{% set id = journal3.uniqueId('field-') %}
<div class="{{ journal3.classes(classes) }}">
  <button aria-label="Edit" class="admin-edit" type="button" data-edit="{{ edit }}"><em class="fa fa-pencil" data-placement="auto" data-toggle="tooltip-hover" data-tooltip-class="admin-edit-tooltip" title="Edit {{ name }}"></em></button>
  {% if title %}
    <h3 class="title module-title">{{ title }}</h3>
  {% endif %}
  <div class="module-body">
    <form action="{{ action }}" method="post" enctype="multipart/form-data" class="form-horizontal" data-language="{{ datepicker }}">
      <fieldset>
        {% for index, item in items %}
          {% if item.type == 'legend' %}
            <legend class="{{ journal3.classes(item.classes) }}">{{ item.label }}</legend>
          {% endif %}

          {% if item.type == 'select' %}
            <div class="form-group custom-field {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
              <label class="col-sm-2 control-label" for="{{ id }}-{{ index }}">{{ item.label }}</label>
              <div class="col-sm-10">
                <select name="item[{{ index }}]" id="{{ id }}-{{ index }}" class="form-control">
                  <option value="">{{ item.placeholder }}</option>
                  {% for subitem in item.items %}
                    <option value="{{ subitem.label }}">{{ subitem.label }}</option>
                  {% endfor %}
                </select>
              </div>
            </div>
          {% endif %}

          {% if item.type == 'radio' %}
            <div class="form-group custom-field form-radio {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
              <label class="col-sm-2 control-label">{{ item.label }}</label>
              <div class="col-sm-10">
                {% for subitem in item.items %}
                  <div class="radio">
                    <label>
                      <input type="radio" name="item[{{ index }}]" value="{{ subitem.label }}"/>
                      {{ subitem.label }}</label>
                  </div>
                {% endfor %}
              </div>
            </div>
          {% endif %}

          {% if item.type == 'checkbox' %}
            <div class="form-group custom-field form-checkbox {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
              <label class="col-sm-2 control-label">{{ item.label }}</label>
              <div class="col-sm-10">
                {% for subitem in item.items %}
                  <div class="checkbox">
                    <label>
                      <input type="checkbox" name="item[{{ index }}][]" value="{{ subitem.label }}"/>
                      {{ subitem.label }}</label>
                  </div>
                {% endfor %}
              </div>
            </div>
          {% endif %}

          {% if item.type == 'text' or item.type == 'name' %}
            <div class="form-group custom-field {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
              <label class="col-sm-2 control-label" for="{{ id }}-{{ index }}">{{ item.label }}</label>
              <div class="col-sm-10">
                <input type="text" name="item[{{ index }}]" value="" placeholder="{{ item.placeholder }}" id="{{ id }}-{{ index }}" class="form-control"/>
              </div>
            </div>
          {% endif %}

          {% if item.type == 'email' %}
            <div class="form-group custom-field {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
              <label class="col-sm-2 control-label" for="{{ id }}-{{ index }}">{{ item.label }}</label>
              <div class="col-sm-10">
                <input type="email" name="item[{{ index }}]" value="" placeholder="{{ item.placeholder }}" id="{{ id }}-{{ index }}" class="form-control"/>
              </div>
            </div>
          {% endif %}

          {% if item.type == 'tel' %}
            <div class="form-group custom-field {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
              <label class="col-sm-2 control-label" for="{{ id }}-{{ index }}">{{ item.label }}</label>
              <div class="col-sm-10">
                <input type="tel" name="item[{{ index }}]" value="" placeholder="{{ item.placeholder }}" id="{{ id }}-{{ index }}" class="form-control"/>
              </div>
            </div>
          {% endif %}

          {% if item.type == 'textarea' %}
            <div class="form-group custom-field {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
              <label class="col-sm-2 control-label" for="{{ id }}-{{ index }}">{{ item.label }}</label>
              <div class="col-sm-10">
                <textarea name="item[{{ index }}]" rows="5" placeholder="{{ item.placeholder }}" id="{{ id }}-{{ index }}" class="form-control"></textarea>
              </div>
            </div>
          {% endif %}

