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    <div class="wrapper wrapper-content animated fadeInRight">
        <form method="POST" action="https://panel.europa-verstehen.de/courses/custom" accept-charset="UTF-8" class="form-horizontal" id="customForm" onkeypress="return event.keyCode != 13;"><input name="_token" type="hidden" value="LEr9a15IHraERoW1Xdi80eQ8MQulwg68ixbCOowt">
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    <input type="hidden" name="region_id" value="18">
    <input type="hidden" name="country_id" value="642">
  <input type="hidden" name="course_type_id" value="2">

  <div class="row">
    <div class="col-lg-12">
      <h1>
        <span class="dynamic" data-key="courses.custom.my_class_log">First European Moment</span>
      </h1>
      <p>
        <span class="dynamic" data-key="courses.custom.my_class_log_desc">Workshopul interactiv First European Moment se adresează elevilor de gimnaziu și liceu. Căutăm școli din România, care ar dori să le ofere elevilor oportunitatea de a identifica primul moment în care s-au simțit europeni, pe baza unui kit creativ cu activități practice. Școlile care nu au încă un profil european sunt încurajate să se înregistreze. Workshopul este facilitat de o echipă de formatori tineri direct la școală. Participarea este gratuită.</span>
      </p>
    </div>

    <div class="col-lg-12">
      <div class="ibox float-e-margins">
        <div class="ibox-title">
          <h3>
            <span class="dynamic" data-key="courses.custom.application_form_custom">
              Formular de înscriere
            </span>
          </h3>
          <b>For course type "Asylum Course" in Romania.</b>
                  </div>
        <div class="ibox-content">
          <h3> </h3>
          <p>
            <span class="req">*</span>
            <span class="dynamic" data-key="courses.custom.fields_mandatory_custom">
              Fields are mandatory for successful registration.
            </span>
          </p>

          <div class="form-horizontal m-t-md" action="#">
            <div class="hr-line-dashed"></div>

            
            <div class="form-group" id="salutation-div">
              <label class="col-sm-3 control-label" for="iSalutation">
                <span class="dynamic" data-key="courses.custom.salutation">
                  Formula de adresare
                </span>
                <span class="req">*</span>
              </label>
              <div class="col-sm-9">
                <select class="form-control" id="salutation" name="salutation"><option value="Mr.">Mr.</option><option value="Mrs.">Ms.</option><option value="other">Other</option></select>
                <input class="form-control other_sal" name="salutation" type="text">
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group">
              <label class="col-sm-3 control-label " for="last_name">
                <span class="dynamic" data-key="courses.custom.surname_teach">
                  Prenume (profesor)
                </span>
                <span class="req">*</span>
              </label>
              <div class="col-sm-9">
                <input name="last_name" type="text" id="surname" class="form-control" placeholder="" required>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group" id="firstName">
              <label class="col-sm-3 control-label" for="firstname">
                <span class="dynamic" data-key="courses.custom.first_name">
                  Nume (profesor)
                </span>
                <span class="req">*</span>
              </label>
              <div class="col-sm-9">
                <input type="text" name="first_name" id="firstname" class="form-control" placeholder="" required>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group" id="email">
              <label class="col-sm-3 control-label" for="email_id">
                <span class="dynamic" data-key="courses.custom.email_teach">
                  Email (profesor)
                </span>
                <span class="req">*</span>
              </label>
              <div class="col-sm-9">
                <input type="email" name="email" id="email_id" class="form-control" placeholder="" required>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group">
              <label class="col-sm-3 control-label" for="tele">
                <span class="dynamic" data-key="courses.custom.tele_teach">
                  Număr de telefon (profesor)
                </span>
                <span class="req">*</span>
              </label>
              <div class="col-sm-9">
                <input type="text" name="telephone" id="tele" class="form-control" placeholder="" required>
                <span class="help-block"></span>
              </div>
            </div>
          </div>
        </div>

