{literal}
	<script src="https://www.google.com/recaptcha/api.js?render=6LegdywdAAAAADKhWf40ZE7xYCwRlvVg_mg3Ot0q"></script>
	<script>
		grecaptcha.ready(function () {
			grecaptcha.execute('6LegdywdAAAAADKhWf40ZE7xYCwRlvVg_mg3Ot0q', { action: 'contact' }).then(function (token) {
				var recaptchaResponse = document.getElementById('recaptchaResponseCallback');
				recaptchaResponse.value = token;
			});
		});
	</script>
{/literal}

<div id="callback_form" style="display:none;" class="modal-forms">

<form class="form-horizontal"  data-style="width: 550px;">

	<div class="callback-header h2" style="font-size: 18px;">Заявка на обратный звонок</div>

	<div class="form-group">
		<label class="col-sm-3 control-label">Имя</label>
		<div class="col-sm-9">
			<input name="name" class="form-control" placeholder="Как к Вам обращаться">
			<div class="help-block err name-error"></div>
		</div>
	</div>

	<div class="form-group">
		<label class="col-sm-3 control-label">Телефон *</label>
		<div class="col-sm-9">
			<input required name="phone" class="form-control" data-min="5" placeholder="Телефон для связи">
			<div class="help-block err phone-error">Телефон должен быть указан</div>
		</div>

	</div>

	<div class="form-group">
		<label class="col-sm-3 control-label">Комментарий</label>
		<div class="col-sm-9">
			<textarea name="comment" class="form-control" placeholder="Комментарий"></textarea>
		</div>
	</div>
	<input type="hidden" name="recaptcha_response" id="recaptchaResponseCallback">
	<div class="form-group" style="padding-left: 20px;">
		<button class="btn btn-default callback-submit" type="submit">Отправить</button>
	</div>

	<input type="hidden" name="_url" value="/modal-form/callback_send.php">


</form>
	<div class="callback-success alert alert-success" style="font-size: 15px;display:none;">Ваше сообщение отправлено</div>
</div>