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<form action="." method="post" novalidate="">
  <label for="lp_fname_0">الاسم الأول</label>
  <input type="text" id="lp_fname_0" name="fname" required="" placeholder="الاسم الأول">
  <label for="lp_lname_0">اسم العائلة</label>
  <input type="text" id="lp_lname_0" name="lname" required="" placeholder="اسم العائلة">
  <label for="lp_email_0">بريد إلكتروني</label>
  <input type="text" id="lp_email_0" name="email" required="" placeholder="بريد إلكتروني">
  <label for="lp_phone_0">هاتف</label>
  <div class="iti iti--allow-dropdown iti--show-selected-dial-code iti--show-flags iti--inline-dropdown">
    <div class="iti__flag-container">
      <div class="iti__selected-flag" role="combobox" aria-haspopup="listbox" aria-controls="iti-0__country-listbox" aria-expanded="false" aria-label="Selected country" tabindex="0">
        <div class="iti__flag"></div>
        <div class="iti__selected-dial-code"></div>
        <div class="iti__arrow"></div>
      </div>
      <div class="iti__dropdown-content iti__hide ">
        <ul class="iti__country-list" id="iti-0__country-listbox" role="listbox" aria-label="List of countries">
          <li id="iti-0__item-br" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="55" data-country-code="br" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__br"></div>
            </div><span class="iti__country-name">Brazil</span><span class="iti__dial-code">+55</span>
          </li>
          <li id="iti-0__item-cl" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="56" data-country-code="cl" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__cl"></div>
            </div><span class="iti__country-name">Chile</span><span class="iti__dial-code">+56</span>
          </li>
          <li id="iti-0__item-co" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="57" data-country-code="co" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__co"></div>
            </div><span class="iti__country-name">Colombia</span><span class="iti__dial-code">+57</span>
          </li>
          <li id="iti-0__item-ec" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="593" data-country-code="ec" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__ec"></div>
            </div><span class="iti__country-name">Ecuador</span><span class="iti__dial-code">+593</span>
          </li>
          <li id="iti-0__item-gt" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="502" data-country-code="gt" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__gt"></div>
            </div><span class="iti__country-name">Guatemala</span><span class="iti__dial-code">+502</span>
          </li>
          <li id="iti-0__item-in" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="91" data-country-code="in" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__in"></div>
            </div><span class="iti__country-name">India</span><span class="iti__dial-code">+91</span>
          </li>
          <li id="iti-0__item-kw" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="965" data-country-code="kw" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__kw"></div>
            </div><span class="iti__country-name">Kuwait</span><span class="iti__dial-code">+965</span>
          </li>
          <li id="iti-0__item-mx" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="52" data-country-code="mx" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__mx"></div>
            </div><span class="iti__country-name">Mexico</span><span class="iti__dial-code">+52</span>
          </li>
          <li id="iti-0__item-pe" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="51" data-country-code="pe" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__pe"></div>
            </div><span class="iti__country-name">Peru</span><span class="iti__dial-code">+51</span>
          </li>
          <li id="iti-0__item-ph" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="63" data-country-code="ph" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__ph"></div>
            </div><span class="iti__country-name">Philippines</span><span class="iti__dial-code">+63</span>
          </li>
          <li id="iti-0__item-sa" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="966" data-country-code="sa" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__sa"></div>
            </div><span class="iti__country-name">Saudi Arabia</span><span class="iti__dial-code">+966</span>
          </li>
          <li id="iti-0__item-ae" class="iti__country iti__standard" tabindex="-1" role="option" data-dial-code="971" data-country-code="ae" aria-selected="false">
            <div class="iti__flag-box">
              <div class="iti__flag iti__ae"></div>
            </div><span class="iti__country-name">United Arab Emirates</span><span class="iti__dial-code">+971</span>
          </li>
        </ul>
      </div>
    </div><input type="tel" id="intl_phone_0" name="phone_wo_code" required="" placeholder="هاتف" class="iti__tel-input" autocomplete="off" data-intl-tel-input-id="0"><input type="hidden" name="phone"><input type="hidden" name="phone_country">
  </div>
  <div class="checkbox">
    <input type="checkbox" name="agree" required="" checked="">
    <p><a href="/privacy-policy/" target="_blank">سياسة الخصوصية</a> و <a href="/terms-conditions/" target="_blank">الشروط والأحكام القانونية</a> عمري يزيد عن 18 عامًا وأقبل هذه الأمور</p>
  </div>
  <div class="error"></div>
  <div class="success"></div>
  <button class="btn-submit" type="submit">ابدأ الآن</button>
</form>

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الاسم الأول اسم العائلة بريد إلكتروني هاتف
 * 
   Brazil+55
 * 
   Chile+56
 * 
   Colombia+57
 * 
   Ecuador+593
 * 
   Guatemala+502
 * 
   India+91
 * 
   Kuwait+965
 * 
   Mexico+52
 * 
   Peru+51
 * 
   Philippines+63
 * 
   Saudi Arabia+966
 * 
   United Arab Emirates+971

سياسة الخصوصية و الشروط والأحكام القانونية عمري يزيد عن 18 عامًا وأقبل هذه
الأمور



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