forms.rxindiaservices.com
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Submitted URL: https://cutt.ly/JeOZLZA3
Effective URL: https://forms.rxindiaservices.com/iwls-visreg?utm_source=Sponsored_Ads&utm_medium=CPC&utm_campaign=IWLS
Submission: On October 24 via api from IN — Scanned from DE
Effective URL: https://forms.rxindiaservices.com/iwls-visreg?utm_source=Sponsored_Ads&utm_medium=CPC&utm_campaign=IWLS
Submission: On October 24 via api from IN — Scanned from DE
Form analysis 1 forms found in the DOM
Name: form1 — POST ./iwls-visreg?utm_source=Sponsored_Ads&utm_medium=CPC&utm_campaign=IWLS
<form name="form1" method="post" action="./iwls-visreg?utm_source=Sponsored_Ads&utm_medium=CPC&utm_campaign=IWLS" onsubmit="javascript:return WebForm_OnSubmit();" id="form1">
<div>
<input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="">
<input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="">
<input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE"
value="oOQakexbBkV955nJYzFrINw7ArzuNSmr7vnd71+nhV43iSAqzS8Plj6aJBaAGePyRpeND97obqgE6t61lFAbVSxCflVTnvQmdO2uJAV3Q0pwPebunCyY4u5yCio9hqrntAWffNOLHaJl/dr7epTg2AMKEXtWxhHi+kvNhP6G8QkfQ82BvpBpsBYysKuSq15CfAU7CYTQoGTmF5L8ARz/LidqP4x4UiPBJguCXgTPWC+jBmYgoLSiGHx6zCwm0QiFAjTocAEkiKSX+0FIXJt2dZVoo/1cKMNdtsfW5ISAY2WKQz2KLgIpb2y4qRoabznURArZcNoaC/jCcU4lOcTLeMC3Nj991TpeelDWEGP423EnRsoXYDbJcPoND1JZP+dOuNqScWpU08Q42L9JF6YUiHOqu/CSSVYVlU6LWmnHrGCWlC38tuLA+fHOHeIkOaALNG2pCWTuafr0RhN8yiRFkVqru9AycbxLN+5ewwUZna+HzM7NTzDeuZHfCh1YyhdiX/FqVLoYGMeqRLibXLiTv1tZ9ORyoi9QdHeZzb1EoeQA0Y1KBRYinHEEdYvWDByjdSvd3hO1I7UwVJKAsqsz5VIHTNeWPDQLkk8lUuHI4h2pUW1kFPiG5dxTMb2e39V5q0VBIViwwONoqXonyXgqNQiHHI0ASlYQTGpFY/9o5HNPaSAOBgC7EiMxmM5nVOIRWIpHOgpaFXkjUrVnxlaJPloMj/w+La8FRzu0VZmlWETbJiUO/8XZBhBQKepi30j3DlaQW6Md2RRzZGYSegXF4QnAwJKcTrHUnrFc2bib77PyerRTfHc3z4862jww34SqdimAYvRcLTzN46RlXYKC8qk2CoC6d5+vrdUVw+3af+rKmt9O39dQLBHJkxtVx7G7BE9lPQ==">
</div>
<script type="text/javascript">
//<![CDATA[
var theForm = document.forms['form1'];
if (!theForm) {
theForm = document.form1;
}
function __doPostBack(eventTarget, eventArgument) {
if (!theForm.onsubmit || (theForm.onsubmit() != false)) {
theForm.__EVENTTARGET.value = eventTarget;
theForm.__EVENTARGUMENT.value = eventArgument;
theForm.submit();
}
}
//]]>
</script>
<script src="/WebResource.axd?d=YVK3sHYEjjyd2Nt9ThikuOXHvBCORqVSt67ebjMTbS0KbR1fyqrWHFJV-yMif-WwMh6os0ceFTrqBFJ4b-6KcsVY_uE1&t=638460022569584809" type="text/javascript"></script>
<script src="/WebResource.axd?d=mzbMKdoDPSL2ML4JkWrsfWYMlSDI_5Ado2mUxZgWRH627IuYOsyNZB9DKtwzOg585tP14n21R5XiQBn0zrQLsGwCV6l2h9UX0xcWYQ39tDWEvbYC0&t=638460022569584809" type="text/javascript"></script>
<script type="text/javascript">
//<![CDATA[
function WebForm_OnSubmit() {
if (typeof(ValidatorOnSubmit) == "function" && ValidatorOnSubmit() == false) return false;
return true;
}
//]]>
</script>
<div>
<input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="B6B3B526">
<input type="hidden" name="__SCROLLPOSITIONX" id="__SCROLLPOSITIONX" value="0">
<input type="hidden" name="__SCROLLPOSITIONY" id="__SCROLLPOSITIONY" value="0">
<input type="hidden" name="__VIEWSTATEENCRYPTED" id="__VIEWSTATEENCRYPTED" value="">
<input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION"
value="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">
</div>
<main id="main">
<img src="assets/img/Banner.jpg?v=1" class="img-fluid" style="width: 100%;">
<section id="portfolio-details" class="portfolio-details1 pt-20">
<div class="container">
<div class="row">
<div class="col-lg-12 form-visg">
<div id="InForm">
<div></div>
