<turbo-stream action="replace" target="internet_page_content"><template><turbo-frame id="internet_page_content">
    <div class="relative m-6"><div class="text-[#26394f] font-century-gothic m-4">
  <h1 class="font-bold text-2xl mb-4">Создание заявки на подключение</h1>
  <form class="simple_form new_order" id="new_order" novalidate="novalidate" action="/internet/orders" accept-charset="UTF-8" method="post"><input type="hidden" name="authenticity_token" value="0Isw9S_zSIfjOxq5m8ID-hoEspgi9hGSsuuyaSlRw3ysIJTK9aesGZwpdsrMbsDlIOHbmNsPKODfj--AP85KIQ" autocomplete="off" />
  <div class="flex flex-col gap-4 w-full md:w-1/2">
    <div class="text-sm"><label class="block mb-1 font-bold leading-6 text-gray-900" for="order_first_name">Имя <abbr title="Обязательное поле">*</abbr></label><input placeholder="Укажите ваше имя" class="shadow appearance-none border border-gray-300 dark:border-primary-600 rounded w-full py-2 px-3 dark:bg-primary-950 dark:text-muted-foreground bg-white focus:outline-none focus:ring-1 focus:border-primary-500 text-gray-700 leading-6 transition-colors duration-200 ease-in-out" required="required" type="text" name="order[first_name]" id="order_first_name" /></div>
    <div class="text-sm"><label class="block mb-1 font-bold leading-6 text-gray-900" for="order_last_name">Фамилия</label><input placeholder="Укажите вашу фамилию" class="shadow appearance-none border border-gray-300 dark:border-primary-600 rounded w-full py-2 px-3 dark:bg-primary-950 dark:text-muted-foreground bg-white focus:outline-none focus:ring-1 focus:border-primary-500 text-gray-700 leading-6 transition-colors duration-200 ease-in-out" type="text" name="order[last_name]" id="order_last_name" /></div>
    <div class="text-sm"><label class="block mb-1 font-bold leading-6 text-gray-900" for="order_phone">Номер телефона <abbr title="Обязательное поле">*</abbr></label><input placeholder="Укажите номер телефона в формате +7(123)-456-7890 или 81234567890" class="shadow appearance-none border border-gray-300 dark:border-primary-600 rounded w-full py-2 px-3 dark:bg-primary-950 dark:text-muted-foreground bg-white focus:outline-none focus:ring-1 focus:border-primary-500 text-gray-700 leading-6 transition-colors duration-200 ease-in-out" required="required" type="tel" name="order[phone]" id="order_phone" /></div>
    <div class="text-sm"><label class="block mb-1 font-bold leading-6 text-gray-900" for="order_email">Электронная почта</label><input placeholder="Укажите электронную почту" class="shadow appearance-none border border-gray-300 dark:border-primary-600 rounded w-full py-2 px-3 dark:bg-primary-950 dark:text-muted-foreground bg-white focus:outline-none focus:ring-1 focus:border-primary-500 text-gray-700 leading-6 transition-colors duration-200 ease-in-out" type="email" name="order[email]" id="order_email" /></div>
    <div class="text-sm"><label class="block mb-1 font-bold leading-6 text-gray-900" for="order_location">Населённый пункт <abbr title="Обязательное поле">*</abbr></label><input placeholder="Укажите населённый пункт" class="shadow appearance-none border border-gray-300 dark:border-primary-600 rounded w-full py-2 px-3 dark:bg-primary-950 dark:text-muted-foreground bg-white focus:outline-none focus:ring-1 focus:border-primary-500 text-gray-700 leading-6 transition-colors duration-200 ease-in-out" required="required" type="text" name="order[location]" id="order_location" /></div>
    <div class="text-sm"><label class="block mb-1 font-bold leading-6 text-gray-900" for="order_street">Улица <abbr title="Обязательное поле">*</abbr></label><input placeholder="Укажите название улицы" class="shadow appearance-none border border-gray-300 dark:border-primary-600 rounded w-full py-2 px-3 dark:bg-primary-950 dark:text-muted-foreground bg-white focus:outline-none focus:ring-1 focus:border-primary-500 text-gray-700 leading-6 transition-colors duration-200 ease-in-out" required="required" type="text" name="order[street]" id="order_street" /></div>
    <div class="text-sm"><label class="block mb-1 font-bold leading-6 text-gray-900" for="order_house">Дом <abbr title="Обязательное поле">*</abbr></label><input placeholder="Укажите номер дома" class="shadow appearance-none border border-gray-300 dark:border-primary-600 rounded w-full py-2 px-3 dark:bg-primary-950 dark:text-muted-foreground bg-white focus:outline-none focus:ring-1 focus:border-primary-500 text-gray-700 leading-6 transition-colors duration-200 ease-in-out" required="required" type="text" name="order[house]" id="order_house" /></div>
    <div class="text-sm"><label class="block mb-1 font-bold leading-6 text-gray-900" for="order_flat">Квартира</label><input placeholder="Укажите номер квартиры" class="shadow appearance-none border border-gray-300 dark:border-primary-600 rounded w-full py-2 px-3 dark:bg-primary-950 dark:text-muted-foreground bg-white focus:outline-none focus:ring-1 focus:border-primary-500 text-gray-700 leading-6 transition-colors duration-200 ease-in-out" type="text" name="order[flat]" id="order_flat" /></div>
  </div>
  <div class="flex flex-row gap-2 mt-4 justify-left items-center">
    <a class="button-secondary" href="/internet/home">Отменить</a>
    <input type="submit" name="commit" value="Отправить заявку" class="button-primary" data-disable-with="Отправить заявку" />
  </div>
</form>
</div>
</div>
</turbo-frame></template></turbo-stream>