<h2>{{ text.subscribe.title }}</h2>
<span id="news_fill_fields">{{ text.subscribe.fields }}</span>
<form id="news_subscribe_form" action="#" method="post">
	<input type="hidden" id="{{ REQUEST.id }}">
	
	<label>{{ text.contact.name }} *</label>
	<input type="text" id="subscribe_name" name="subscribe[name]" class="validate[required,custom[name]] form-control" placeholder="">
	<label>{{ text.misc.email }} *</label>
	<input type="text" id="subscribe_email" name="subscribe[email]" class="validate[required,custom[email]] form-control" placeholder="">
	<label>{{ text.contact.phone }} </label>
	<input type="text" id="subscribe_phone" name="subscribe[phone]" class="validate[custom[phone_world]] form-control" placeholder="">
	<label>{{ text.misc.fields.country.desc }} *</label>
	<select id="subscribe_id_country" name="subscribe[id_country]" class="validate[required] form-control">
		<option value="" selected="selected" disabled="disabled">{{ text.misc.fields.country.placeholder }} </option>
		{% for country in template.data.countries %}
			<option value="{{ country.id }}">{{ country.desc }}</option>
		{% endfor %}
	</select>
	<label>{{ text.contact.obs }} *</label>
	<textarea id="subscribe_obs" name="subscribe[obs]" class="validate[required,custom[text]] form-control" placeholder=""></textarea>

	{% if captcha_show %}
		<label for="captcha">{{ text.contact.captcha }}: <span id="captcha_question_sub">{{ captcha(key = 'answer_subscribe') | raw }}</span> *</label>
		<input type="text" id="captcha" name="subscribe[captcha] " class="validate[required] form-control" />
	{% endif %}
	
	{% block _ext_data_form_content_consent %}{% endblock %}
	
	<input type="submit" id="subscribe_send" name="subscribe[send]" value="{{ text.contact.send }}" class="small-button">
	<span id="news_subscribe_ob_fields">* {{ text.subscribe.ob_fields }}</span>
</form>