This is a custom code placeholder.
Switch to Preview or publish the page
to see how your code works.
Double-click to edit
<div class="text-center bg-light p-3 border border-bottom-0">
<h5 class="mb-0">Register Now</h5>
</div>
<form class="reg-form p-4 bg-white border" method="get" action="" id="registrationForm">
<div class="row mb-3">
<div class="col-6 ">
<input class="form-control" type="text" id="first_name" name="first_name"
placeholder="First Name" required />
<span class="help-block" for="first_name"></span>
</div>
<div class="col-6">
<input class="form-control" type="text" id="last_name" name="last_name" placeholder="Last Name"
required />
<span class="help-block" for="last_name"></span>
</div>
</div>
<div class="row mb-3">
<div class="col-12">
<input class="form-control" type="text" id="email" name="email"
placeholder="Email Address" required />
<span class="help-block" for="email"></span>
</div>
</div>
<div class="row mb-3">
<div class="col-12">
<select class="form-control form-select" id="country" name="country" required>
<option value="select">Country of Residence</option>
</select>
<span class="help-block" for="country"></span>
</div>
</div>
<div class="row mb-3">
<div class="col-5">
<input class="form-control" type="text" id="post_code" name="post_code" placeholder="Country Code" required />
<span class="help-block" for="post_code"></span>
</div>
<div class="col-7">
<input class="form-control" type="text" id="phone" name="phone" placeholder="Phone Number" required />
<span class="help-block" for="phone"></span>
</div>
</div>
<div class="row mb-3">
<div class="col-12">
<div class="form-check">
<input class="form-check-input" type="checkbox" value="" id="flexCheckDefault" name="confirm1" required>
<label class="form-check-label small" for="flexCheckDefault">
By opening this account, I confirm that I have had access to, reviewed, read, understood, and accept the full set of INGOT Brokers legal documents including the
Client Agreement,
<a target="_blank" href="#" id="terms-and-conditions">Terms & Conditions</a>,
<a target="_blank" href="#" id="privacy-policy">Privacy Policy</a>,
Product Disclosure Statement and Financial Services Guide
</label>
<span class="help-block" for="confirm1"></span>
</div>
</div>
</div>
<div class="row">
<div class="col-12">
<input class="btn btn-dark w-100" type="submit" value="Register" />
</div>
</div>
</form>
<link href="https://cdn.jsdelivr.net/npm/bootstrap@5.0.2/dist/css/bootstrap.min.css" rel="stylesheet">
<style>
.reg-form {
direction: ltr;
}
.reg-form a {
color: #000;
text-decoration: underline;
}
.reg-form .form-control {
padding: 0.75rem .75rem;
}
.reg-form .btn {
padding: .75rem .75rem;
}
.reg-form .has-error *,
.reg-form .help-block {
color: #cd2124 !important;
}
.reg-form .help-block {
width: 100%;
margin-top: 0.35rem;
font-size: 70%;
text-transform: lowercase;
display: block;
}
.reg-form .has-error .custom-file-label,
.reg-form .has-error .input-group-text,
.reg-form .has-error input,
.reg-form .has-error select,
.reg-form .has-error textarea {
border-color: #cd2124;
background: rgba(205, 33, 36, .2);
}
.reg-form .form-check .form-check-input {
float: revert;
margin-right : 3px;
margin-left: -1.5em;
}
.reg-form .form-check {
display: block;
min-height: 1.5rem;
padding-right: 0;
margin-bottom: 0.125rem;
padding-left: 1.5em;
}
.reg-form .form-select {
background-position: right 0.75rem center;
}
</style>
<script src="https://cdn.jsdelivr.net/npm/jquery@3.5.1/dist/jquery.min.js"></script>
<script type="text/javascript">
$(document).ready(function() {
let domain = "https://" + window.location.host.replace('campaign.', 'portal.');
let language = 'en';
$.ajax({
url: domain + "/api/v1/ingot/get-countries-api",
dataType: 'json',
headers: {
'Access-Control-Allow-Origin': '*',
},
data: {
'lang': language,
},
success: function(response, textStatus, jqXHR) {
if (response.data) {
$.each(response.data, function(key, value) {
$('#country').append($("<option></option>").attr("value", key).text(value));
});
document.getElementById('country').value='KE';
document.getElementById('post_code').value='465';
}
},
error: function(jqXHR, textStatus, errorThrown) {}
});
$('#country').change(function() {
var countryCode = $('#country').val();
getPostode(countryCode);
});
function getPostode(countryCode) {
$.ajax({
url: domain + "/api/v1/ingot/get-postcode-api",
dataType: 'json',
headers: {
'Access-Control-Allow-Origin': '*',
},
data: {
'country_code': countryCode,
},
success: function(response, textStatus, jqXHR) {
if (response.data) {
$('#post_code').val(response.data[0]);
}
},
error: function(jqXHR, textStatus, errorThrown) {}
});
}
//account forms
$.ajax({
url: domain + "/api/v1/ingot/get-account-form",
dataType: 'json',
headers: {
'Access-Control-Allow-Origin': '*',
},
data: {
'lang': language,
'domain' : domain
},
success: function(response, textStatus, jqXHR) {
if (response.data) {
$account_form = response.data;
Object.entries($account_form).map(([key, value]) => {
if($("#" + key).length != 0) {
document.getElementById(key).href = value;
}
})
}
},
error: function(jqXHR, textStatus, errorThrown) {}
});
$('#registrationForm').submit(function(e) {
e.preventDefault();
var first_name = $("input[name=first_name]").val();
var last_name = $("input[name=last_name]").val();
var email = $("input[name=email]").val();
var country = $("select[name=country]").val();
var phone = $("input[name=phone]").val();
var post_code = $("input[name=post_code]").val();
var campaign_name = window.location.pathname.replace('/landing/', '');;
$("#registrationForm").find("input, button, select").attr('disabled', true);
$.ajax({
url: domain + "/api/v1/ingot/create-application-get",
dataType: 'json',
headers: {
'Access-Control-Allow-Origin': '*',
},
data: {
'first_name': first_name,
'last_name': last_name,
'email': email,
'country': country,
'post_code': post_code,
'phone': phone,
'campaign_name': campaign_name,
'referral': '11',
'account_type': 'individual',
'host': domain,
'lang': language
},
success: function(response, textStatus, jqXHR) {
if (!response.success) {
// enable enput
$("#registrationForm").find("input, button, select").attr('disabled', false);
// reset form
$("#registrationForm *").removeClass("has-error");
$("#registrationForm .help-block").text('');
// display error validation
$.each(response.data, function(key, value) {
$('#' + key).parent().addClass('has-error');
$('#' + key).next().text(value);
});
} else if (response.data.redirect_url) {
window.location.href = response.data.redirect_url;
}
},
error: function(jqXHR, textStatus, errorThrown) {
$("#registrationForm").find("input, button, select").attr('disabled',false);
}
});
});
});
</script>