{% extends '@App/uibase/subbase/useraccount/account-base.html.twig' %}

{% block accountcontent %}
    <script>



        function autotab(original,destination){
            if (original.getAttribute&&original.value.length==original.getAttribute("maxlength"))
                destination.focus()
        }

    </script>
    <table border="0" width="100%"><tr><td>

                {% if msg is defined %}
                    <span class="box-contents"><b>{{ msg }}</b></span><br />
                {% endif %}

                {% if msg2 is defined %}
                    <h2 class="box-contents">{{ msg2 }}</h2>
                {% endif %}

            </td></tr>
        <tr><td class="content-text">
                {{ form_start(form ) }}
                {{ form_errors(form) }}
                <table class="content-text" width="100%">

                    <tr><td colspan="2"><strong>Profile Nickname:</strong><br />
                            (used only to identify this profile at checkout)<br />
                            {{ form_errors(form.nickname) }}
                            {{ form_widget(form.nickname) }}</td><td colspan="2"><strong>First/Last Name:</strong><br />
                            (as it appears on card)<br />
                            {{ form_errors(form.nameoncard) }}
                            {{ form_widget(form.nameoncard) }}
                            {{ form_errors(form.lnameoncard) }}
                            {{ form_widget(form.lnameoncard) }}
                        </td></tr>
                    <tr><td colspan="4"><strong>Billing Address:</strong></td></tr>

                    <tr><td colspan="4">Address: {{ form_errors(form.add1) }}{{ form_widget(form.add1) }}</td></tr>
                    <tr><td colspan="4">Address Line 2 {{ form_errors(form.add2) }}{{ form_widget(form.add2) }}</td></tr>
                    <tr><td colspan="4">City: {{ form_errors(form.city) }}{{ form_widget(form.city) }}</td></tr>
                    <tr><td colspan="4">State: {{ form_errors(form.state) }}{{ form_widget(form.state) }}</td></tr>
                    <tr><td colspan="4">Zip Code: {{ form_errors(form.zip) }}{{ form_widget(form.zip) }}</td></tr>
                    <tr><td colspan="4"><strong>Card Number:</strong></td></tr>
                    <tr><td colspan="4" align="left">
                            <table>
                                <tr><td>{{ form_errors(form.cc1) }}
                                        {{ form_widget(form.cc1) }}
                                        -</td><td>
                                        {{ form_errors(form.cc2) }}
                                        {{ form_widget(form.cc2) }}
                                        -</td><td>
                                        {{ form_errors(form.cc3) }}
                                        {{ form_widget(form.cc3) }}
                                        -</td><td>
                                        {{ form_errors(form.cc4) }}
                                        {{ form_widget(form.cc4) }}
                                    </td></tr>

                            </table>
                        </td></tr>

                    <tr><td colspan="2" align="left"><strong>EXP Date:</strong><br />
                            (EX 02 16) = Feb 2016
                        </td><td colspan="2"><strong>Card Type:</strong><br />
                            (choose one)</td></tr>

                    <tr><td colspan="2" align="left">
                            <table border="0" class="content-text">
                                <tr><td align="right">MM /</td><td align="left"> YY</td></tr>
                                <tr><td align="right"> {{ form_errors(form.ccexpmo) }}
                                        {{ form_widget(form.ccexpmo) }}</td>
                                    <td align="left"> {{ form_errors(form.ccexpyr) }}
                                        {{ form_widget(form.ccexpyr) }}</td></tr>
                            </table>

                        </td>
                        <td colspan="2"> {{ form_errors(form.cardtype) }}
                            {{ form_widget(form.cardtype) }}</td>
                    </tr>
                    <tr><td colspan="2"><strong>CVV Code (3-4 digits in signature strip)</strong></td>
                        <td colspan="2">{{ form_errors(form.cvv) }}
                            {{ form_widget(form.cvv) }}</td>
                    </tr>
                </table>

                {{ form_widget(form.Save) }}
                {{ form_end(form) }}
            </td></tr>

    </table>
{% endblock %}