{{ form = data.form;"" }}
{{ form.action = 'profiel_opslaan';"" }}

	<!-- default template -->
	<article>
	    <h1 class="border">Profiel</h1>
	
	                            
	    <!-- start flashmessenger -->
		<!-- end flashmessenger -->

		<form method="POST" name="myForm" class="form-inline" id="myForm" ng-submit="submit()" >
	
			<input type="hidden" name="action" ng-model="form.action">
			<input type="hidden" name="id" ng-model="form.id">
			
			<fieldset>
				<ol>
					<li>
						<label for="input-email">E-mailadres <em><em>*</em></em> </label>
						<input type="text" name="input-email" ng-model="form.email" required>
					</li>
					<li>
						<label for="input-password">Verander Wachtwoord </label>
						<input type="password" name="input-password" ng-model="form.password" value="">
					</li>
					<li>
						<legend>Persoonsgegevens</legend>
						<label for="input-firstname">Voornaam <em>*</em> </label>
						<input type="text" name="input-firstname" ng-model="form.firstname" required>
					</li>
					<li>
						<label for="input-lastname">Achternaam <em>*</em> </label>
						<input type="text" name="input-lastname" ng-model="form.lastname" required>
					</li>
					<li>
						<label for="input-gender"  class="labelform" >Geslacht <em>*</em> </label>
					
						<label class="labelform">
							<input type="radio" name="input-gender" class="no-margin" value="M" ng-model="form.gender" ng-selected="form.gender=='M'" required>Man
						</label>
						
						<label class="labelform">
							<input type="radio" name="input-gender" class="no-margin" value="V" ng-model="form.gender" ng-selected="form.gender=='V'" required>Vrouw
						</label>
						<br /><br />
					</li>
					<li>
						<label for="input-dateofbirth">Geboortedatum <em>*</em> </label>
						<input type="text" name="input-dateofbirth" ng-model="form.dateofbirth" required>
					</li>
					<li>
						<legend>Adresgegevens</legend>
						<label for="input-address">Adres <em>*</em> </label>
						<input type="text" name="input-address" ng-model="form.address" required>
					</li>
					<li>
						<label for="input-zipcode">Postcode <em>*</em> </label>
						<input type="text" name="input-zipcode" ng-model="form.zipcode" required>
					</li>
					<li>
						<label for="input-city">Woonplaats <em>*</em> </label>
						<input type="text" name="input-city" ng-model="form.city" required>
					</li>
					<li>
						<label for="input-telephone">Telefoon <em>*</em> </label>
						<input type="text" name="input-telephone" ng-model="form.telephone" required>
					</li>
					<li>
						<legend>Nieuwsbrieven</legend>
						<label for="input-opt-newsletter" class="checkbox">
							<!-- <input type="hidden"   name="input-opt-newsletter" ng-model="form.newsletter" ng-checked="form.newsletter"> -->
							<input type="checkbox" name="input-opt-newsletter" ng-model="form.newsletter" ng-checked="form.newsletter">Ik wil de tweewekelijkse nieuwsbrief van Classic FM ontvangen. 
						</label>
					</li>
					<li>
						<label for="input-opt-partners" class="checkbox">
							<!-- <input type="hidden" name="input-opt-partners" value="0" ng-model="form.partners" ng-checked="form.newsletter"> -->
							<input type="checkbox" name="input-opt-partners" ng-model="form.partners" ng-checked="form.partners">Ik wil incidenteel (max. 2 x p/mnd) passende commerci&euml;le aanbiedingen ontvangen uit bijvoorbeeld de retail, telecom, en automotive branche, waar ik mij op elk gewenst moment voor kan afmelden. 
						</label>
					</li>
					
					<li>
					</li>
					
					<li>
					</li>
				
				</ol>
			</fieldset>
	
			<div class="form-actions">
				<small>Velden met een * zijn verplicht</small>
				<div ng-if="error!=''"><em>{{ error }}</em></div>
				<button type="submit" name="input-submit"><span><i class="fa fa-check"></i> Opslaan</span></button>
				<button type="reset" name="reset"><span><i class="fa fa-check"></i> Wis velden</span></button>
			</div>
		</form>
		
		        
		<div class="hr"></div>
		
		<!--
        <h1>Koppel accounts</h1>
        <p>Koppel ook onderstaande accounts aan je profiel</p>

        <ul class="social-login">
        	<li><a class="facebook" href="/facebook/connect" title="Koppel je Facebook"><span class="hide-text"></span></a></li>
            <li><a class="twitter" href="/twitter/connect" title="Koppel je Twitter"><span class="hide-text"></span></a></li>
        </ul>
        -->
	        
	</article>