greencoastae.co
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https://greencoastae.co/index.php?ref=Salvador
Submission: On September 18 via manual from PA — Scanned from DE
Submission: On September 18 via manual from PA — Scanned from DE
Form analysis
2 forms found in the DOMPOST
<form action="" method="post" enctype="multipart/form-data">
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label>First Name <span class="text-danger">*</span></label>
<input type="text" name="fname" class="form-control" id="firstName" placeholder="Enter first name" maxlength="20">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Last Name <span class="text-danger">*</span></label>
<input type="text" name="lname" class="form-control" id="lastName" placeholder="Enter last name" maxlength="20">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Username <span class="text-danger">*</span></label>
<input type="text" name="username" class="form-control" id="username" placeholder="Enter username" maxlength="30">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Email Address <span class="text-danger">*</span></label>
<input type="text" class="form-control" id="emailId" placeholder="Enter email address" name="email" maxlength="80">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Password <span class="text-danger">*</span></label>
<input type="password" name="password" class="form-control" id="password" placeholder="Create login password" maxlength="30">
<div class="input-abs" onclick="hideShowPassword('pwd_a','password')">
<i class="fa fa-solid fa-eye-slash" id="pwd_a"></i>
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Confirm Password <span class="text-danger">*</span></label>
<input type="password" name="cpassword" class="form-control" id="confirmPassword" placeholder="Enter confirm password" maxlength="30">
<div class="input-abs" onclick="hideShowPassword('cpwd_a','confirmPassword')">
<i class="fa fa-solid fa-eye-slash" id="cpwd_a"></i>
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Country <span class="text-danger">*</span></label>
<select class="form-control form-select" name="nation" id="countryName">
<option value="">Select Country</option>
<option value="Aland Islands_0"> Aland Islands (+0) </option>
<option value="Albania_355">Albania (+355)</option>
<option value="Algeria_213">Algeria (+213)</option>
<option value="American Samoa_1684"> American Samoa (+1684) </option>
<option value="Andorra_376">Andorra (+376)</option>
<option value="Angola_244">Angola (+244)</option>
<option value="Anguilla_1264">Anguilla (+1264)</option>
<option value="Antarctica_0">Antarctica (+0)</option>
<option value="Antigua and Barbuda_1268"> Antigua and Barbuda (+1268) </option>
<option value="Argentina_54">Argentina (+54)</option>
<option value="Armenia_374">Armenia (+374)</option>
<option value="Aruba_297">Aruba (+297)</option>
<option value="Australia_61">Australia (+61)</option>
<option value="Austria_43">Austria (+43)</option>
<option value="Azerbaijan_994">Azerbaijan (+994)</option>
<option value="Bahamas_1242">Bahamas (+1242)</option>
<option value="Bahrain_973">Bahrain (+973)</option>
<option value="Bangladesh_880">Bangladesh (+880)</option>
<option value="Barbados_1246">Barbados (+1246)</option>
<option value="Belarus_375">Belarus (+375)</option>
<option value="Belgium_32">Belgium (+32)</option>
<option value="Belize_501">Belize (+501)</option>
<option value="Benin_229">Benin (+229)</option>
<option value="Bermuda_1441">Bermuda (+1441)</option>
<option value="Bhutan_975">Bhutan (+975)</option>
<option value="Bolivia, Plurinational State of_591"> Bolivia, Plurinational State of (+591) </option>
<option value="Bonaire, Sint Eustatius and Saba_0"> Bonaire, Sint Eustatius and Saba (+0) </option>
<option value="Bosnia and Herzegovina_387"> Bosnia and Herzegovina (+387) </option>
<option value="Botswana_267">Botswana (+267)</option>
<option value="Bouvet Island_0"> Bouvet Island (+0) </option>
<option value="Brazil_55">Brazil (+55)</option>
<option value="British Indian Ocean Territory_0"> British Indian Ocean Territory (+0) </option>
<option value="Brunei Darussalam_673"> Brunei Darussalam (+673) </option>
<option value="Bulgaria_359">Bulgaria (+359)</option>