        <div class="ibox-content">
          <div class="row">
            <div class="col-md-8">
              <h3>
                <span class="dynamic"
                    data-key="courses.custom.has_eu_compact_held_earlier">Au mai fost ținute ateliere de acest gen la dvs. în școală?</span>
                <span class="req">*</span>
              </h3>
              <p>

              </p>
            </div>
          </div>

          <div class="form-horizontal m-t-md" action="#">
            <div class="form-horizontal m-t-md" action="#">
              <div class="form-group">
                <div class="col-xs-6">
                  <label class="col-xs-5 control-label" for="optionsRadios2a">
                    <span class="dynamic"
                        data-key="courses.custom.yes">Da</span>

                  </label>
                  <div class="i-checks"><label class="">
                      <input type="radio" value="1" id="optionsRadios2a" name="compact_held" required>
                  </div>
                </div>
                <div class="col-xs-6">
                  <label class="col-xs-5 control-label" for="optionsRadios2b">
                    <span class="dynamic"
                        data-key="courses.custom.no">Nu</span>
                  </label>
                  <div class="i-checks"><label class="">
                      <input type="radio" value="0" id="optionsRadios2b" name="compact_held" required>
                  </div>
                </div>
                <div class="col-sm-3 col-xs-12 text-right-custom">
                  <div id="erroRadio-EU"></div>
                </div>

              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group">
              <label class="col-sm-3 control-label" for="school_name">
                <span class="dynamic"
                    data-key="courses.custom.name_school">Numele școlii:</span>
                <span class="req">*</span></label>
              <div class="col-sm-9">
                <input type="text" class="form-control" id="school_name" placeholder="" name="name" required>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group">
              <label class="col-sm-3 control-label" for="school_form">
                <span class="dynamic"
                    data-key="courses.custom.school_form">Tipul școlii</span>
                <span class="req">*</span></label>
              <div class="col-sm-9">
                <select class="select2_demo_1 form-control select2-hidden-accessible" id="school_form"
                    name="school_type_id" aria-hidden="true" disabled onchange="otherSchool(this.value)" required>
                  <option value="-" disabled selected>-</option>
                                                            <option value="1">Berufskolleg</option>
                                                                                <option value="2">Förderschule</option>
                                                                                <option value="3">Gemeinschaftsschule</option>
                                                                                <option value="4">Gesamtschule</option>
                                                                                <option value="5">Gymnasium</option>
                                                                                <option value="6">Hauptschule</option>
                                                                                <option value="7">Oberstufenzentrum</option>
                                                                                <option value="8">Oberschule</option>
                                                                                <option value="9">Realschule</option>
                                                                                <option value="10">Sekundarschule</option>
                                                                                <option value="11">Waldorfschule</option>
                                                                                <option value="12">Stadtteilschule</option>
                                                                                <option value="13">Other</option>
                                                                                <option value="14">Grundschule</option>
                                                                                <option value="15">Berufliche Schule (z.B. Berufsschule, Fachoberschule, Berufskolleg, ...)</option>
                                                                                <option value="16">Zweiter Bildungsweg</option>
                                                                                <option value="17">Integrierte Sekundarschule</option>
                                                                                <option value="18">Mittelschule</option>
                                                                                <option value="19">Sonstige</option>
                                                                                <option value="21">Vmbo-b</option>
                                                                                <option value="22">Vmbo-b</option>
                                                                                <option value="23">Vmbo-g</option>
                                                                                <option value="24">Vmbo-k</option>
                                                                                <option value="25">Vmbo-t/mavo</option>
                                                                                <option value="26">HAVO</option>
                                                                                <option value="27">VWO</option>
                                                                                <option value="30">Escuela pública</option>
                                                                                <option value="31">Escuela concertada</option>
                                                                                <option value="32">Escuela privada</option>
                                                                                <option value="33">Escuela de Formación Profesional Inicial (grado medio y grado superior)</option>
                                                                                <option value="34">Universidad</option>
                                                                                <option value="35">Otro</option>
                                                                                <option value="36">ASO/Général</option>
                                                                                <option value="37">TSO/Technique</option>
                                                                                <option value="38">BSO/Professionnel</option>
                                                                                <option value="39">KSO/Artistique</option>
                                                                                <option value="40">Other/Ander/Autre</option>
                                                                                <option value="41">EYP Session</option>
                                                                                <option value="42">Europolis</option>
                                                                                <option value="43">Parlons ensemble d’Europe</option>
                                                                                <option value="44">Liceo</option>
                                                                                <option value="45">Istituto tecnico</option>
                                                                                <option value="46">Istituto professionale</option>
                                                                                <option value="47">AHS</option>
                                                                                <option value="48">BAKIP</option>
                                                                                <option value="49">BS</option>
                                                                                <option value="50">HAK</option>
                                                                                <option value="51">HASch</option>
                                                                                <option value="52">HLA</option>
                                                                                <option value="53">HTL</option>
                                                                                <option value="54">NMS</option>
                                                                                <option value="55">Polytechnische Schule</option>
                                                                                <option value="56">andere</option>
                                                                                <option value="57">Escola Básica de 3º Ciclo</option>
                                                                                <option value="58">Escola Secundária</option>
                                                                                <option value="59">Escola Profissional</option>
                                                                                <option value="60">High school (Ավագ դպրոց)</option>
                                                                                <option value="61">College (Քոլեջ կամ վարժարան)</option>
                                                                                <option value="62">Educational complex (Կրթահամալիր)</option>
                                                                                <option value="63">Middle School of General Education (ZOSh) </option>
                                                                                <option value="64">Lyceum</option>
                                                                                <option value="65">Gymnаsium</option>
                                                                                <option value="66">Vocational school</option>
                                                                                <option value="67">Other (Այլ)</option>
                                                                                <option value="68">State Anatolian High School / Devlet Anadolu Lisesi</option>
                                                                                <option value="69">State Scientific High School / Devlet Fen Lisesi</option>
                                                                                <option value="70">State Vocational School / Devlet Meslek Lisesi</option>
                                                                                <option value="71">State Religious School / Devlet Anadolu İmam Hatip Lisesi</option>
                                                                                <option value="72">Private Anatolian High School / Özel Anadolu Lisesi</option>
                                                                                <option value="73">Private Scientific High School / Özel Fen Lisesi</option>
                                                                                <option value="74">Private Vocational School / Özel Meslek Lisesi</option>
                                                                                <option value="75">Private Foreign School based in Turkey / Türkiye’de Faaliyet Gösteren Yabancı Liseler</option>
                                                                                <option value="76">Gimanzial</option>
                                                                                <option value="77">Liceal</option>
                                                                                <option value="78">Universitar</option>
                                                      </select>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="form-group other-school-box">

