{"id":3362,"date":"2018-01-15T09:12:35","date_gmt":"2018-01-15T09:12:35","guid":{"rendered":"http:\/\/jmtmuath.itgsolutions.com\/?page_id=4290"},"modified":"2018-01-17T09:12:19","modified_gmt":"2018-01-17T09:12:19","slug":"agent-registration","status":"publish","type":"page","link":"https:\/\/www.medxjordan.com\/en\/agent-registration\/","title":{"rendered":"Agent Registration"},"content":{"rendered":"<div class=\"registration-style\">\n    <div class=\"row\">\n        <div id=\"iv-form3\" class=\"col-md-12\">\n            <form id=\"iv_directories_registrationrr\" name=\"iv_directories_registrationrr\" class=\"form-horizontal\" action=\"https:\/\/www.medxjordan.com\/en\/agent-registration\/?&submit_iv_directoriesregister_patient=register_patient\" method=\"post\" role=\"form\">\n                <input type=\"hidden\" name=\"pippin_register_new_patient_check_nonce\" value=\"b39cc7db4a\"\/>\n                <input type=\"hidden\" name=\"iv-submit-stripe\" id=\"iv-submit-stripe\" value=\"register\">\n                <input type=\"hidden\" name=\"submit_iv_directoriesregister_agent\" id=\"submit_iv_directoriesregister_agent\" value=\"register_agent\">\n                <div class=\"content\">\n                    <h1  class=\"form-title\">Agent Registration<\/h1>\n                    <div class=\"form-content\">\n                        <div class=\"row\">\n                            <div class=\"col-md-12\">\n                                                                <!--\n                                        For Form Validation we used plugins http:\/\/formvalidator.net\/index.html#reg-form\n                                        This is in line validation so you can add fields easily.\n                                -->\n                                <div>\n                                    <div id=\"selected-column-1\" class=\" \">\n                                        <div class=\"text-center\" id=\"loading\"> <\/div>\n                                        <div class=\"form-group row\"  >\n                                            <label  class=\"col-md-3 control-label\">\n                                                Agent                                                <span class=\"chili\"><\/span>\n                                            <\/label>\n                                            <div class=\"col-md-9\">\n                                                <select name=\"iv_agent_type\" id=\"iv_agent_type\">\n                                                    <option value=\"\">-- Select --<\/option>\n                                                                                                            <option  value=\"travel\">Travel<\/option>\n                                                                                                                <option  value=\"real_estate\">Real Estate<\/option>\n                                                                                                        <\/select>\n                                            <\/div>\n                                        <\/div>\n                                        <div class=\"form-group row\"  >\n                                            <label  class=\"col-md-3 control-label\">Agent Name<span class=\"chili\"><\/span><\/label>\n                                            <div class=\"col-md-9\">\n                                                <input type=\"text\"  name=\"iv_member_lname\" placeholder=\"Enter Agent Name\" data- value=\"\" >\n                                            <\/div>\n                                        <\/div>\n                                        <div class=\"form-group row\"  >\n                                            <label  class=\"col-md-3 control-label\">Username<span class=\"chili\"><\/span><\/label>\n                                            <div class=\"col-md-9\">\n                                                <input type=\"text\"  name=\"iv_member_user_name\"   value=\"\" class=\"form-control ctrl-textbox\" placeholder=\"Enter Username\"  >\n                                            <\/div>\n                                        <\/div>\n                                        <div class=\"form-group row\">\n                                            <label  class=\"col-md-3 control-label\" >Email Address<span class=\"chili\"><\/span><\/label>\n                                            <div class=\"col-md-9\">\n                                                                                                <input type=\"text\" name=\"iv_member_email\"  class=\"form-control ctrl-textbox\" placeholder=\"Enter Email Address\" value=\"\" >\n                                            <\/div>\n                                        <\/div>\n                                        <!-- add field mobile number on Patient form   -->\n                                        <div id=\"mobile_number\" class=\"form-group row\">\n                                            <label for=\"text\" class=\"col-md-3 control-label\">Mobile Number<span class=\"chili\"><\/span><\/label>\n                                            <div class=\"col-md-9\">\n                                                <input type=\"hidden\" name=\"phone\" id=\"phone\"  >\n                                                <input style=\"z-index:10000; background:rgba(0,0,0,0);\" type=\"tel\" maxlength=\"10\" placeholder=\"Ex:07XXXXXXXX\" onchange=\"change_number () ;\" id=\"mobile\" class=\"form-control\" name=\"mobile\" value=\"+962\" \/>         \n                                            <\/div>\n                                        <\/div>\n                                                                                <br\/>\n                                        <!