{% set aRegParams = oView.getRegParams() %}
<form id="c4s-newsletter-form" action="{{ oViewConf.getSslSelfLink()|raw }}" method="post" role="form" novalidate="novalidate">
    {{ oViewConf.getHiddenSid()|raw }}
    <input type="hidden" name="fnc" value="send">
    <input type="hidden" name="cl" value="newsletter">
    <input type="hidden" name="editval[oxuser__oxcountryid]" value="{{ oView.getHomeCountryId() }}">

    <div class="form-group">
        <label class="form-label col-lg-2">{{ translate({ ident: "TITLE" }) }}</label>

        <div class="col-lg-5">
            {% include "form/fieldset/salutation.html.twig" with {name: "editval[oxuser__oxsal]", value: aRegParams.oxuser__oxsal, class: "form-select selectpicker show-tick", required: false} %}
        </div>
    </div>
    <div class="form-group">
        <label class="form-label col-lg-2">{{ translate({ ident: "FIRST_NAME" }) }}</label>

        <div class="col-lg-5">
            <input class="form-control" id="newsletterFname" type="text" name="editval[oxuser__oxfname]" maxlength="40" value="{% if aRegParams.oxuser__oxfname %}{{ aRegParams.oxuser__oxfname }}{% endif %}">
        </div>
    </div>
    <div class="form-group">
        <label class="form-label col-lg-2">{{ translate({ ident: "LAST_NAME" }) }}</label>

        <div class="col-lg-5">
            <input class="form-control" id="newsletterLname" type="text" name="editval[oxuser__oxlname]" maxlength="40" value="{% if aRegParams.oxuser__oxlname %}{{ aRegParams.oxuser__oxlname }}{% endif %}">
        </div>
    </div>
    <div class="form-group{% if aErrors %} is-invalid{% endif %}">
        <label class="form-label col-lg-2 c4s-label-required">{{ translate({ ident: "EMAIL" }) }}</label>

        <div class="col-lg-5">
            <input id="newsletterUserName" type="email" class="form-control" name="editval[oxuser__oxusername]" maxlength="40" value="{% if aRegParams.oxuser__oxusername %}{{ aRegParams.oxuser__oxusername }}{% endif %}" required="required">
        </div>
    </div>
    <div class="form-group">
        <div class="col-lg-offset-2 col-lg-5">
            <label for="newsletterSubscribeOn" class="form-label checkbox-inline">
                <input id="newsletterSubscribeOn" type="radio" name="subscribeStatus" value="1" checked> {{ translate({ ident: "SUBSCRIBE" }) }}
            </label>
            <label for="newsletterSubscribeOff" class="form-label checkbox-inline">
                <input id="newsletterSubscribeOff" type="radio" name="subscribeStatus" value="0"> {{ translate({ ident: "UNSUBSCRIBE" }) }}
            </label>
        </div>
    </div>
    <div class="form-group">
        <div class="col-lg-offset-2 col-lg-5">
            <div class="alert alert-info" role="alert">{{ translate({ ident: "COMPLETE_MARKED_FIELDS" }) }}</div>
            <button id="newsLetterSubmit" class="btn btn-primary" type="submit">{{ translate({ ident: "SUBMIT" }) }}</button>
        </div>
    </div>
</form>