Server : Apache/2 System : Linux server-15-235-50-60 5.15.0-164-generic #174-Ubuntu SMP Fri Nov 14 20:25:16 UTC 2025 x86_64 User : gositeme ( 1004) PHP Version : 8.2.29 Disable Function : exec,system,passthru,shell_exec,proc_close,proc_open,dl,popen,show_source,posix_kill,posix_mkfifo,posix_getpwuid,posix_setpgid,posix_setsid,posix_setuid,posix_setgid,posix_seteuid,posix_setegid,posix_uname Directory :  /home/gositeme/domains/gositeme.com/public_html/whmcs/templates/phox/

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{if $errorMessageHtml}
  {include file="$template/includes/alert.tpl" type="error" errorshtml=$errorMessageHtml}
{/if}

<script>
  var stateNotRequired = true;
  jQuery(document).ready(function() {
    WHMCS.form.register();
  });
</script>
<script src="{$BASE_PATH_JS}/StatesDropdown.js"></script>

<div class="alert alert-block alert-info">
  <form class="form-horizontal" role="form" method="post" action="{routePath('account-contacts')}">
    <div class="row">
      <label for="inputContactId" class="col-sm-3 control-label">{$LANG.clientareachoosecontact}</label>
      <div class="col-sm-6">
        <select name="contactid" id="inputContactId" onchange="submit()" class="form-control">
          {foreach $contacts as $contact}
          <option value="{$contact.id}">{$contact.name} - {$contact.email}</option>
          {/foreach}
          <option value="new" selected="selected">{$LANG.clientareanavaddcontact}</option>
        </select>
      </div>
      <div class="col-sm-2 hidden-xs">
        <button type="submit" class="btn btn-default btn-block">{$LANG.go}</button>
      </div>
    </div>
  </form>
</div>

<form role="form" method="post" action="{routePath('account-contacts-new')}">

  <div class="row">
    <div class="col-sm-6">

      <div class="form-group">
        <label for="inputFirstName" class="control-label">{$LANG.clientareafirstname}</label>
        <input type="text" name="firstname" id="inputFirstName" value="{$formdata.firstname}" class="form-control" />
      </div>

      <div class="form-group">
        <label for="inputLastName" class="control-label">{$LANG.clientarealastname}</label>
        <input type="text" name="lastname" id="inputLastName" value="{$formdata.lastname}" class="form-control" />
      </div>

      <div class="form-group">
        <label for="inputCompanyName" class="control-label">{$LANG.clientareacompanyname}</label>
        <input type="text" name="companyname" id="inputCompanyName" value="{$formdata.companyname}" class="form-control" />
      </div>

      <div class="form-group">
        <label for="inputEmail" class="control-label">{$LANG.clientareaemail}</label>
        <input type="email" name="email" id="inputEmail" value="{$formdata.email}" class="form-control" />
      </div>

      <div class="form-group">
        <label for="inputPhone" class="control-label">{$LANG.clientareaphonenumber}</label>
        <input type="tel" name="phonenumber" id="inputPhone" value="{$formdata.phonenumber}" class="form-control" />
      </div>

      {if $showTaxIdField}
      <div class="form-group">
        <label for="inputTaxId" class="control-label">{lang key=$taxIdLabel}</label>
        <input type="text" name="tax_id" id="inputTaxId" class="form-control" value="{$formdata.tax_id}" />
      </div>
      {/if}

    </div>
    <div class="col-sm-6 col-xs-12 pull-right">

      <div class="form-group">
        <label for="inputAddress1" class="control-label">{$LANG.clientareaaddress1}</label>
        <input type="text" name="address1" id="inputAddress1" value="{$formdata.address1}" class="form-control" />
      </div>

      <div class="form-group">
        <label for="inputAddress2" class="control-label">{$LANG.clientareaaddress2}</label>
        <input type="text" name="address2" id="inputAddress2" value="{$formdata.address2}" class="form-control" />
      </div>

      <div class="form-group">
        <label for="inputCity" class="control-label">{$LANG.clientareacity}</label>
        <input type="text" name="city" id="inputCity" value="{$formdata.city}" class="form-control" />
      </div>

      <div class="form-group">
        <label for="inputState" class="control-label">{$LANG.clientareastate}</label>
        <input type="text" name="state" id="inputState" value="{$formdata.state}" class="form-control" />
      </div>

      <div class="form-group">
        <label for="inputPostcode" class="control-label">{$LANG.clientareapostcode}</label>
        <input type="text" name="postcode" id="inputPostcode" value="{$formdata.postcode}" class="form-control" />
      </div>

      <div class="form-group">
        <label class="control-label" for="country">{$LANG.clientareacountry}</label>
        {$countriesdropdown}
      </div>

    </div>
  </div>

  <div class="form-group">
    <h3 class="wdes-main-title">{$LANG.clientareacontactsemails}</h3>
    <div class="wdes-checks-email controls checkbox">
      {foreach $formdata.emailPreferences as $emailType => $value}
      <label>
        <input type="hidden" name="email_preferences[{$emailType}]" value="0">
        <input type="checkbox" name="email_preferences[{$emailType}]" id="{$emailType}emails" value="1" {if $value} checked="checked" {/if} />
        {lang key="clientareacontactsemails"|cat:$emailType}
      </label>{if !($emailType@last)}<br />{/if}
      {/foreach}
    </div>
  </div>

  <div class="form-group text-center">
    <input class="btn btn-primary" type="submit" name="save" value="{$LANG.clientareasavechanges}" />
    <input class="btn btn-default" type="reset" value="{$LANG.cancel}" />
  </div>

</form>