              <label class="col-sm-3 control-label" for="locationField"></label>
              <div class="col-sm-9" id="locationField">
                <input id="other-school" type="text" class="form-control" name="other_school_form" placeholder=""
                    required>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>

            <div class="form-group">
              <label class="col-sm-3 control-label" for="route">
                <span class="dynamic"
                    data-key="courses.custom.street">Strada</span>
                <span class="req">*</span></label>
              <div class="col-sm-9">
                <input type="text" class="form-control" id="route" name="street" placeholder="" required>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="form-group">
              <label class="col-sm-3 control-label" for="postal_code">
                <span class="dynamic"
                    data-key="courses.custom.post_code">Codul poștal</span>

                <span class="req">*</span></label>
              <div class="col-sm-9">
                <input class="form-control" id="postal_code" name="postcode" placeholder=""
                    required>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="form-group">
              <label class="col-sm-3 control-label" for="locality">
                <span class="dynamic"
                    data-key="courses.custom.city">Oraș</span>

                <span class="req">*</span></label>
              <div class="col-sm-9">
                <input type="text" class="form-control" id="locality" name="city" placeholder="" required>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="form-group" style="display:none;">
              <label class="col-sm-3 control-label">Co-ordinates<span class="req">*</span></label>
              <div class="col-sm-4">
                <input type="text" class="form-control" id="co-lat" name="lat" placeholder="">
                <span class="help-block"></span>
              </div>
              <div class="col-sm-4">
                <input type="text" class="form-control" id="co-lng" name="lng" placeholder="">
                <span class="help-block"></span>
              </div>
            </div>
          </div>
        </div>

