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<!DOCTYPE html> <html lang="zxx"> <head> <meta charset="utf-8"> <meta http-equiv="x-ua-compatible" content="IE=edge"> <meta name="viewport" content="width=device-width, initial-scale=1"> <meta name="description" content=""> <meta name="keyword" content=""> <meta name="author" content="Custom Assist Inc."> <!--! The above 6 meta tags *must* come first in the head; any other head content must come *after* these tags !--> <!--! BEGIN: Apps Title--> <title>Sign Up</title> <!--! END: Apps Title--> <!--! BEGIN: Favicon--> <link rel="shortcut icon" type="image/x-icon" href="./assets/images/favicon.png"> <!--! END: Favicon--> <!--! BEGIN: Bootstrap CSS--> <link rel="stylesheet" type="text/css" href="./assets/css/bootstrap.min.css"> <!--! END: Bootstrap CSS--> <!--! BEGIN: Vendors CSS--> <link rel="stylesheet" type="text/css" href="./assets/vendors/css/vendors.min.css"> <!--! END: Vendors CSS--> <!--! BEGIN: Custom CSS--> <link rel="stylesheet" type="text/css" href="./assets/css/theme.min.css"> <!--! END: Custom CSS--> <!--! HTML5 shim and Respond.js for IE8 support of HTML5 elements and media queries !--> <!--! WARNING: Respond.js doesn"t work if you view the page via file: !--> <!--[if lt IE 9]> <script src="https:oss.maxcdn.com/html5shiv/3.7.2/html5shiv.min.js"></script> <script src="https:oss.maxcdn.com/respond/1.4.2/respond.min.js"></script> <![endif]--> <style> .auth-minimal-wrapper { background: radial-gradient(circle at 24.1% 68.8%, rgb(50, 50, 50) 0%, rgb(0, 0, 0) 99.4%); background-size: 400% 400%; -webkit-animation: gradient 100s ease infinite; animation: gradient 100s ease infinite; background-image: url(./assets/images/bg/logo-light.png); background-size: 40%; background-position: top 80% left 66%; background-attachment: fixed; background-repeat: no-repeat; } } /*Gradient Effect*/ @-webkit-keyframes gradient { 0% { background-position: 0% 50%; } 50% { background-position: 100% 50%; } 100% { background-position: 0% 50%; } } @keyframes gradient { 0% { background-position: 0% 50%; } 50% { background-position: 100% 50%; } 100% { background-position: 0% 50%; } } </style> <!--/Additional--> {if E::V(['name'=>'recaptcha_signup']) and E::V(['name'=>'google_recaptcha_site'])} <script src="https://www.google.com/recaptcha/api.js?render={E::V(['name'=>'google_recaptcha_site'])}"></script> {literal} <script> grecaptcha.ready(function () { grecaptcha.execute('{/literal}{Extended::Value(['name'=>'google_recaptcha_site'])}{literal}', { action: 'login' }).then(function (token) { var recaptchaResponse = document.getElementById('recaptchaResponse'); recaptchaResponse.value = token; }); }); </script> {/literal} {/if} <!-- /theme JS files --> </head> <body> <!--! ================================================================ !--> <!--! [Start] Main Content !--> <!--! ================================================================ !--> <main class="auth-minimal-wrapper"> <div class="auth-minimal-inner"> <div class="minimal-card-wrapper"> <div class="card mb-4 mt-5 mx-4 mx-sm-0 position-relative"> <div class="wd-80 bg-white p-2 rounded-circle shadow-lg position-absolute translate-middle top-0 start-50"> <img src="./assets/images/logo-dark-abbr.png" alt="Logo" class="img-fluid"> </div> <div class="card-body p-sm-5"> <h2 class="fs-20 fw-bolder mb-4 text-primary text-uppercase">Sign Up <a href="./index.php?dad=user&jc=auth&a=form" class="float-end fs-8 fw-semibold text-muted text-underline">Login Instead!</a></h2> <h4 class="fs-13 fw-medium mb-2">Create An Account</h4> <p class="fs-12 fw-medium text-muted">Let's get you all setup, so you can verify your personal account and begin setting up your profile.</p> <p class="fs-10 text-danger">{$MSG}</p> <form action="index.php" method="post" enctype="multipart/form-data" class="w-100 mt-4 pt-2"> <div class="row"> <input type="hidden" name="dad" value="user" /> <input type="hidden" name="jc" value="activate"> <input type="hidden" name="a" value="web" /> <input type="hidden" name="subaction" value="{$subaction}" /> <input type="hidden" name="recaptcha_response" id="recaptchaResponse"> <input type="hidden" name="md5" value="false"> <!