<div class="contact-wrapper ftp-wrapper">
    <h3>Your Information</h3>
    <div id="text-above">
        <?php echo do_shortcode(get_field('text_on_the_top')) ?>
    </div>

    <div class="row">
        <form action="" method="post" id="register-form" class="newsletter-and-alerts-login">
            <input type="hidden" name="action" value="ftp_form" action="verify.php"/>
            <div class="col-sm-6">
                <span class="error" id="register-error"></span>
                <div class="form-row">
                    <div class="row">
                        <div class="col-sm-12 no-padding-left">
                            <input type="text" class="form-control order_txt required" name="full-name" placeholder="Full Name (Required)" value="<?php echo @$_POST['full-name'] ?>" >
                            <span class="error">* <?php echo get_field('register_full_name_error_message') ?></span>
                        </div>
                    </div>




                </div><!-- Form Row Ends -->
                <div class="form-row">
                    <div class="row">
                        <div class="col-sm-12 no-padding-left">
                            <input type="text" id="email" name="email" value="<?php echo $_COOKIE['email'] ?>"  class="form-control order_txt required" placeholder="Email (Required)" >
                            <span class="error">* <?php echo get_field('register_email_error_message') ?></span>
                        </div>
                    </div>
                </div><!-- Form Row Ends -->
                <div class="form-row">
                    <div class="row">
                        <div class="col-sm-12 no-padding-left">
                            <input type="text" id="phone" name="phone" value="<?php echo $_COOKIE['phone'] ?>"  class="form-control order_txt required" placeholder="Phone (Required)" >
                            <span class="error">* <?php echo get_field('register_phone_error_message') ?></span>
                        </div>
                    </div>
                </div><!-- Form Row Ends -->

                <div class="form-row">
                    <div class="row">
                        <div class="col-sm-12 no-padding-left">
                            <input type="text" id="company" name="company" value="<?php echo $_COOKIE['company'] ?>"  class="form-control order_txt" placeholder="Company" >
                        </div>
                    </div>
                </div><!-- Form Row Ends -->


                <div class="checkbox-wrapper">

                    <div class="row">
                        <div>
                            <label>
                                <input type="checkbox" name="remember" id="remember" value="yes" class="" >
                                <span>Remember me</span>
                            </label>
                        </div>
                    </div>
                </div>
            </div>
            <input type="submit" style="display:none"/>
        </form>

    </div>

    <div class="col-sm-6 no-padding-left text-right">

    </div>
    <div class="col-sm-6 no-padding-left text-right">
        <input type="submit" id="register-button" class="order_btn" value="Continue to Upload Page">
    </div>
</form>
</div><!-- END of .affiliate-wrapper -->