        <div class="ibox-content" style="display:none">
          <h3 style="display: inline;">Map</h3>
          <div class="ibox-tools" style="display: inline; float:right;">
            <a class="map-togg" onclick="clickInit()">
              <i class="fa fa-chevron-down"></i>
            </a>
          </div>
          <div class="ibox-content map-content visib-hidden">
            <div class="row">
              <div id="map"></div>
            </div>
          </div>
        </div>
        <div class="ibox-content">
          <div class="row">
            <div class="col-md-8">
              <h3>
                <span class="dynamic"
                    data-key="courses.custom.eu_compact_student">Detalii despre curs *</span>
              </h3>
              <p>
                <span class="dynamic"
                    data-key="courses.custom.eu_compact_student.desc">Un workshop First European Moment  este disponibil pentru un număr de maximum 25 de elevi. În cazul în care doriți mai multe cursuri de acest gen, pentru un număr mai mare de beneficiari, vă rugăm să completați formulare separate.</span>

              </p>
            </div>
          </div>

          <div class="form-horizontal m-t-md" action="#">
            <div class="form-group">
              <label class="col-sm-3 control-label" for="participants">
                <span class="dynamic"
                    data-key="courses.custom.number_pf_participants">Număr de participanți</span>

                <span class="req">*</span></label>
              <div class="col-sm-9">
                <input type="number" min="0" step="1" id="participants" class="form-control" name="no_of_students"
                    placeholder="" required>
                <span class="help-block"></span>
              </div>
            </div>
          </div>
        </div>
        <div class="ibox-content">
          <div class="row">
            <div class="col-md-8">
              <h3>
                <span class="dynamic"
                    data-key="courses.custom.for_prelimnary">Vă rugăm să ne oferiți câteva informații cu privire la grupul de elevi:</span>


              </h3>
              <p>
              </p>
            </div>
          </div>

          <div class="form-horizontal m-t-md" action="#">
            <div class="form-group">
              <label class="col-sm-3 control-label" for="student_class_id">
                <span class="dynamic"
                    data-key="courses.custom.Jahrgangsstufe">Clasa</span>

                <span class="req">*</span></label>
              <div class="col-sm-9">
                <select class="select2_demo_1 form-control select2-hidden-accessible" id="student_class_id"
                    name="student_class_id" disabled
                    required aria-hidden="true">
                  <option value="-" disabled selected>-</option>
                </select>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group">
              <label class="col-sm-3 control-label" for="courses_related">
                <span class="dynamic"
                    data-key="courses.custom.if_course_relate_to_diff">Dacă ați dori să implementați aceste curs la mai multe clase, vă rugăm să specificați aici despre ce clase este vorba</span>
              </label>
              <div class="col-sm-9">
                <textarea class="form-control" name="diffrent_grades" id="courses_related" placeholder=""
                    rows="4"></textarea>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group">
              <label class="col-sm-3 control-label" for="relevant">
                <span class="dynamic"
                    data-key="courses.custom.are_they_relevant">Există anumite aspecte pe care ați dori să ne concentrăm în discuțiile despre primul moment european??</span>
              </label>
              <div class="col-sm-9">
                <textarea class="form-control" id="relevant" name="relevant_debates" placeholder="" rows="4"></textarea>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="form-group">
              <label class="col-sm-3 col-xs-10 control-label" for="compact_course">
                <span class="dynamic"
                    data-key="courses.the_eu_compact_courses">Cursurile despre Uniunea Europeană sunt destinate în primul rând elevilor fără cunoștințe anterioare despre UE și politicile acesteia. Au elevii dvs. cunoștințe anterioare despre conținutul cursului (de exemplu, istoria UE, politici/sisteme UE sau posibilități participative)?</span>
              </label>
              <div class="i-checks"><label class="">
                  <div class="icheckbox_square-green">

