{include file="includes/header.html"}

{form name="thelia.customer.creation"}
<form method="post" action="index_dev.php?action=createCustomer&view=connexion" {form_enctype form=$form} >

    {form_hidden_fields form=$form}

    {form_field form=$form field="title"}
        {form_error form=$form field="title"}
            {$message}
        {/form_error}

        <label> <span>{intl l="{$label}"} : </span></label>
        <select name="{$name}">
            <option value="1">M.</option>
            <option value="2">Mme.</option>

        </select>
        <br />
    {/form_field}

    {form_field form=$form field="firstname"}
        {form_error form=$form field="firstname"}
            {$message}
        {/form_error}

        <label> <span>{intl l="{$label}"} : </span></label><input type="text" name="{$name}" value="{$value}" {$attr} > <br />
    {/form_field}

    {form_field form=$form field="lastname"}
        {form_error form=$form field="lastname"}
            {$message}
        {/form_error}

        <label> <span>{intl l="{$label}"} : </span></label><input type="text" name="{$name}" value="{$value}" {$attr} > <br />
    {/form_field}

    {form_field form=$form field="address1"}
        {form_error form=$form field="address1"}
            {$message}
        {/form_error}

        <label> <span>{intl l="{$label}"} : </span></label><input type="text" name="{$name}" value="{$value}" {$attr} > <br />
    {/form_field}

    {form_field form=$form field="address2"}
        {form_error form=$form field="address2"}
            {$message}
        {/form_error}

        <label> <span>{intl l="{$label}"} : </span></label><input type="text" name="{$name}" value="{$value}" {$attr} > <br />
    {/form_field}

    {form_field form=$form field="address3"}
        {form_error form=$form field="address3"}
            {$message}
        {/form_error}

        <label> <span>{intl l="{$label}"} : </span></label><input type="text" name="{$name}" value="{$value}" {$attr} > <br />
    {/form_field}

    {form_field form=$form field="zipcode"}
        {form_error form=$form field="zipcode"}
            {$message}
        {/form_error}

        <label> <span>{intl l="{$label}"} : </span></label><input type="text" name="{$name}" value="{$value}" {$attr} > <br />
    {/form_field}

    {form_field form=$form field="city"}
        {form_error form=$form field="city"}
            {$message}
        {/form_error}

        <label> <span>{intl l="{$label}"} : </span></label><input type="text" name="{$name}" value="{$value}" {$attr} > <br />
    {/form_field}

    {form_field form=$form field="country"}
        {form_error form=$form field="country"}
            {$message}
        {/form_error}

        <label> <span>{intl l="{$label}"} : </span></label>
            <select name="{$name}">
                <option value="1">France</option>
                <option value="2">Belgium</option>

            </select>
        <br />
    {/form_field}

    {form_field form=$form field="phone"}
        {form_error form=$form field="phone"}
            {$message}
        {/form_error}
        <label> <span>{intl l="{$label}"} : </span></label><input type="text" name="{$name}" value="{$value}" {$attr}> <br />
    {/form_field}

    {form_field form=$form field="cellphone"}
        {form_error form=$form field="cellphone"}
            {$message}
        {/form_error}
        <label> <span>{intl l="{$label}"} : </span></label><input type="text" name="{$name}" value="{$value}" {$attr}> <br />
    {/form_field}

    {form_field form=$form field="email"}
        {form_error form=$form field="email"}
            {#message}
        {/form_error}
        <label><span>{intl l="{$label}"}</span></label><input type="email" name="{$name}" value="{$value}" {$attr} ><br />
    {/form_field}

    {form_field form=$form field="email_confirm"}
        {form_error form=$form field="email_confirm"}
            {#message}
        {/form_error}
        <label><span>{intl l="{$label}"}</span></label><input type="email" name="{$name}" {$attr} ><br />
    {/form_field}

    {form_field form=$form field="password"}
        {form_error form=$form field="password"}
            {#message}
        {/form_error}
        <label><span>{intl l="{$label}"}</span></label><input type="password" name="{$name}" {$attr} ><br />
    {/form_field}

    {form_field form=$form field="password_confirm"}
        {form_error form=$form field="password_confirm"}
            {#message}
        {/form_error}
        <label><span>{intl l="{$label}"}</span></label><input type="password" name="{$name}" {$attr} ><br />
    {/form_field}

<input type="submit" value="valider">
</form>
{/form}

{include file="includes/footer.html"}