<script src="https://cdn.ingo.me/widgets/DE6FA665037C49438055D2899047675E.js" data-ingo-manual="https://forms.rxindiaservices.com/iwls-visreg?disable-login-widget-popup=true" data-ingo-modal="true" data-ingo-disable-close="true"
data-ingo-autostart="true"></script>
<div></div>
<script src="https://cdn.ingo.me/widgets/31A588CC3E394589AD8C24A272AE058B.js" data-ingo-fields.user.last-name="#FullName" data-ingo-fields.user.email="#Email" data-ingo-fields.user.company="#Company"
data-ingo-fields.user.company-position="#JobTitle"></script>
<h4><b>Get your FREE entry ticket by completing this form</b>
</h4>
<div class="plr-15">
<div class="row">
<div class="col-lg-4">
<label>First Name</label>
<span id="RequiredFieldValidator1" style="color:Red;font-style:italic;display:none;">Required</span>
<span id="RegularExpressionValidator1" style="color:Red;font-style:italic;display:none;">No special characters allowed.</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text"><i class="fa fa-user"></i></span>
</div>
<input name="FirstName" type="text" id="FirstName" class="form-control RequiredValid" placeholder="Enter your first name" maxlength="100">
</div>
</div>
<div class="col-lg-4">
<label>Last Name</label>
<span id="RequiredFieldValidator8" style="color:Red;font-style:italic;display:none;">Required</span>
<span id="RegularExpressionValidator6" style="color:Red;font-style:italic;display:none;">No special characters allowed.</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text"><i class="fa fa-user"></i></span>
</div>
<input name="LastName" type="text" id="LastName" class="form-control RequiredValid" placeholder="Enter your last name" maxlength="100">
</div>
</div>
<div class="col-lg-4">
<label>Company</label>
<span id="RequiredFieldValidator3" style="color:Red;font-style:italic;display:none;">Required</span>
<span id="RegularExpressionValidator8" style="color:Red;font-style:italic;display:none;">Invalid format.</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text"><i class="fa fa-building"></i></span>
</div>
<input name="Company" type="text" id="Company" class="form-control RequiredValid" placeholder="Enter company name" maxlength="100">
</div>
</div>
<div class="col-lg-4">
<label>Job Title</label>
<span id="RequiredFieldValidator2" style="color:Red;font-style:italic;display:none;">Required</span>
<span id="RegularExpressionValidator2" style="color:Red;font-style:italic;display:none;">No special characters allowed.</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text"><i class="fa fa-briefcase"></i></span>
</div>
<input name="JobTitle" type="text" id="JobTitle" class="form-control RequiredValid" placeholder="Enter job title" maxlength="100">
</div>
</div>
<div class="col-lg-4">
<label>Email</label>
<span id="RequiredFieldValidator5" style="color:Red;font-style:italic;display:none;">Required</span>
<span id="regexEmailValid" style="color:Red;font-style:italic;display:none;">Invalid Email Format.</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text"><i class="fa fa-envelope"></i></span>
</div>
<input name="Email" type="text" id="Email" class="form-control RequiredValid" placeholder="Enter your email" maxlength="100">
</div>
</div>
<div class="col-lg-4">
<label>Mobile</label>
<span id="RequiredFieldValidator14" style="color:Red;font-style:italic;display:none;">Required</span>
<span id="RegularExpressionValidator7" style="color:Red;font-style:italic;display:none;">Mobile number should be off 10-12 digits.</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text"><i class="fa fa-mobile"></i></span>
</div>
<input name="Mobile" type="text" id="Mobile" class="form-control RequiredValid number" maxlength="12" placeholder="Enter your mobile number">
