<form method="post" action="[% post_uri %]">

   <div class="o-layout o-layout--center u-padding">

    <div class="o-layout__item u-1/1 u-2/3@tablet u-3/5@desktop">
      [% IF set_access_durations.size > 1 %]
      <div class="input-container">
        <label>[% i18n("Access duration") %]</label>
        <select name="access_duration">
          <option value="">[% i18n('Select access duration') %]</option>
          [% FOREACH access_duration IN set_access_durations %]
          <option value='[% access_duration.value %]'>[% access_duration.label %]</option>
          [% END %]
        </select>
      </div>
      [% END %]

      [%# submit %]
      <div class="u-margin-top">
        <button type="submit" name="submit" class="c-btn c-btn--primary u-1/1">
          [% i18n('Validate') %]
        </button>
      </div>
  </div>
</div>

</form>
