?>
<?php
echo $form->field($model, 'street')->textInput(['maxlength' => 60]);
?>
<?php
echo $form->field($model, 'zip')->textInput(['maxlength' => 60]);
?>
<?php
echo $form->field($model, 'city')->textInput(['maxlength' => 60]);
?>
<?php
echo $form->field($model, 'country_id')->dropDownList(Country::getMapWithHeader(['Germany']), ['prompt' => Yii::t('general', 'Please select')]);
?>
<?php
echo $form->field($model, 'email')->textInput(['maxlength' => 100]);
?>
<?php
echo $form->field($model, 'phone')->textInput(['maxlength' => 60]);
?>
<?php
echo $form->field($model, 'special_request')->textarea(['rows' => 6]);
?>
<div class="form-group">