<option value="Burkina Faso_226"> Burkina Faso (+226) </option>
<option value="Burundi_257">Burundi (+257)</option>
<option value="Cambodia_855">Cambodia (+855)</option>
<option value="Cameroon_237">Cameroon (+237)</option>
<option value="Canada_1">Canada (+1)</option>
<option value="Cape Verde_238">Cape Verde (+238)</option>
<option value="Cayman Islands_1345"> Cayman Islands (+1345) </option>
<option value="Central African Republic_236"> Central African Republic (+236) </option>
<option value="Chad_235">Chad (+235)</option>
<option value="Chile_56">Chile (+56)</option>
<option value="China_86">China (+86)</option>
<option value="Christmas Island_618"> Christmas Island (+618) </option>
<option value="Cocos (Keeling) Islands_618"> Cocos (Keeling) Islands (+618) </option>
<option value="Colombia_57">Colombia (+57)</option>
<option value="Comoros_269">Comoros (+269)</option>
<option value="Congo_242">Congo (+242)</option>
<option value="Congo, The Democratic Republic of the_243"> Congo, The Democratic Republic of the (+243) </option>
<option value="Cook Islands_682"> Cook Islands (+682) </option>
<option value="Costa Rica_506">Costa Rica (+506)</option>
<option value="Cote d'Ivoire_225"> Cote d'Ivoire (+225) </option>
<option value="Croatia_385">Croatia (+385)</option>
<option value="Cuba_53">Cuba (+53)</option>
<option value="Curacao_0">Curacao (+0)</option>
<option value="Cyprus_357">Cyprus (+357)</option>
<option value="Czech Republic_420"> Czech Republic (+420) </option>
<option value="Denmark_45">Denmark (+45)</option>
<option value="Djibouti_253">Djibouti (+253)</option>
<option value="Dominica_1767">Dominica (+1767)</option>
<option value="Dominican Republic_1809"> Dominican Republic (+1809) </option>
<option value="Ecuador_593">Ecuador (+593)</option>
<option value="Egypt_20">Egypt (+20)</option>
<option value="El Salvador_503"> El Salvador (+503) </option>
<option value="Equatorial Guinea_240"> Equatorial Guinea (+240) </option>
<option value="Eritrea_291">Eritrea (+291)</option>
<option value="Estonia_372">Estonia (+372)</option>
<option value="Ethiopia_251">Ethiopia (+251)</option>
<option value="Falkland Islands (Malvinas)_500"> Falkland Islands (Malvinas) (+500) </option>
<option value="Faroe Islands_298"> Faroe Islands (+298) </option>
<option value="Fiji_679">Fiji (+679)</option>
<option value="Finland_358">Finland (+358)</option>
<option value="France_33">France (+33)</option>
<option value="French Guiana_594"> French Guiana (+594) </option>
<option value="French Polynesia_689"> French Polynesia (+689) </option>
<option value="French Southern Territories_0"> French Southern Territories (+0) </option>
<option value="Gabon_241">Gabon (+241)</option>
<option value="Gambia_220">Gambia (+220)</option>
<option value="Georgia_995">Georgia (+995)</option>
<option value="Germany_49">Germany (+49)</option>
<option value="Ghana_233">Ghana (+233)</option>
<option value="Gibraltar_350">Gibraltar (+350)</option>
<option value="Greece_30">Greece (+30)</option>
<option value="Greenland_299">Greenland (+299)</option>
<option value="Grenada_1473">Grenada (+1473)</option>
<option value="Guadeloupe_590">Guadeloupe (+590)</option>
<option value="Guam_1671">Guam (+1671)</option>
<option value="Guatemala_502">Guatemala (+502)</option>
<option value="Guernsey_0">Guernsey (+0)</option>
<option value="Guinea_224">Guinea (+224)</option>
<option value="Guinea-Bissau_245"> Guinea-Bissau (+245) </option>
<option value="Guyana_592">Guyana (+592)</option>
<option value="Haiti_509">Haiti (+509)</option>
<option value="Heard Island and McDonald Islands_0"> Heard Island and McDonald Islands (+0) </option>
<option value="Holy See (Vatican City State)_379"> Holy See (Vatican City State) (+379) </option>
<option value="Honduras_504">Honduras (+504)</option>
<option value="Hong Kong_852">Hong Kong (+852)</option>
<option value="Hungary_36">Hungary (+36)</option>
<option value="Iceland_354">Iceland (+354)</option>
<option value="India_91">India (+91)</option>
<option value="Indonesia_62">Indonesia (+62)</option>
<option value="Iran, Islamic Republic of_98"> Iran, Islamic Republic of (+98) </option>
<option value="Iraq_964">Iraq (+964)</option>
