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|
<div class="modal modal--full open" data-plugin-modal="">
<div class="modal__bg modal__close"></div>
<div class="modal__wrap">
<button class="modal__close modal__closeButton iconButton iconButton--s iconButton--black icon-close"></button>
<div class="modal__content">
<div class="registrationForm">
<h2 class="modal__title">Εγγραφή νέου χρήστη</h2>
<div class="formWrap formWrap--center">
<form class="form" data-qa="form_register">
<h3 class="form__title">Είδος Λογαριασμού</h3>
<div class="form__row">
<div class="field field--full">
<div class="field__inner">
<div class="radiobuttons radiobuttons--toggle">
<div class="radiobutton ">
<label class="radiobutton__label" for="personal">
<input class="radiobutton__input" type="radio" id="personal"
name="accounttype">
<span class="radiobutton__icon icon"></span>
<span class="radiobutton__text">Προσωπικός</span>
</label>
</div>
<div class="radiobutton ">
<label class="radiobutton__label" for="company">
<input class="radiobutton__input" type="radio" id="company"
name="accounttype">
<span class="radiobutton__icon icon"></span>
<span class="radiobutton__text">Εταιρικός</span>
</label>
</div>
</div>
</div>
</div>
</div>
<div class="form__row">
<div class="field field--half">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="afm">Εταιρικός ΑΦΜ *</label>
<input class="field__input" id="afm" type="number">
</div>
</div>
</div>
<div class="field field--half">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="eponymia">Επωνυμία</label>
<input class="field__input" id="eponymia" type="text" readonly="">
</div>
</div>
</div>
</div>
<div class="form__row">
<div class="field field--half">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="job">Επάγγελμα</label>
<input class="field__input" id="job" type="text" readonly="">
</div>
</div>
</div>
<div class="field field--half">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="doy">ΔΟΥ</label>
<input class="field__input" id="doy" type="text" readonly="">
</div>
</div>
</div>
</div>
<div class="form__row">
<div class="field field--small">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="region">Προσφώνηση *</label>
<div class="select" data-plugin-select="">
<div class="select__main">
<button class="select__button">
<span class="select__placeholder">
Επίλεξε
</span>
</button>
<div class="select__listWrap">
<ul class="select__list">
<li class="select__option" data-value="option1">Option 1</li>
<li class="select__option" data-value="option2">Option 2</li>
<li class="select__option" data-value="option3">Option 3</li>
<li class="select__option" data-value="option4">Option 4</li>
<li class="select__option" data-value="option5">Option 5</li>
<li class="select__option" data-value="option6">Option 6</li>
<li class="select__option" data-value="option7">Option 7</li>
<li class="select__option" data-value="option8">Option 8</li>
</ul>
</div>
</div>
<input type="hidden" class="select__input">
</div>
</div>
</div>
</div>
</div>
<div class="form__row">
<div class="field field--half">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="name">'Ονομα*</label>
<input class="field__input" id="name" type="text">
</div>
</div>
</div>
<div class="field field--half">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="surname">Επώνυμο *</label>
<input class="field__input" id="surname" type="text">
</div>
</div>
</div>
</div>
<div class="form__row">
<div class="field field--half">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="tel">Kινητό *</label>
<input class="field__input" id="tel" type="tel">
</div>
</div>
</div>
<div class="field field--half">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="telland">Σταθερό Τηλέφωνο</label>
<input class="field__input" id="telland" type="tel">
</div>
</div>
</div>
</div>
<div class="form__row">
<div class="field field--half">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="email">Email *</label>
<input class="field__input" id="email" type="email">
</div>
</div>
</div>
<div class="field field--half">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="password">Κωδικός πρόσβασης *</label>
<input class="field__input field__input--password" id="password"
type="password">
<button class="iconButton togglePassword" data-plugin-password=""></button>
</div>
</div>
<div class="field__more field__more--spaceS">
<div class="passwordValidation">
<p>Ο κωδικός πρόσβασης πρέπει να περιέχει 6 έως 25 χαρακτήρες, χωρίς κενά, οι
οποίοι μπορεί να είναι λατινικά γράμματα, αριθμοί ή και τα σύμβολα !@#$+_-
</p>
</div>
</div>
</div>
</div>
<h3 class="form__title">Διεύθυνση</h3>
<div class="form__row">
<div class="field field--full">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="address2">Οδός & αριθμός</label>
<input class="field__input" id="address2" type="text" readonly="">
</div>
</div>
</div>
<div class="field field--small">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="floor2">Όροφος</label>
<input class="field__input" id="floor2" type="text">
</div>
</div>
</div>
</div>
<div class="form__row">
<div class="field field--full">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="city2">Περιοχή *</label>
<input class="field__input" id="city2" type="text" value="Αγία Παρασκευή"
readonly="">
</div>
</div>
</div>
<div class="field field--small">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="zipcode2">Ταχ. κώδικας</label>
<input class="field__input" id="zipcode2" type="text" value="15443" readonly="">
</div>
</div>
</div>
</div>
<div class="form__row">
<div class="field field--full">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="region2">Νομός/Περιφέρεια</label>
<input class="field__input" id="region2" type="text" value="Αττικής"
readonly="">
</div>
</div>
</div>
</div>
<div class="form__row">
<div class="field field--full field--comments">
<div class="field__inner">
<div class="field__wrap ">
<label class="field__label" for="comments">Οδηγίες παράδοσης</label>
<div class="textarea">
<textarea class="textarea__field" id="comments"
placeholder="Γράψτε το σχόλιό σας πχ. οδηγίες για την παράδοση, διευκρίνιση για προϊόν κ.λπ."></textarea>
</div>
</div>
</div>
</div>
</div>
<div class="formTip formTip--border">
<p>Τα πεδία με (*) είναι υποχρεωτικά</p>
</div>
<div class="field field field--centered">
<div class="field__inner">
<div class="checkbox ">
<label class="checkbox__label" for="terms">
<input class="checkbox__input" type="checkbox" id="terms" name="terms">
<span class="checkbox__icon icon"></span>
Έχω διαβάσει και αποδέχομαι τους όρους χρήσης και την πολιτική απορρήτου.*
</label>
</div>
</div>
</div>
<div class="field field--submit">
<div class="btnWrap btnWrap--hCenter">
<button data-qa="form_back" class="button button--border">Προηγούμενο</button>
<button data-qa="form_submit" class="button widthAuto" type="submit">Εγγραφή</button>
</div>
</div>
</form>
</div>
</div>
</div>
</div>
</div>
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