="city"><?php echo \Illuminate\Support\Facades\Lang::get('offer.city'); ?><em>*</em></label><input class="required" id="city" type="text"*/ ?>
                                                                     <?php /*name="city"></div>*/ ?>
        <?php /*</div>*/ ?>

        <label for="formMessage"><?php echo \Illuminate\Support\Facades\Lang::get('offer.message'); ?><em>*</em></label>
        <span class="error-log <?php echo ($errors->has('formMessage')? 'active' :''); ?>"><?php echo $errors->first('formMessage'); ?></span>
        <textarea class="required" id="formMessage" name="formMessage"></textarea>

        <div class="submit-button">
            <?php echo \Illuminate\Support\Facades\Lang::get('offer.submit'); ?><span></span>
            <?php echo Form::submit(trans('translations.send')); ?>

        </div>

    </form>
</div>