-- <div >\n                                            <label for=\"text\" class=\"col-md-3 control-label\">Type Number<span class=\"chili\"><\/span><\/label>\n                                            <div class=\"col-md-9\">\n\n                                                                                    <\/div>\n                                        <\/div> -->\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t                                        <div class=\"form-group row\"  >\n                                            <label  class=\"col-md-4 control-label\">Password<span class=\"chili\"><\/span><\/label>\n                                            <div class=\"col-md-8\">\n                                                <input type=\"password\"  name=\"iv_member_pass\" placeholder=\"Password\" data- value=\"\" >\n                                            <\/div>\n                                        <\/div>\n                                        <div class=\"form-group row\"  >\n                                            <label  class=\"col-md-4 control-label\">Confirm Password<span class=\"chili\"><\/span><\/label>\n                                            <div class=\"col-md-8\">\n                                                <input type=\"password\"  name=\"iv_member_confirm_pass\" placeholder=\"Confirm Password\" data- value=\"\" >\n                                            <\/div>\n                                        <\/div>\n\n                                                                            <\/div>\n                                <\/div>\n                                <input type=\"hidden\" name=\"CountryCode\" id=\"CountryCode\" value=\"\" >\n                                <input type=\"hidden\" name=\"hidden_form_name\" id=\"hidden_form_name\" value=\"iv_directories_registration\">\n                                <div class=\"form-group row \">\n                                    <label  class=\"col-md-12 control-label\">\n                                        <input type=\"checkbox\" class=\"input-checkbox\" name=\"iv_member_term\" id=\"iv_member_term\"  >\n                                        <span>I\u2019ve read and accept the <a href=\"https:\/\/www.medxjordan.com\/en\/terms-of-use\/\" target=\"_blank\">Terms of Use<\/a>.<\/span>\n                                    <\/label>        \n                                <\/div>\n                                <div class=\"row\">\n                                    <div class=\"col-md-3 \"> \n                                    <\/div>\n\n                                    <div class=\"col-md-9 \">\n                                        <input type=\"submit\" id=\"submit_iv_directories_payment\" name=\"submit_iv_directories_payment\"  class=\"btn-new btn-custom ctrl-btn\" value=\"Submit\" >\n                                    <\/div>\n                                <\/div>\n                            <\/div>\n                        <\/div>\n                    <\/div>\n                <\/div>\n                <br\/>\n            <\/form>\n            <div style=\"display: none;\">\n                <img src='https:\/\/www.medxjordan.com\/wp-content\/themes\/medical-directory\/framework\/hospital-doctor-directory\/admin\/files\/images\/loader.gif' \/>\n            <\/div>\n        <\/div>\n    <\/div>\n<\/div>\n\n\n<script type=\"text\/javascript\">\n\n\n    jQuery ( document ).ready ( function ()\n    {\n        \/\/ vaildation mobile number must be numbers only \n\n        jQuery ( document ).on ( \"keydown\" , \"#mobile\" , function ( event )\n        {\n            var keycode = event.which ;\n            if ( !( event.shiftKey == false && ( keycode == 46 || \/*keycode == 107 ||*\/ keycode == 8 || keycode == 37 || keycode == 39 || ( keycode >= 48 && keycode <= 57 ) || ( keycode >= 96 && keycode <= 105 ) ) ) )\n            {\n                event.preventDefault () ;\n            }\n        } ) ;\n\n        \/\/ setTimeout ( \"change_number();\" , 100 ) ;\n        jQuery ( '#mobile_number' )\n                .find ( '[name=\"mobile\"]' )\n                .intlTelInput ( {\n                    utilsScript : 'https:\/\/www.medxjordan.com\/wp-content\/themes\/medical-directory-child\/intl-tel-input-11.0.10\/build\/js\/utils.js' ,\n                    autoPlaceholder : false ,\n                    preferredCountries : [ 'jo' ]\n                } ) ;\n    } ) ;\n\n    jQuery ( window ).load ( function ()\n    {\n        setTimeout ( \"change_number();\" , 400 ) ;\n         jQuery ( '#mobile' ).val('');\n        \/\/ jQuery ( '.flag-container' ).css ( \"pointer-events\" , \" none\" ) ;\n    } ) ;\n\n    function change_country ()\n    {\n\n        setTimeout ( \"change_number();\" , 300 ) ; \n    }\n\n    function change_number ()\n    {\n        var q = jQuery ( '.selected-flag .iti-flag' ).attr ( 'class' ) ;\n        var t = q.split ( 'iti-flag' ) ;\n        jQuery ( '#CountryCode' ).val ( t[1].trim () ) ;\n\n        var xxx = jQuery ( '.selected-flag' ).attr ( 'title' ) ;\n        xxx = xxx.split ( \"+\" ).pop () ;\n        xxx = \"+\" + xxx ;\n        jQuery ( '#phone' ).val ( xxx ) ;\n        jQuery ( '#mobile' ).val ( jQuery ( '#mobile' ).val ().replace ( jQuery ( '#phone' ).val (  ) , '' ) ) ;\n    }\n\n<\/script>\n\n","protected":false},"excerpt":{"rendered":"Agent Registration Agent -- Select -- Travel Real Estate Agent Name Username Email Address Mobile Number Password Confirm Password I\u2019ve read and accept the Terms of Use.","protected":false},"author":1,"featured_media":4290,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"templates\/full-width-page.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-3362","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.medxjordan.com\/en\/wp-json\/wp\/v2\/pages\/3362","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.medxjordan.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.medxjordan.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.medxjordan.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.medxjordan.com\/en\/wp-json\/wp\/v2\/comments?post=3362"}],"version-history":[{"count":0,"href":"https:\/\/www.medxjordan.com\/en\/wp-json\/wp\/v2\/pages\/3362\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.medxjordan.com\/en\/wp-json\/wp\/v2\/media\/4290"}],"wp:attachment":[{"href":"https:\/\/www.medxjordan.com\/en\/wp-json\/wp\/v2\/media?parent=3362"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}