<form class="form-horizontal">
  <fieldset id="payment">
    <legend>{{ text_credit_card }}</legend>
    <div class="form-group required">
      <label class="col-sm-2 control-label" for="input-cc-type">{{ entry_cc_type }}</label>
      <div class="col-sm-10">
        <select name="cc_type" id="input-cc-type" class="form-control">
          
         {% for card in cards %}
            
          <option value="{{ card.code }}">{{ card.text }}</option>
          
          {% endfor %}
        
        </select>
      </div>
    </div>
    <div class="form-group required">
      <label class="col-sm-2 control-label" for="input-cc-name">{{ entry_cc_name }}</label>
      <div class="col-sm-10">
        <input type="text" name="cc_name" value="" placeholder="{{ entry_cc_name }}" id="input-cc-name" class="form-control" />
      </div>
    </div>
    <div class="form-group required">
      <label class="col-sm-2 control-label" for="input-cc-number">{{ entry_cc_number }}</label>
      <div class="col-sm-10">
        <input type="text" name="cc_number" value="" placeholder="{{ entry_cc_number }}" id="input-cc-number" class="form-control" />
      </div>
    </div>
    <div class="form-group required">
      <label class="col-sm-2 control-label" for="input-cc-expire-date">{{ entry_cc_expire_date }}</label>
      <div class="col-sm-3">
        <select name="cc_expire_date_month" id="input-cc-expire-date" class="form-control">
          
         {% for month in months %}
          
          <option value="{{ month.value }}">{{ month.text }}</option>
          
          {% endfor %}
        
        </select>
      </div>
      <div class="col-sm-3">
        <select name="cc_expire_date_year" class="form-control">
          
         {% for year in year_expire %}
            
          <option value="{{ year.value }}">{{ year.text }}</option>
          
          {% endfor %}
        
        </select>
      </div>
    </div>
    <div class="form-group required">
      <label class="col-sm-2 control-label" for="input-cc-cvv2">{{ entry_cc_cvv2 }}</label>
      <div class="col-sm-10">
        <input type="text" name="cc_cvv2" value="" placeholder="{{ entry_cc_cvv2 }}" id="input-cc-cvv2" class="form-control" />
      </div>
    </div>
    <div class="form-group">
      <label class="col-sm-2 control-label" for="input-cc-issue"><span data-toggle="tooltip" title="{{ help_issue }}">{{ entry_cc_issue }}</span></label>
      <div class="col-sm-10">
        <input type="text" name="cc_issue" value="" placeholder="{{ entry_cc_issue }}" id="input-cc-issue" class="form-control" />
      </div>
    </div>
  </fieldset>
</form>
<div class="buttons">
    <input type="button" value="{{ button_confirm }}" id="button-confirm" data-loading-text="{{ text_loading }}" class="button button-primary br-7" />
</div>
<script type="text/javascript"><!--
$('#button-confirm').bind('click', function() {
  $.ajax({
    url: 'index.php?route=extension/payment/globalpay_remote/send',
    type: 'post',
    data: $('#payment :input'),
    dataType: 'json',
    cache: false,
    beforeSend: function() {
      $('#globalpay-message-error').remove();
      $('#button-confirm').attr('disabled', true);
      $('#payment').before('<div id="globalpay-message-wait" class="alert alert-info"><i class="fa fa-info-circle"></i> {{ text_wait }}</div>');
    },
    success: function(json) {
      // if 3ds redirect instruction
      if (json['ACSURL']) {
        $('#3dauth').remove();

        html  = '<form action="' + json['ACSURL'] + '" method="post" id="3dauth">';
        html += '  <input type="hidden" name="MD" value="' + json['MD'] + '" />';
        html += '  <input type="hidden" name="PaReq" value="' + json['PaReq'] + '" />';
        html += '  <input type="hidden" name="TermUrl" value="' + json['TermUrl'] + '" />';
        html += '</form>';

        $('#payment').after(html);

        $('#3dauth').submit();
      }

      // if error
      if (json['error']) {
        $('#payment').before('<div id="globalpay-message-error" class="alert alert-warning"><i class="fa fa-info-circle"></i> '+json['error']+'</div>');
        $('#button-confirm').attr('disabled', false);
        $('#globalpay-message-wait').remove();
      }

      // if success
      if (json['success']) {
        location = json['success'];
      }
    }
  });
});
//--></script>