{"id":2484,"date":"2020-12-22T05:51:30","date_gmt":"2020-12-22T11:51:30","guid":{"rendered":"\/?page_id=2484"},"modified":"2021-01-19T09:49:52","modified_gmt":"2021-01-19T15:49:52","slug":"affiliate-quick-form","status":"publish","type":"page","link":"https:\/\/wealtheo.com\/affiliate-quick-form\/","title":{"rendered":"Affiliate Quick Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2484\" class=\"elementor elementor-2484\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bf83fd8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"bf83fd8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-16bd5e5\" data-id=\"16bd5e5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4bb3783 uael-gf-button-center uael-gf-btn-size-lg uael-gf-ajax-true uael-gf-style-box uael-gf-input-size-sm uael-gf-enable-classes-no elementor-widget elementor-widget-uael-gf-styler\" data-id=\"4bb3783\" data-element_type=\"widget\" data-widget_type=\"uael-gf-styler.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"uael-gf-style uael-gf-check-style elementor-clickable\">\n\t\t<h3 class=\"uael-gf-form-title\">Pre-Launch Enrollment Form<\/h3>\n\t\t<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_safari gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_20' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_20'  action='\/wp-json\/wp\/v2\/pages\/2484' data-formid='20' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_20' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_20_6\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_20_6\" ><div class='ginput_container ginput_container_text'><input name='input_6' id='input_20_6' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='1' \/><\/div><\/li><li id=\"field_20_11\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden\"  data-js-reload=\"field_20_11\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_11'>sponsor_firstname<\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_20_11' type='text' value='' class='medium'   tabindex='1'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_20_10\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden\"  data-js-reload=\"field_20_10\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_10'>sponsor_lastname<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_20_10' type='text' value='' class='medium'   tabindex='2'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_20_12\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden\"  data-js-reload=\"field_20_12\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_12'>sponsor_email<\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_20_12' type='text' value='' class='medium'   tabindex='3'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_20_9\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden\"  data-js-reload=\"field_20_9\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_9'>wealtheo_sponsor<\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_20_9' type='text' value='' class='medium'   tabindex='4'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_20_13\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden\"  data-js-reload=\"field_20_13\" ><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><label class='gfield_label gform-field-label' for='input_20_13'>rep_did<\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_20_13' type='text' value='' class='medium'   tabindex='5'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_20_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_20_1\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_20_1'>\n                            \n                            <span id='input_20_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_20_1_3' value='' tabindex='7'  aria-required='true'   placeholder='First Name'  \/>\n                                                    <label for='input_20_1_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>First Name<\/label>\n                                                <\/span>\n                            \n                            <span id='input_20_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_20_1_6' value='' tabindex='9'  aria-required='true'   placeholder='Last Name'  \/>\n                                                    <label for='input_20_1_6' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Last Name<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_20_3\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_20_3\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_20_3_container'>\n                                <span id='input_20_3_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_3' id='input_20_3' value='' tabindex='11'  placeholder='Enter Email Address' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_20_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_20_3_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_3_2' id='input_20_3_2' value='' tabindex='12'  placeholder='Confirm Email Address' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_20_3_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_20_7\" class=\"gfield gfield--type-phone gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_20_7\" ><label class='gfield_label gform-field-label' for='input_20_7'>Mobile Number<\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_20_7' type='tel' value='' class='medium' tabindex='13'   aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_20_2\" class=\"gfield gfield--type-date gfield--input-type-datedropdown gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_20_2\" ><label class='gfield_label gform-field-label' >Date of Birth (YYYY-MM-DD)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_20_2' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_20_2_3_container'><select name='input_2[]' id='input_20_2_3' tabindex='14'  aria-required='true'  ><option value=''>Year<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_20_2_1_container'><select name='input_2[]' id='input_20_2_1' tabindex='15'  aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_20_2_2_container'><select name='input_2[]' id='input_20_2_2' tabindex='16'  aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><\/div><\/div><\/li><li id=\"field_20_4\" class=\"gfield gfield--type-password gfield_contains_required field_sublabel_below gfield--has-description field_description_above gfield_visibility_visible\"  data-js-reload=\"field_20_4\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Create Your Own Password<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_20_4'>(Must contain minimum of 8 characters, no spaces.)<\/div><div class='ginput_complex ginput_container ginput_container_password gform-grid-row' id='input_20_4_container'>\n\t\t\t\t\t\t<span id='input_20_4_1_container' class='ginput_password ginput_left gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_4' id='input_20_4'   value='' tabindex='17'  aria-required=\"true\" aria-invalid=\"false\"  aria-describedby=\"gfield_description_20_4\"\/>\n\t\t\t\t\t\t\t<button type='button' class='gform_show_password gform-theme-button gform-theme-button--simple' onclick='javascript:gformToggleShowPassword(\"input_20_4\");' aria-live='polite' aria-label='Show Password' data-label-show='Show Password' data-label-hide='Hide Password'><span class='dashicons dashicons-hidden' aria-hidden='true'><\/span><\/button>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<label for='input_20_4' class='gform-field-label gform-field-label--type-sub '>Enter Password<\/label>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span id='input_20_4_2_container' class='ginput_password ginput_right gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_4_2' id='input_20_4_2'   value='' tabindex='18'  aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t\t\t\t<button type='button' class='gform_show_password gform-theme-button gform-theme-button--simple' onclick='javascript:gformToggleShowPassword(\"input_20_4_2\");' aria-live='polite' aria-label='Show Password' data-label-show='Show Password' data-label-hide='Hide Password'><span class='dashicons dashicons-hidden' aria-hidden='true'><\/span><\/button>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<label for='input_20_4_2' class='gform-field-label gform-field-label--type-sub '>Confirm Password<\/label>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<div class='gf_clear gf_clear_complex'><\/div>\n\t\t\t\t\t<\/div><\/li><li id=\"field_20_5\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_20_5\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_5.1' id='input_20_5_1' type='checkbox' value='1' tabindex='19'  aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_20_5_1' >I have read and agree to the website <a id=\"show-tos\" href=\"#show-tos\">terms and conditions<\/a><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/label><input type='hidden' name='input_5.2' value='I have read and agree to the website &lt;a id=&quot;show-tos&quot; href=&quot;#show-tos&quot;&gt;terms and conditions&lt;\/a&gt;' class='gform_hidden' \/><input type='hidden' name='input_5.3' value='2' class='gform_hidden' \/><\/div><\/li><li id=\"field_20_8\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_20_8\" ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_8.1' id='input_20_8_1' type='checkbox' value='1' tabindex='20'  aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_20_8_1' >I have read and agree to the registration <a id=\"show-membership-agreement\" href=\"#show-membership-agreement\">terms and conditions<\/a><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/label><input type='hidden' name='input_8.2' value='I have read and agree to the registration &lt;a id=&quot;show-membership-agreement&quot; href=&quot;#show-membership-agreement&quot;&gt;terms and conditions&lt;\/a&gt;' class='gform_hidden' \/><input type='hidden' name='input_8.3' value='2' class='gform_hidden' \/><\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_20' class='gform_button button' value='Submit' tabindex='21' onclick='if(window[\"gf_submitting_20\"]){return false;}  if( !jQuery(\"#gform_20\")[0].checkValidity || jQuery(\"#gform_20\")[0].checkValidity()){window[\"gf_submitting_20\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_20\"]){return false;} if( !jQuery(\"#gform_20\")[0].checkValidity || jQuery(\"#gform_20\")[0].checkValidity()){window[\"gf_submitting_20\"]=true;}  jQuery(\"#gform_20\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_20' value='1' \/>\n            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