			<div class="pd-15">
				<div class="block">
					<div class="block_head">
						Добавить заявку
					</div>
					<div class="col-md-6">
						<div class="form-group">
							<label for="class">
								<h4>
									<span class="glyphicon glyphicon-tasks"></span> Сервер
									<span class="glyphicon glyphicon-pushpin ness"></span>
								</h4>
							</label>
							<select id="server" class="form-control" onchange="local_change_server();">
								{servers}
							</select>
						</div>
						<div id="none" class="disp-n">
							<div class="form-group">
								<label for="nick">
									<h4>
										<span class="glyphicon glyphicon-user"></span> Ваш ник
										<span class="glyphicon glyphicon-pushpin ness"></span>
									</h4>
								</label>
								<input type="text" class="form-control" id="nick" maxlength="250" autocomplete="off">
							</div>
							<div class="form-group">
								<label for="reason">
									<h4>
										<span class="glyphicon glyphicon-warning-sign"></span> Причина бана
										<span class="glyphicon glyphicon-pushpin ness"></span>
									</h4>
								</label>
								<input type="text" class="form-control" id="reason" maxlength="250" autocomplete="off">
							</div>
						</div>

						<div id="db" class="disp-n">
							<div class="form-group">
								<label for="nick_db">
									<h4>
										<span class="glyphicon glyphicon-user"></span> Ваш идентификатор
										<span class="glyphicon glyphicon-pushpin ness"></span>
									</h4>
								</label>
								<input type="text" class="form-control" id="nick_db" maxlength="250" placeholder="Введите ник/steam_id/ip">
								<button class="btn2 mt-10" onclick="find_bans();">Найти</button>
								<div id="bans_table" class="table-responsive mb-0 mt-10 disp-n">
									<table class="table table-bordered">
										<thead>
											<tr>
												<td>Действие</td>
												<td>Ник</td>
												<td>Причина</td>
												<td>Дата окончания</td>
											</tr>
										</thead>
										<tbody id="search_ban_res_min">
											<tr><td colspan="4">
												<center><img src="{site_host}templates/{template}/img/loader.gif"></center>
											</td></tr>
										</tbody>
									</table>
								</div>
								<div id="search_ban_res_full" class="mt-10"></div>
							</div>
						</div>

						<div id="dop" class="disp-n">
							<div class="form-group">
								<label for="text">
									<h4>
										<span class="glyphicon glyphicon-comment"></span> Пояснения
										<span class="glyphicon glyphicon-pushpin ness"></span>
									</h4>
								</label><br>
								<textarea id="text" class="form-control maxMinW100 maxH200" rows="3" maxlength="2000"></textarea>
							</div>
							<div class="form-group">
								<label>
									<h4>
										<span class="glyphicon glyphicon-picture"></span> Скриншоты
									</h4>
								</label><br>
								<div class="input-group">
									<form enctype="multipart/form-data" action="ajax/actions_a.php" method="POST" id="add_img_form">
										<input type="hidden" id="token" name="token" value="{token}">
										<input type="hidden" id="add_ban_img" name="add_ban_img" value="1">
										<input type="hidden" id="phpaction" name="phpaction" value="1">
										<input class="input-file f-l" type="file" id="ban_img" accept="image/*" name="ban_img"/><br>
										<input type="hidden" id="counter" name="counter" value="0">
										<input class="btn btn-default f-l" type="submit" value="Загрузить">
									</form>
								</div>
								<input value="" type="hidden" id="screens" autocomplete="off">
								<small>Максимальное количество прикрепляемых скриншотов: 5</small>
								<div id="img_result" class="mt-10"></div>
								<div id="imgs" class="mt-10"></div>
								<script>
									$(document).ready(function() {
										init_tinymce("text", "lite", "{file_manager_theme}", "{file_manager}", "{{md5($conf->code)}}");
									});
									$("#add_img_form").submit(function (event){
										NProgress.start();
										event.preventDefault();
										var data = new FormData($('#add_img_form')[0]);
										$.ajax({
											type: "POST",
											url: "../ajax/actions_a.php",
											data: data,
											contentType: false,
											processData: false,
										}).done(function (html) {
											NProgress.done();
											$("#img_result").empty();
											$("#img_result").append(html);
											$('#add_img_form')[0].reset();
										});
									});
								</script>
							</div>
							<div class="form-group">
								<label for="demo">
									<h4>
										<span class="glyphicon glyphicon-globe"></span> Ссылка на демо
									</h4>
								</label>
								<input type="text" class="form-control" id="demo" maxlength="250" autocomplete="off">
							</div>

							<div class="form-group">
								<p class="help-block">Поля, отмеченные <span class="glyphicon glyphicon-pushpin ness"></span>, обязательны для заполнения!</p>
							</div>
							<div id="new_result" class="mt-10"></div>
							<button id="create_btn" onclick="add_ban();" type="button" class="btn2 btn-big">Создать</button><br><br>
						</div>
						{script}
					</div>
					<div class="col-md-6">
						<div id="info_block" class="bs-callout bs-callout-info transition_h_2">
							<h4>Инструкция к заполнению</h4>
							<div>
								{include file="/bans/instructions.tpl"}
							</div>
						</div>
					</div>
				</div>
			</div>
			<script>
				function local_change_server() {
					var server_type = $('#server option:selected').attr('data-server-type');
					select_ban_type(server_type);
				}
				local_change_server();
			</script>
		</div>
	</div>
</div>