<form method="POST" action="<?php echo $data['actionPath']; ?>">
    <table>
        <tr>
            <td><label for="t_name">Client name*</label></td>
            <td><input type="text" name="name" id="t_name" required/></td>
        </tr>
        <tr>
            <td><label for="t_email">Client email*</label></td>
            <td><input type="email" name="email" id="t_email" required/></td>
        </tr>
        <tr>
            <td><label for="t_desc">Payment description*</label></td>
            <td><input type="text" name="desc" id="t_desc" required/></td>
        </tr>
        <tr>
            <td><label for="t_amount">Amount*</label></td>
            <td><input type="text" name="amount" id="t_amount" required placeholder="12.50"/></td>
        </tr>
        <tr>
            <td><label for="t_order_id">Associated order ID</label></td>
            <td><input type="text" name="order_id" id="t_order_id"/></td>
        </tr>
        <tr>
            <td><label for="t_return_url_success">Thank you page URL</label></td>
            <td><input type="url" name="return_url_success" id="t_return_url_success"/></td>
        </tr>
        <tr>
            <td><label for="t_return_url_error">Error page URL</label></td>
            <td><input type="url" name="return_url_error" id="t_return_url_error"/></td>
        </tr>
        <tr>
            <td><label for="t_currency">Payment currency*</label></td>
            <td><select name="currency" id="t_currency" required>
                    <?php
                    foreach ($data['currencies'] as $currencyCode => $currencyName) {
                        echo "<option value='$currencyCode'>$currencyName</option>";
                    }
                    ?>
                </select></td>
        </tr>
        <tr>
            <td><label for="t_language">Client language</label></td>
            <td><select name="language" id="t_language" required>
                    <?php
                    foreach ($data['languages'] as $language) {
                        echo "<option value='$language'>$language</option>";
                    }
                    ?>
                </select></td>
        </tr>
    </table>
    <input type="submit" value="Build"">
</form>