<option value="Ireland_353">Ireland (+353)</option>
<option value="Isle of Man_0">Isle of Man (+0)</option>
<option value="Israel_972">Israel (+972)</option>
<option value="Italy_39">Italy (+39)</option>
<option value="Jamaica_1876">Jamaica (+1876)</option>
<option value="Japan_81">Japan (+81)</option>
<option value="Jersey_0">Jersey (+0)</option>
<option value="Jordan_962">Jordan (+962)</option>
<option value="Kazakhstan_7">Kazakhstan (+7)</option>
<option value="Kenya_254">Kenya (+254)</option>
<option value="Kiribati_686">Kiribati (+686)</option>
<option value="Korea, Democratic People's Republic of_850"> Korea, Democratic People's Republic of (+850) </option>
<option value="Korea, Republic of_82"> Korea, Republic of (+82) </option>
<option value="Kuwait_965">Kuwait (+965)</option>
<option value="Kyrgyzstan_996">Kyrgyzstan (+996)</option>
<option value="Lao People's Democratic Republic_856"> Lao People's Democratic Republic (+856) </option>
<option value="Latvia_371">Latvia (+371)</option>
<option value="Lebanon_961">Lebanon (+961)</option>
<option value="Lesotho_266">Lesotho (+266)</option>
<option value="Liberia_231">Liberia (+231)</option>
<option value="Libyan Arab Jamahiriya_218"> Libyan Arab Jamahiriya (+218) </option>
<option value="Liechtenstein_423"> Liechtenstein (+423) </option>
<option value="Lithuania_370">Lithuania (+370)</option>
<option value="Luxembourg_352">Luxembourg (+352)</option>
<option value="Macao_853">Macao (+853)</option>
<option value="Macedonia, The former Yugoslav Republic of_389"> Macedonia, The former Yugoslav Republic of (+389) </option>
<option value="Madagascar_261">Madagascar (+261)</option>
<option value="Malawi_265">Malawi (+265)</option>
<option value="Malaysia_60">Malaysia (+60)</option>
<option value="Maldives_960">Maldives (+960)</option>
<option value="Mali_223">Mali (+223)</option>
<option value="Malta_356">Malta (+356)</option>
<option value="Marshall Islands_692"> Marshall Islands (+692) </option>
<option value="Martinique_596">Martinique (+596)</option>
<option value="Mauritania_222">Mauritania (+222)</option>
<option value="Mauritius_230">Mauritius (+230)</option>
<option value="Mayotte_262">Mayotte (+262)</option>
<option value="Mexico_52">Mexico (+52)</option>
<option value="Micronesia, Federated States of_691"> Micronesia, Federated States of (+691) </option>
<option value="Moldova, Republic of_373"> Moldova, Republic of (+373) </option>
<option value="Monaco_377">Monaco (+377)</option>
<option value="Mongolia_976">Mongolia (+976)</option>
<option value="Montenegro_382">Montenegro (+382)</option>
<option value="Montserrat_1664"> Montserrat (+1664) </option>
<option value="Morocco_212">Morocco (+212)</option>
<option value="Mozambique_258">Mozambique (+258)</option>
<option value="Myanmar_95">Myanmar (+95)</option>
<option value="Namibia_264">Namibia (+264)</option>
<option value="Nauru_674">Nauru (+674)</option>
<option value="Nepal_977">Nepal (+977)</option>
<option value="Netherlands_31">Netherlands (+31)</option>
<option value="New Caledonia_687"> New Caledonia (+687) </option>
<option value="New Zealand_64">New Zealand (+64)</option>
<option value="Nicaragua_505">Nicaragua (+505)</option>
<option value="Niger_227">Niger (+227)</option>
<option value="Nigeria_234">Nigeria (+234)</option>
<option value="Niue_683">Niue (+683)</option>
<option value="Norfolk Island_672"> Norfolk Island (+672) </option>
<option value="Northern Mariana Islands_1670"> Northern Mariana Islands (+1670) </option>
<option value="Norway_47">Norway (+47)</option>
<option value="Oman_968">Oman (+968)</option>
<option value="Pakistan_92">Pakistan (+92)</option>
<option value="Palau_680">Palau (+680)</option>
<option value="Palestinian Territory, Occupied_970"> Palestinian Territory, Occupied (+970) </option>
<option value="Panama_507">Panama (+507)</option>
<option value="Papua New Guinea_675"> Papua New Guinea (+675) </option>
<option value="Paraguay_595">Paraguay (+595)</option>
<option value="Peru_51">Peru (+51)</option>
<option value="Philippines_63">Philippines (+63)</option>
<option value="Pitcairn_870">Pitcairn (+870)</option>
<option value="Poland_48">Poland (+48)</option>