                    <input type="checkbox" value="1" id="compact_course" name="know_eu">
                    <ins class="iCheck-helper"></ins>
                  </div>
                  <i></i></label>
              </div>
            </div>
          </div>
        </div>
        <div class="ibox-content">
          <div class="row">
            <div class="col-md-8">
              <h3>
                <span class="dynamic"
                    data-key="courses.custom.what_could_courses_take">Ce date preferați pentru desfășurarea acestui atelier în școala dvs.? *</span>
              </h3>
              <p>
                <span class="dynamic"
                    data-key="courses.custom.please_note">Vă rugăm să alegeți date la o distanță de cel puțin 14 zile de completarea formularului.</span>
              </p>
            </div>
          </div>


          <div class="form-horizontal m-t-md" action="#">
            <div class="form-group">
              <label class="col-sm-3 control-label" for="pref1">
                <span class="dynamic"
                    data-key="courses.custom.preferences">Varianta 1</span>

                1 <span class="req">*</span></label>
              <div class="col-sm-9">
                <input type="text" id="pref1" readonly name="preference[]" class="form-control datepicker" required
                    placeholder="">
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group">
              <label class="col-sm-3 control-label" for="pref2">
                <span class="dynamic"
                    data-key="courses.custom.preferences">Varianta 1</span>
                2</label>
              <div class="col-sm-9">
                <input type="text" id="pref2" readonly name="preference[]" class="form-control datepicker"
                    placeholder="">
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group">
              <label class="col-sm-3 control-label" for="pref3">
                <span class="dynamic"
                    data-key="courses.custom.preferences">Varianta 1</span>
                3</label>
              <div class="col-sm-9">
                <input type="text" readonly name="preference[]" id="pref3" class="form-control datepicker"
                    placeholder="">
                <span class="help-block"></span>
              </div>
            </div>
          </div>
        </div>
        <div class="ibox-content">
          <div class="row">
            <div class="col-md-8">
              <h3>
                <span class="dynamic"
                    data-key="courses.custom.when_EU_cc_be_held">În ce parte a zilei preferați să desfășurăm acest curs? *</span>
                <span class="req">*</span>
              </h3>
              <p>
                <span class="dynamic"
                    data-key="courses.custom.when_the_courses_held_desc">Cursul durează până la 3 ore, cu pauze intercalate.</span>

              </p>
            </div>
          </div>

          <div class="form-horizontal m-t-md" required action="#">
            <div class="form-group">
              <label class="col-sm-3 control-label" for="preferred_time">
                <span class="dynamic"
                        data-key="courses.custom.preferred_time">Interval orar</span>
                <span class="req">*</span></label>
              <div class="col-sm-9">
                <input type="text" class="form-control" id="preferred_time" name="preferred_time" placeholder="" required>
                <span class="help-block"></span>
              </div>
            </div>

            <div class="hr-line-dashed"></div>

            <div class="hr-line-dashed"></div>

            <div class="form-group">
              <div class="col-sm-3 text-right-custom">
                <div id="erroRadio-preferred_time"></div>
              </div>
            </div>
          </div>
        </div>
        <div class="ibox-content">
          <div class="row">
            <div class="col-md-8">
              <h3>
                                    <span class="dynamic" data-key="courses.custom.concluding_part">

                                    Câteva întrebări de final</span>
              </h3>
              <p>

              </p>
            </div>
          </div>
          <div class="form-horizontal m-t-md" action="#">
            <div class="form-group">
              <label class="col-sm-3 control-label" for="textbox1">
                <span class="dynamic"
                    data-key="courses.custom.how_hear_about">Cum ați auzit despre cursul nostru?</span>
              </label>
              <div class="col-sm-9">
                <textarea class="form-control" id="textbox1" name="how_did_hear" placeholder="" rows="4"></textarea>
                <span class="help-block"></span>
              </div>
            </div>
            <div class="hr-line-dashed"></div>
            <div class="form-group">
              <label class="col-sm-3 control-label" for="textbox2">
                <span class="dynamic"
                    data-key="courses.custom.remarks">Comentarii suplimentare</span>

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