</div>
</div>
<div class="col-lg-4">
<label>Address</label>
<span id="RequiredFieldValidator9" style="color:Red;font-style:italic;display:none;">Required</span>
<span id="RegularExpressionValidator9" style="color:Red;font-style:italic;display:none;">Invalid format.</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text"><i class="fa fa-building"></i></span>
</div>
<input name="Address" type="text" id="Address" class="form-control RequiredValid" placeholder="Enter your address" maxlength="100">
</div>
</div>
<div class="col-lg-4">
<label>City</label>
<span id="RequiredFieldValidator4" style="color:Red;font-style:italic;display:none;">Required</span>
<span id="RegularExpressionValidator3" style="color:Red;font-style:italic;display:none;">No special characters allowed.</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text">
<i class="fa fa-building"></i></span>
</div>
<input name="City" type="text" id="City" class="form-control RequiredValid" placeholder="Enter your city" maxlength="100">
</div>
</div>
<div class="col-lg-4">
<label>State</label>
<span id="RequiredFieldValidator7" style="color:Red;font-style:italic;display:none;">Required</span>
<span id="RegularExpressionValidator5" style="color:Red;font-style:italic;display:none;">No special characters allowed.</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text"><i class="fa fa-building"></i></span>
</div>
<input name="State" type="text" id="State" class="form-control RequiredValid" placeholder="Enter your state" maxlength="100">
</div>
</div>
<div class="col-lg-4">
<label>Country</label>
<span id="RequiredFieldValidator6" style="color:Red;font-style:italic;display:none;">Required!</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text">
<i class="fa fa-globe"></i></span>
</div>
<select name="Country" id="Country" class="form-control">
<option selected="selected" value="91" data-countrycode="IN">India (+91)</option>
<option value="Other Countries" disabled="disabled">Other Countries</option>
<option value="93" data-countrycode="AF">Afghanistan (+93)</option>
<option value="213" data-countrycode="DZ">Algeria (+213)</option>
<option value="376" data-countrycode="AD">Andorra (+376)</option>
<option value="244" data-countrycode="AO">Angola (+244)</option>
<option value="1264" data-countrycode="AI">Anguilla (+1264)</option>
<option value="1268" data-countrycode="AG">Antigua & Barbuda (+1268)</option>
<option value="54" data-countrycode="AR">Argentina (+54)</option>
<option value="374" data-countrycode="AM">Armenia (+374)</option>
<option value="297" data-countrycode="AW">Aruba (+297)</option>
<option value="61" data-countrycode="AU">Australia (+61)</option>
<option value="43" data-countrycode="AT">Austria (+43)</option>
<option value="994" data-countrycode="AZ">Azerbaijan (+994)</option>
<option value="1242" data-countrycode="BS">Bahamas (+1242)</option>
<option value="973" data-countrycode="BH">Bahrain (+973)</option>
<option value="880" data-countrycode="BD">Bangladesh (+880)</option>
<option value="1246" data-countrycode="BB">Barbados (+1246)</option>
<option value="375" data-countrycode="BY">Belarus (+375)</option>
<option value="32" data-countrycode="BE">Belgium (+32)</option>
<option value="501" data-countrycode="BZ">Belize (+501)</option>
<option value="229" data-countrycode="BJ">Benin (+229)</option>
<option value="1441" data-countrycode="BM">Bermuda (+1441)</option>
<option value="975" data-countrycode="BT">Bhutan (+975)</option>
<option value="591" data-countrycode="BO">Bolivia (+591)</option>