--Personal Details--> <h4 class="fs-12 fw-medium mb-2 text-primary">Personal Details</h4> {if Users::Form('fname')} <div class="col-6 mb-4"> <input type="text" class="form-control border-primary" autocomplete="off" placeholder="First Name"name="fname" value="{$smarty.post.fname|default:''}" required> </div> {/if} {if Users::Form('lname')} <div class="col-6 mb-4"> <input type="text" class="form-control border-primary" autocomplete="off" placeholder="Last Name" name="lname" value="{$smarty.post.lname|default:''}" required> </div> {/if} {assign var='ef' value=Users::Form('email')} {if $ef} <div class="col-6 mb-4"> <input type="email" class="form-control border-primary" autocomplete="off" placeholder="Email Address" name="email" value="{$smarty.post.email|default:''}" {if $ef.required}required required{/if}> </div> {else if Users::Form('username')} <div class="col-6 mb-4"> <input type="text" class="form-control border-primary" autocomplete="off" placeholder="Username" name="username" value="{$smarty.post.username|default:''}" required> </div> {/if} {if Users::Form('phone')} <div class="col-6 mb-4"> <input type="tel" class="form-control border-primary" autocomplete="off" placeholder="Phone Number (International Format) Eg +256.752567374" name="phone" value="{$smarty.post.phone|default:''}" required> </div> {/if} {if Users::Form('agentid')} <div class="col-6 mb-4"> <input type="text" class="form-control border-primary" autocomplete="off" placeholder="{$LANG.T000030}" name="agentid" value="{$smarty.post.agentid|default:''}"> </div> {/if} <!--Identification Details--> {if Users::Form('id_type')} <h4 class="fs-12 fw-medium mb-2 text-primary">Identification Details</h4> <div class="col-6 mb-4"> <select class="form-control border-primary" data-select2-selector="city" name="identity[code]" required> <option data-city="bg-primary" value="national_id">National ID</option> <option data-city="bg-primary" value="passport">Passport</option> <option data-city="bg-primary" value="driving_license">Driving Permit</option> </select> </div> <div class="col-6 mb-4"> <input type="text" class="form-control border-primary" name="identity[number]" value="{$smarty.post.identity.number}" placeholder="ID Number" required> </div> <div class="mb-4"> <div class="col-lg-12 border border-primary rounded"> <div class="mb-4 mb-md-0 d-flex gap-4 your-brand"> <div class="wd-100 ht-100 position-relative overflow-hidden border border-gray-2 rounded"> <img src="./assets/images/stock/avatar/1.png" class="upload-pic img-fluid rounded h-100 w-100" alt="Upload Image"> <div class="position-absolute start-50 top-50 end-0 bottom-0 translate-middle h-100 w-100 align-items-center justify-content-center c-pointer upload-button" style="opacity: 0.3;"> </div> <input class="file-upload" type="file" name="identity[]" accept="image/*" required> </div> <div class="d-flex flex-column gap-1"> <div class="fs-11 text-gray-500 mt-2"># Upload your ID</div> <div class="fs-11 text-gray-500"># Should be an image</div> <div class="fs-11 text-gray-500"># Should have both front & back</div> <div class="fs-11 text-gray-500"># Please ensure it's valid</div> </div> </div> </div> </div> {/if} <!--Bank Details--> {if Users::Form('bank')} <h4 class="fs-12 fw-medium mb-2 text-primary">Bank Details</h4> <div class="col-6 mb-4"> <input type="text" class="form-control border-primary" autocomplete="off" placeholder="Bank Name" name="bank[bank]" value="{$smarty.post.bank.bank}" required> </div> <div class="col-6 mb-4"> <input type="text" class="form-control border-primary" autocomplete="off" placeholder="Account Number" name="bank[number]" value="{$smarty.post.bank.number}" required> </div> <div class="col-12 mb-4"> <input type="text" class="form-control border-primary" autocomplete="off" placeholder="Account Name" name="bank[name]" value="{$smarty.post.bank.name}" required> </div> {/if} {if Users::Form('kin')} <!--Next of Kin Details--> <h4 class="fs-12 fw-medium mb-2 text-primary">Next of Kin Details</h4> <div class="col-6 mb-4"> <input type="text" class="form-control border-primary" autocomplete="off" placeholder="Kin Name" name="kin[name]" value="{$smarty.post.kin.name}"> </div> <div class="col-6 mb-4"> <input type="tel" class="form-control border-primary" autocomplete="off" placeholder="Phone Number" name="kin[phone]" value="{$smarty.post.kin.phone}"> </div> {/if} <!--Password Details--> {if Users::Form('password')} <h4 class="fs-12 fw-medium mb-2 text-primary">Password</h4> <div class="mb-4"> <input type="password" class="form-control border-primary" autocomplete="off" placeholder="Enter Password" name="password" value="{$smarty.post.password|default:''}" id="register_password" required> </div> <div class="mb-4"> <input type="password" class="form-control border-primary" autocomplete="off" placeholder="Confirm Password" name="password2" value="{$smarty.post.password2|default:''}" required> </div> {/if} {if E::V(['name'=>'recaptcha_signup'])} <div class="mb-4"> <label class="control-label"><img src="{$securebase}/libs/captcha/captcha.php" /></label> </div> <div class="mb-4"> <input type="text" name="CAPTCHA" autocomplete="off" class="form-control" placeholder="Enter captcha as seen above" required> </div> {/if} <div class="mt-4"> <div class="custom-control custom-checkbox"> <input type="checkbox" name="terms" class="custom-control-input" id="termsCondition" checked required> <label class="custom-control-label c-pointer text-muted" for="termsCondition" style="font-weight: 400 !important">I agree to all the <a href="?dad=index&jc=terms" target="_blank">Terms of Service</a> & <a href="?dad=index&jc=ppolicy" target="_blank">Privacy Policy</a>.