<option value="Portugal_351">Portugal (+351)</option>
<option value="Puerto Rico_1787"> Puerto Rico (+1787) </option>
<option value="Qatar_974">Qatar (+974)</option>
<option value="Reunion_262">Reunion (+262)</option>
<option value="Romania_40">Romania (+40)</option>
<option value="Russian Federation_7"> Russian Federation (+7) </option>
<option value="Rwanda_250">Rwanda (+250)</option>
<option value="Saint Barthelemy_0"> Saint Barthelemy (+0) </option>
<option value="Saint Helena, Ascension and Tristan Da Cunha_290"> Saint Helena, Ascension and Tristan Da Cunha (+290) </option>
<option value="Saint Kitts and Nevis_1869"> Saint Kitts and Nevis (+1869) </option>
<option value="Saint Lucia_1758"> Saint Lucia (+1758) </option>
<option value="Saint Martin (French Part)_0"> Saint Martin (French Part) (+0) </option>
<option value="Saint Pierre and Miquelon_508"> Saint Pierre and Miquelon (+508) </option>
<option value="Saint Vincent and The Grenadines_1784"> Saint Vincent and The Grenadines (+1784) </option>
<option value="Samoa_685">Samoa (+685)</option>
<option value="San Marino_378">San Marino (+378)</option>
<option value="Sao Tome and Principe_239"> Sao Tome and Principe (+239) </option>
<option value="Saudi Arabia_966"> Saudi Arabia (+966) </option>
<option value="Senegal_221">Senegal (+221)</option>
<option value="Serbia_381">Serbia (+381)</option>
<option value="Seychelles_248">Seychelles (+248)</option>
<option value="Sierra Leone_232"> Sierra Leone (+232) </option>
<option value="Singapore_65">Singapore (+65)</option>
<option value="Sint Maarten (Dutch Part)_0"> Sint Maarten (Dutch Part) (+0) </option>
<option value="Slovakia_421">Slovakia (+421)</option>
<option value="Slovenia_386">Slovenia (+386)</option>
<option value="Solomon Islands_677"> Solomon Islands (+677) </option>
<option value="Somalia_252">Somalia (+252)</option>
<option value="South Africa_27"> South Africa (+27) </option>
<option value="South Georgia and The South Sandwich Islands_0"> South Georgia and The South Sandwich Islands (+0) </option>
<option value="South Sudan_0">South Sudan (+0)</option>
<option value="Spain_34">Spain (+34)</option>
<option value="Sri Lanka_94">Sri Lanka (+94)</option>
<option value="Sudan_249">Sudan (+249)</option>
<option value="Suriname_597">Suriname (+597)</option>
<option value="Svalbard and Jan Mayen_47"> Svalbard and Jan Mayen (+47) </option>
<option value="Swaziland_268">Swaziland (+268)</option>
<option value="Sweden_46">Sweden (+46)</option>
<option value="Switzerland_41">Switzerland (+41)</option>
<option value="Syrian Arab Republic_963"> Syrian Arab Republic (+963) </option>
<option value="Taiwan, Province of China_886"> Taiwan, Province of China (+886) </option>
<option value="Tajikistan_992">Tajikistan (+992)</option>
<option value="Tanzania, United Republic of_255"> Tanzania, United Republic of (+255) </option>
<option value="Thailand_66">Thailand (+66)</option>
<option value="Timor-Leste_670"> Timor-Leste (+670) </option>
<option value="Togo_228">Togo (+228)</option>
<option value="Tokelau_690">Tokelau (+690)</option>
<option value="Tonga_676">Tonga (+676)</option>
<option value="Trinidad and Tobago_1868"> Trinidad and Tobago (+1868) </option>
<option value="Tunisia_216">Tunisia (+216)</option>
<option value="Turkey_90">Turkey (+90)</option>
<option value="Turkmenistan_993"> Turkmenistan (+993) </option>
<option value="Turks and Caicos Islands_1649"> Turks and Caicos Islands (+1649) </option>
<option value="Tuvalu_688">Tuvalu (+688)</option>
<option value="Uganda_256">Uganda (+256)</option>
<option value="Ukraine_380">Ukraine (+380)</option>
<option value="United Arab Emirates_971"> United Arab Emirates (+971) </option>
<option value="United Kingdom_44"> United Kingdom (+44) </option>
<option value="United States_1"> United States (+1) </option>
<option value="United States Minor Outlying Islands_0"> United States Minor Outlying Islands (+0) </option>
<option value="Uruguay_598">Uruguay (+598)</option>
<option value="Uzbekistan_998">Uzbekistan (+998)</option>
<option value="Vanuatu_678">Vanuatu (+678)</option>
<option value="Venezuela, Bolivarian Republic of_58"> Venezuela, Bolivarian Republic of (+58) </option>
