<div class="rb-popup-form" id="rb-popup-form">
  <button type="button" class="rb-popup-close js-rb-popup-close" aria-label="Закрыть форму">
    <span aria-hidden="true">
      <svg viewBox="0 0 24 24" width="24" height="24" fill="none">
        <path d="M6 6L18 18M18 6L6 18" stroke="currentColor" stroke-width="2" stroke-linecap="round"/>
      </svg>
    </span>
  </button>

  <div class="rb-popup-success" hidden>
    <h3 class="rb-popup-title">Спасибо за заявку!</h3>
    <p class="rb-popup-desc">Наш менеджер перезвонит вам в ближайшее время</p>
  </div>

  <form class="rb-form js-rb-form" method="post" action="#">
    <h3 class="rb-popup-title">Оставьте заявку</h3>
    <p class="rb-popup-desc">Мы свяжемся с вами и обсудим все детали</p>

    <div class="rb-form-grid">
      <div class="rb-field">
        <input
          type="text"
          name="formname"
          class="rb-input"
          placeholder="Ваше имя"
          autocomplete="name"
          required
        />
      </div>

      <div class="rb-field rb-select-wrap">
        <span class="rb-select-icon js-rb-select-icon" aria-hidden="true">
          <svg viewBox="0 0 24 24" width="22" height="22" fill="none">
            <path d="M4 7h16M4 12h16M4 17h16" stroke="currentColor" stroke-width="2" stroke-linecap="round"/>
          </svg>
        </span>

        <select name="select_conn" class="rb-select js-rb-select" required>
          <option value="">Выберите удобный способ связи</option>
          <option value="Телефон">Телефон</option>
          <option value="MAX">MAX</option>
          <option value="Telegram">Telegram</option>
          <option value="WhatsApp">WhatsApp</option>
        </select>

        <span class="rb-select-arrow" aria-hidden="true">
          <svg viewBox="0 0 24 24" width="18" height="18" fill="none">
            <path d="M6 9l6 6 6-6" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round"/>
          </svg>
        </span>
      </div>
    </div>

    <div class="rb-conditional js-rb-group" data-group="Телефон" hidden>
      <div class="rb-field">
        <input
          type="tel"
          name="number"
          class="rb-input js-rb-phone"
          placeholder="Введите номер телефона"
          autocomplete="tel"
        />
      </div>
    </div>

    <div class="rb-conditional js-rb-group" data-group="MAX" hidden>
      <div class="rb-field">
        <input
          type="tel"
          name="maxnumber"
          class="rb-input js-rb-phone"
          placeholder="Введите номер телефона"
          autocomplete="tel"
        />
      </div>
    </div>

    <div class="rb-conditional js-rb-group" data-group="WhatsApp" hidden>
      <div class="rb-field">
        <input
          type="tel"
          name="whatsappnumber"
          class="rb-input js-rb-phone"
          placeholder="Введите номер телефона"
          autocomplete="tel"
        />
      </div>
    </div>

    <div class="rb-conditional js-rb-group" data-group="Telegram" hidden>
      <div class="rb-field">
        <input
          type="text"
          name="telegramusername"
          class="rb-input"
          placeholder="Введите username"
        />
      </div>

      <div class="rb-note">
        На случай блокировок или если не найдём ваш профиль, введите номер телефона
      </div>

      <div class="rb-field">
        <input
          type="tel"
          name="telegramnumber"
          class="rb-input js-rb-phone"
          placeholder="Введите номер телефона"
          autocomplete="tel"
        />
      </div>
    </div>

    <div class="rb-field">
      <textarea
        name="form_comment"
        class="rb-textarea"
        rows="5"
        maxlength="300"
        placeholder="Введите свой вопрос или комментарий"
      ></textarea>
    </div>

    <input type="hidden" name="page_title" value="Главная" />
    <input type="hidden" name="event_subtitle" value="" />
    <input type="hidden" name="utm_source" value="" />
    <input type="hidden" name="utm_medium" value="" />
    <input type="hidden" name="utm_campaign" value="" />
    <input type="hidden" name="utm_term" value="" />
    <input type="hidden" name="utm_content" value="" />
    <input type="hidden" name="ymuid" value="" />

    <div class="rb-submit-wrap">
      <button type="submit" class="rb-submit">Отправить</button>
    </div>
  </form>
</div>