</label> </div> </div> <div class="mt-5"> <button type="submit" class="btn btn-lg btn-primary w-100">Create Account</button> </div> </div> </form> <div class="mt-5 text-muted"> <span>Already have an account?</span> <a href="?dad=user&jc=auth&a=form" class="fw-bold text-primary text-underline">Login</a> </div> </div> </div> </div> </div> </main> <!--! ================================================================ !--> <!--! [End] Main Content !--> <!--! ================================================================ !--> <!--! ================================================================ !--> <!--! BEGIN: Theme Customizer !--> <!--! ================================================================ !--> <div class="theme-customizer"> <div class="customizer-handle"> <a href="javascript:void(0);" class="cutomizer-open-trigger bg-primary"> <i class="feather-settings"></i> </a> </div> <div class="customizer-sidebar-wrapper"> <div class="customizer-sidebar-header px-4 ht-80 border-bottom d-flex align-items-center justify-content-between"> <h5 class="mb-0">Theme Settings</h5> <a href="javascript:void(0);" class="cutomizer-close-trigger d-flex"> <i class="feather-x"></i> </a> </div> <div class="customizer-sidebar-body position-relative p-4" data-scrollbar-target="#psScrollbarInit"> <!--! BEGIN: [Skins] !--> <div class="position-relative px-3 pb-3 pt-4 mt-3 mb-5 border border-gray-2 theme-options-set"> <label class="py-1 px-2 fs-8 fw-bold text-uppercase text-muted text-spacing-2 bg-white border border-gray-2 position-absolute rounded-2 options-label" style="top: -12px">Skins</label> <div class="row g-2 theme-options-items app-skin" id="appSkinList"> <div class="col-6 text-center position-relative single-option light-button active"> <input type="radio" class="btn-check" id="app-skin-light" name="app-skin" value="1" data-app-skin="app-skin-light"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-skin-light">Light</label> </div> <div class="col-6 text-center position-relative single-option dark-button"> <input type="radio" class="btn-check" id="app-skin-dark" name="app-skin" value="2" data-app-skin="app-skin-dark"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-skin-dark">Dark</label> </div> </div> </div> <!--! END: [Skins] !--> <!--! BEGIN: [Typography] !--> <div class="position-relative px-3 pb-3 pt-4 mt-3 mb-0 border border-gray-2 theme-options-set"> <label class="py-1 px-2 fs-8 fw-bold text-uppercase text-muted text-spacing-2 bg-white border border-gray-2 position-absolute rounded-2 options-label" style="top: -12px">Typography</label> <div class="row g-2 theme-options-items font-family" id="fontFamilyList"> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-lato" name="font-family" value="1" data-font-family="app-font-family-lato"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-lato">Lato</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-rubik" name="font-family" value="2" data-font-family="app-font-family-rubik"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-rubik">Rubik</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-inter" name="font-family" value="3" data-font-family="app-font-family-inter" checked> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-inter">Inter</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-cinzel" name="font-family" value="4" data-font-family="app-font-family-cinzel"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-cinzel">Cinzel</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-nunito" name="font-family" value="6" data-font-family="app-font-family-nunito"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-nunito">Nunito</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-roboto" name="font-family" value="7" data-font-family="app-font-family-roboto"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-roboto">Roboto</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-ubuntu" name="font-family" value="8" data-font-family="app-font-family-ubuntu"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-ubuntu">Ubuntu</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-poppins" name="font-family" value="9" data-font-family="app-font-family-poppins"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-poppins">Poppins</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-raleway" name="font-family" value="10" data-font-family="app-font-family-raleway"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-raleway">Raleway</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-system-ui" name="font-family" value="11" data-font-family="app-font-family-system-ui"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-system-ui">System