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<div class="popup_form_area"><h3>Оставить заявку </h3><form xmlns="http://www.w3.org/1999/xhtml" xmlns:umi="http://www.umi-cms.ru/TR/umi" class="contact-form" method="post" action="/webforms/send_pre/" enctype="multipart/form-data"><input type="hidden" name="system_email_to" value="959"/><div class="col-md-12"><div class="row"><div class="form-group phone1"><input class="form-control" id="field-phone1-211" name="phone1" placeholder="Phone" type="text"/><span class="alert-error"/></div></div></div><div class="col-md-12"><div class="row"><div class="form-group phone1"><input class="form-control" id="field-phone1-866" name="data[new][phone1]" placeholder="&#x422;&#x435;&#x43B;&#x435;&#x444;&#x43E;&#x43D;" type="text"/><span class="alert-error"/></div></div></div><div class="col-md-12"><div class="row"><div class="imya form-group required"><input class="form-control" id="field-imya-867" name="data[new][imya]" placeholder="&#x418;&#x43C;&#x44F;*" type="text" required="required"/><span class="alert-error"/></div></div></div><div class="col-md-12"><div class="row"><div class="telefon form-group required"><input class="form-control" id="field-telefon-868" name="data[new][telefon]" placeholder="&#x422;&#x435;&#x43B;&#x435;&#x444;&#x43E;&#x43D;*" type="text" required="required"/><span class="alert-error"/></div></div></div><div class="col-md-12"><div class="row"><div class="form-group kommentarij"><textarea class="form-control" id="field-kommentarij-869" name="data[new][kommentarij]" placeholder="&#x41A;&#x43E;&#x43C;&#x43C;&#x435;&#x43D;&#x442;&#x430;&#x440;&#x438;&#x439;"/><span class="alert-error"/></div></div></div><div class="col-md-12"><div class="row"><div class="agreement form-group required"><div xmlns="" class="checkbox"><input type="checkbox" id="field-agreement-870-ajax" name="data[new][agreement]" value="1" required="required" class="checkbox"/><label for="field-agreement-870-ajax">Согласен/согласна на обработку моих персональных данных <a href="" target="_blank">(Ознакомиться с соглашением)</a></label></div><span class="alert-error"/></div></div></div><input type="hidden" name="system_form_id" value="211"/><input type="hidden" name="ref_onsuccess" value="/webforms/posted/211/"/><div class="col-md-12 button_area"><div class="row"><button type="submit" name="submit">Отправить <i class="fa fa-paper-plane"/></button></div></div><div class="col-md-12 alert-notification"><div class="alert-msg"></div></div></form></div>
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