{% endfor %}
          </select>
          <div class="other-input" style="display:none;">
            <input type="text" id="withdrawal-reason-other" name="withdrawal-reason-other" placeholder="Please write your reason here"/>
          </div>
          <footer class="p-withdrawal-modal__footer">
            <button class="p-button--base" aria-controls="withdrawal-modal">Cancel</button>
            <button type="submit" name="submit" class="p-button--positive">Send email</button>
          </form>
        