UI</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-noto-sans" name="font-family" value="12" data-font-family="app-font-family-noto-sans"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-noto-sans">Noto Sans</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-fira-sans" name="font-family" value="13" data-font-family="app-font-family-fira-sans"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-fira-sans">Fira Sans</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-work-sans" name="font-family" value="14" data-font-family="app-font-family-work-sans"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-work-sans">Work Sans</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-open-sans" name="font-family" value="15" data-font-family="app-font-family-open-sans"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-open-sans">Open Sans</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-maven-pro" name="font-family" value="16" data-font-family="app-font-family-maven-pro"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-maven-pro">Maven Pro</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-quicksand" name="font-family" value="17" data-font-family="app-font-family-quicksand"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-quicksand">Quicksand</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-montserrat" name="font-family" value="18" data-font-family="app-font-family-montserrat"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-montserrat">Montserrat</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-josefin-sans" name="font-family" value="19" data-font-family="app-font-family-josefin-sans"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-josefin-sans">Josefin Sans</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-ibm-plex-sans" name="font-family" value="20" data-font-family="app-font-family-ibm-plex-sans"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-ibm-plex-sans">IBM Plex Sans</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-source-sans-pro" name="font-family" value="5" data-font-family="app-font-family-source-sans-pro"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-source-sans-pro">Source Sans Pro</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-montserrat-alt" name="font-family" value="21" data-font-family="app-font-family-montserrat-alt"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-montserrat-alt">Montserrat Alt</label> </div> <div class="col-6 text-center single-option"> <input type="radio" class="btn-check" id="app-font-family-roboto-slab" name="font-family" value="22" data-font-family="app-font-family-roboto-slab"> <label class="py-2 fs-9 fw-bold text-dark text-uppercase text-spacing-1 border border-gray-2 w-100 h-100 c-pointer position-relative options-label" for="app-font-family-roboto-slab">Roboto Slab</label> </div> </div> </div> <!--! END: [Typography] !--> </div> <div class="customizer-sidebar-footer px-4 ht-60 border-top d-flex align-items-center gap-2"> <div class="flex-fill w-50"> <a href="javascript:void(0);" class="btn btn-danger" data-style="reset-all-common-style">Reset</a> </div> <div class="flex-fill w-50"> <a href="javascript:void(0);" class="btn btn-primary">Download</a> </div> </div> </div> </div> <!--! ================================================================ !--> <!--! [End] Theme Customizer !--> <!--! ================================================================ !--> <!--! ================================================================ !--> <!--! Footer Script !--> <!--! ================================================================ !--> <!--! BEGIN: Vendors JS !--> <script src="./assets/vendors/js/vendors.min.js"></script> <!-- vendors.min.js always must need to be top --> <script src="./assets/vendors/js/lslstrength.min.js"></script> <!--! END: Vendors JS !--> <!--! BEGIN: Apps Init !--> <script src="./assets/js/common-init.min.js"></script> <script src="./assets/js/customers-create-init.min.js"></script> <!--! END: Apps Init !--> <!--! BEGIN: Theme Customizer !--> <script src="./assets/js/theme-customizer-init.min.js"></script> <!--! END: Theme Customizer !--> </body> </html>
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