<option value="Viet Nam_84">Viet Nam (+84)</option>
<option value="Virgin Islands, British_1284"> Virgin Islands, British (+1284) </option>
<option value="Virgin Islands, U.S._1340"> Virgin Islands, U.S. (+1340) </option>
<option value="Wallis and Futuna_681"> Wallis and Futuna (+681) </option>
<option value="Western Sahara_0"> Western Sahara (+0) </option>
<option value="Yemen_967">Yemen (+967)</option>
<option value="Zambia_260">Zambia (+260)</option>
<option value="Zimbabwe_263">Zimbabwe (+263)</option>
</select>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Mobile Number <span class="text-danger">*</span></label>
<input type="number" name="num" class="form-control" id="mobileNo" placeholder="Enter mobile number" maxlength="16">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Gender <span class="text-danger">*</span></label>
<select class="form-control form-select" name="gender" id="gender">
<option value="">Gender</option>
<option value="Male">Male</option>
<option value="Female">Female</option>
<option value="Other">Other</option>
</select>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label>Date of Birth <span class="text-danger">*</span></label>
<input type="date" name="dob" class="form-control" id="dob" placeholder="Select date of birth">
</div>
</div>
</div>
<div class="form-group">
<label>Sponsor Id <span class="text-danger"></span></label>
<input type="text" class="form-control" name="ref" id="referralName" placeholder="Ref name">
</div>
<!-- <div class="form-group">
<div id="captchaTheme" class="form-group"></div>
</div> -->
<div class="form-check">
<input type="checkbox" name="terms" class="form-check-input" id="agreeTerms">
<label class="form-check-label" for="agreeTerms"> I have read and accept <a href="https://greencoast.ae/our-business/" target="_blank">Business Model</a>. </label>
</div>
<button class="btn btn_theme w-100 text-uppercase mt-4" name="register" id="isCallData"> Register <span class="loading" style="display: none"><i class="fa fa-spinner fa-spin"></i></span>
</button>
</form>
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Text Content
Powered by Google Übersetzer ALREADY HAVE AN ACCOUNT? LOGIN CREATE AN ACCOUNT REGISTER First Name * Last Name * Username * Email Address * Password * Confirm Password * Country * Select Country Aland Islands (+0) Albania (+355) Algeria (+213) American Samoa (+1684) Andorra (+376) Angola (+244) Anguilla (+1264) Antarctica (+0) Antigua and Barbuda (+1268) Argentina (+54) Armenia (+374) Aruba (+297) Australia (+61) Austria (+43) Azerbaijan (+994) Bahamas (+1242) Bahrain (+973) Bangladesh (+880) Barbados (+1246) Belarus (+375) Belgium (+32) Belize (+501) Benin (+229) Bermuda (+1441) Bhutan (+975) Bolivia, Plurinational State of (+591) Bonaire, Sint Eustatius and Saba (+0) Bosnia and Herzegovina (+387) Botswana (+267) Bouvet Island (+0) Brazil (+55) British Indian Ocean Territory (+0) Brunei Darussalam (+673) Bulgaria (+359) Burkina Faso (+226) Burundi (+257) Cambodia (+855) Cameroon (+237) Canada (+1) Cape Verde (+238) Cayman Islands (+1345) Central African Republic (+236) Chad (+235) Chile (+56) China (+86) Christmas Island (+618) Cocos (Keeling) Islands (+618) Colombia (+57) Comoros (+269) Congo (+242) Congo, The Democratic Republic of the (+243) Cook Islands (+682) Costa Rica (+506) Cote d'Ivoire (+225) Croatia (+385) Cuba (+53) Curacao (+0) Cyprus (+357) Czech Republic (+420) Denmark (+45) Djibouti (+253) Dominica (+1767) Dominican Republic (+1809) Ecuador (+593) Egypt (+20) El Salvador (+503) Equatorial Guinea (+240) Eritrea (+291) Estonia (+372) Ethiopia (+251) Falkland Islands (Malvinas) (+500) Faroe Islands (+298) Fiji (+679) Finland (+358) France (+33) French Guiana (+594) French Polynesia (+689) French Southern Territories (+0) Gabon (+241) Gambia (+220) Georgia (+995) Germany (+49) Ghana (+233) Gibraltar (+350) Greece (+30) Greenland (+299) Grenada (+1473) Guadeloupe (+590) Guam (+1671) Guatemala (+502) Guernsey (+0) Guinea (+224) Guinea-Bissau (+245) Guyana (+592) Haiti (+509) Heard Island and McDonald Islands (+0) Holy See (Vatican City State) (+379) Honduras (+504) Hong Kong (+852) Hungary (+36) Iceland 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