{"id":8829,"date":"2019-10-30T04:34:53","date_gmt":"2019-10-30T08:34:53","guid":{"rendered":"https:\/\/dev.ampm365insurance.com\/membership-join\/membership-registration\/"},"modified":"2019-10-30T04:34:53","modified_gmt":"2019-10-30T08:34:53","slug":"agent-registration","status":"publish","type":"page","link":"https:\/\/ampm365insurance.com\/agent-join\/agent-registration\/","title":{"rendered":"Registration"},"content":{"rendered":"<div class=\"swpm-registration-widget-form\">\r\n    <form id=\"swpm-registration-form\" class=\"swpm-validate-form\" name=\"swpm-registration-form\" method=\"post\" action=\"\">\r\n        <input type =\"hidden\" name=\"level_identifier\" value=\"c81e728d9d4c2f636f067f89cc14862c\" \/>\r\n        <table>\r\n            <tr class=\"swpm-registration-username-row\" >\r\n                <td><label for=\"user_name\">Username<\/label><\/td>\r\n                <td><input type=\"text\" id=\"user_name\" class=\"validate[required,custom[noapostrophe],custom[SWPMUserName],minSize[4],ajax[ajaxUserCall]]\" value=\"\" size=\"50\" name=\"user_name\" \/><\/td>\r\n            <\/tr>\r\n            <tr class=\"swpm-registration-email-row\">\r\n                <td><label for=\"email\">Email<\/label><\/td>\r\n                <td><input type=\"text\" autocomplete=\"off\" id=\"email\" class=\"validate[required,custom[email],ajax[ajaxEmailCall]]\" value=\"\" size=\"50\" name=\"email\" \/><\/td>\r\n            <\/tr>\r\n            <tr class=\"swpm-registration-password-row\">\r\n                <td><label for=\"password\">Password<\/label><\/td>\r\n                <td><input type=\"password\" autocomplete=\"off\" id=\"password\" class=\"\" value=\"\" size=\"50\" name=\"password\" \/><\/td>\r\n            <\/tr>\r\n            <tr class=\"swpm-registration-password-retype-row\">\r\n                <td><label for=\"password_re\">Repeat Password<\/label><\/td>\r\n                <td><input type=\"password\" autocomplete=\"off\" id=\"password_re\" value=\"\" size=\"50\" name=\"password_re\" \/><\/td>\r\n            <\/tr>\r\n            <tr class=\"swpm-registration-firstname-row\" >\r\n                <td><label for=\"first_name\">First Name<\/label><\/td>\r\n                <td><input type=\"text\" id=\"first_name\" value=\"\" size=\"50\" name=\"first_name\" \/><\/td>\r\n            <\/tr>\r\n            <tr class=\"swpm-registration-lastname-row\" >\r\n                <td><label for=\"last_name\">Last Name<\/label><\/td>\r\n                <td><input type=\"text\" id=\"last_name\" value=\"\" size=\"50\" name=\"last_name\" \/><\/td>\r\n            <\/tr>\r\n            <tr class=\"swpm-registration-membership-level-row\" >\r\n                <td><label for=\"membership_level\">Membership Level<\/label><\/td>\r\n                <td>\r\n                    Agent<input type=\"hidden\" value=\"2\" size=\"50\" name=\"swpm_membership_level\" id=\"membership_level\" \/><input type=\"hidden\" name=\"swpm_level_hash\" value=\"bd6781bcc301b274a88de4f48bedb98a\" \/>                <\/td>\r\n            <\/tr>\r\n                    <\/table>\r\n\r\n        <div class=\"swpm-before-registration-submit-section\" align=\"center\"><div class=\"swpm-recaptcha-section\" style=\"margin-bottom: 15px;\"><style type=\"text\/css\">@media screen and (max-width: 375px) {\n            .swpm_g_captcha{transform:scale(0.77);transform-origin:0;-webkit-transform:scale(0.77);-webkit-transform-origin:0 0;}\n        }<\/style><script src=\"https:\/\/www.google.com\/recaptcha\/api.js\" async defer><\/script><div class=\"swpm_g_captcha\"><div class=\"g-recaptcha\" data-sitekey=\"6LcX2G8UAAAAAI2YWdkbkBQ6BHodn_JVZXrr4qyF\" data-theme=\"light\" data-size=\"normal\"><\/div><\/div><\/div><\/div>\r\n\r\n        <div class=\"swpm-registration-submit-section\" align=\"center\">\r\n            <input type=\"submit\" value=\"Register\" class=\"swpm-registration-submit\" name=\"swpm_registration_submit\" \/>\r\n        <\/div>\r\n\r\n        <input type=\"hidden\" name=\"action\" value=\"custom_posts\" \/>\r\n\r\n    <\/form>\r\n<\/div>\r\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":8828,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"agentregistration.php","meta":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.2.1 - 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