          {% if item.type == 'file' %}
          <div class="form-group custom-field {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
            <label class="col-sm-2 control-label" for="form-upload-{{ id }}-{{ index }}">{{ item.label }}</label>
            <div class="col-sm-10">
              <button type="button" id="form-upload-{{ id }}-{{ index }}" data-loading-text="{{ text_loading }}" class="btn btn-default upload-btn"><i class="fa fa-upload"></i> {{ button_upload }}</button>
              <input type="hidden" name="item[{{ index }}]" value="" id="{{ id }}-{{ index }}" class="form-control"/>
            </div>
          </div>
          {% endif %}

          {% if item.type == 'date' %}
            <div class="form-group custom-field {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
              <label class="col-sm-2 control-label" for="{{ id }}-{{ index }}">{{ item.label }}</label>
              <div class="col-sm-10">
                <div class="input-group {% if not journal3_is_oc4 %}date{% endif %}" data-picker-class="module-form-{{ module_id }}">
                  <input type="text" name="item[{{ index }}]" value="" placeholder="{{ item.label }}" data-date-format="YYYY-MM-DD" id="{{ id }}-{{ index }}" class="form-control {% if journal3_is_oc4 %}date{% endif %}"/>
                  <div class="input-group-btn">
                    <button type="button" class="btn btn-default"><i class="fa fa-calendar"></i></button>
                  </div>
                </div>
              </div>
            </div>
          {% endif %}

          {% if item.type == 'time' %}
            <div class="form-group custom-field {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
              <label class="col-sm-2 control-label" for="{{ id }}-{{ index }}">{{ item.label }}</label>
              <div class="col-sm-10">
                <div class="input-group {% if not journal3_is_oc4 %}time{% endif %}" data-picker-class="module-form-{{ module_id }}">
                  <input type="text" name="item[{{ index }}]" value="" placeholder="{{ item.label }}" data-date-format="HH:mm" id="{{ id }}-{{ index }}" class="form-control {% if journal3_is_oc4 %}time{% endif %}"/>
                  <div class="input-group-btn">
                    <button type="button" class="btn btn-default"><i class="fa fa-calendar"></i></button>
                  </div>
                </div>
              </div>
            </div>
          {% endif %}

          {% if item.type == 'datetime' %}
            <div class="form-group custom-field {% if item.required %}required{% endif %} {{ journal3.classes(item.classes) }}">
              <label class="col-sm-2 control-label" for="{{ id }}-{{ index }}">{{ item.label }}</label>
              <div class="col-sm-10">
                <div class="input-group {% if not journal3_is_oc4 %}datetime{% endif %}" data-picker-class="module-form-{{ module_id }}">
                  <input type="text" name="item[{{ index }}]" value="" placeholder="{{ item.label }}" data-date-format="YYYY-MM-DD HH:mm" id="{{ id }}-{{ index }}" class="form-control {% if journal3_is_oc4 %}datetime{% endif %}"/>
                  <div class="input-group-btn">
                    <button type="button" class="btn btn-default"><i class="fa fa-calendar"></i></button>
                  </div>
                </div>
              </div>
            </div>
          {% endif %}
        {% endfor %}
        {% if captcha %}
        <div class="form-group captcha">
          {{ captcha }}
        </div>
        {% endif %}
        {% if agree_data %}
          <div class="checkbox">
            <label>
              <input type="checkbox" name="agree" value="1"/>
              {{ agree_data.text }}
            </label>
          </div>
        {% endif %}
      </fieldset>
      <div class="buttons">
        <div class="pull-right">
          <button type="submit" class="btn btn-primary"  data-loading-text="<span>{{ button_submit }}</span>"><span>{{ button_submit }}</span></button>
        </div>
      </div>
    </form>
  </div>
</div>