<option value="387" data-countrycode="BA">Bosnia Herzegovina (+387)</option>
<option value="267" data-countrycode="BW">Botswana (+267)</option>
<option value="55" data-countrycode="BR">Brazil (+55)</option>
<option value="673" data-countrycode="BN">Brunei (+673)</option>
<option value="359" data-countrycode="BG">Bulgaria (+359)</option>
<option value="226" data-countrycode="BF">Burkina Faso (+226)</option>
<option value="257" data-countrycode="BI">Burundi (+257)</option>
<option value="855" data-countrycode="KH">Cambodia (+855)</option>
<option value="237" data-countrycode="CM">Cameroon (+237)</option>
<option value="1" data-countrycode="CA">Canada (+1)</option>
<option value="238" data-countrycode="CV">Cape Verde Islands (+238)</option>
<option value="1345" data-countrycode="KY">Cayman Islands (+1345)</option>
<option value="236" data-countrycode="CF">Central African Republic (+236)</option>
<option value="56" data-countrycode="CL">Chile (+56)</option>
<option value="86" data-countrycode="CN">China (+86)</option>
<option value="57" data-countrycode="CO">Colombia (+57)</option>
<option value="269" data-countrycode="KM">Comoros (+269)</option>
<option value="242" data-countrycode="CG">Congo (+242)</option>
<option value="682" data-countrycode="CK">Cook Islands (+682)</option>
<option value="506" data-countrycode="CR">Costa Rica (+506)</option>
<option value="385" data-countrycode="HR">Croatia (+385)</option>
<option value="53" data-countrycode="CU">Cuba (+53)</option>
<option value="90" data-countrycode="CY">Cyprus - North (+90)</option>
<option value="357" data-countrycode="CY">Cyprus - South (+357)</option>
<option value="420" data-countrycode="CZ">Czech Republic (+420)</option>
<option value="45" data-countrycode="DK">Denmark (+45)</option>
<option value="253" data-countrycode="DJ">Djibouti (+253)</option>
<option value="1809" data-countrycode="DM">Dominica (+1809)</option>
<option value="1809" data-countrycode="DO">Dominican Republic (+1809)</option>
<option value="593" data-countrycode="EC">Ecuador (+593)</option>
<option value="20" data-countrycode="EG">Egypt (+20)</option>
<option value="503" data-countrycode="SV">El Salvador (+503)</option>
<option value="240" data-countrycode="GQ">Equatorial Guinea (+240)</option>
<option value="291" data-countrycode="ER">Eritrea (+291)</option>
<option value="372" data-countrycode="EE">Estonia (+372)</option>
<option value="251" data-countrycode="ET">Ethiopia (+251)</option>
<option value="500" data-countrycode="FK">Falkland Islands (+500)</option>
<option value="298" data-countrycode="FO">Faroe Islands (+298)</option>
<option value="679" data-countrycode="FJ">Fiji (+679)</option>
<option value="358" data-countrycode="FI">Finland (+358)</option>
<option value="33" data-countrycode="FR">France (+33)</option>
<option value="594" data-countrycode="GF">French Guiana (+594)</option>
<option value="689" data-countrycode="PF">French Polynesia (+689)</option>
<option value="241" data-countrycode="GA">Gabon (+241)</option>
<option value="220" data-countrycode="GM">Gambia (+220)</option>
<option value="7880" data-countrycode="GE">Georgia (+7880)</option>
<option value="49" data-countrycode="DE">Germany (+49)</option>
<option value="233" data-countrycode="GH">Ghana (+233)</option>
<option value="350" data-countrycode="GI">Gibraltar (+350)</option>
<option value="30" data-countrycode="GR">Greece (+30)</option>
<option value="299" data-countrycode="GL">Greenland (+299)</option>
<option value="1473" data-countrycode="GD">Grenada (+1473)</option>
<option value="590" data-countrycode="GP">Guadeloupe (+590)</option>
<option value="671" data-countrycode="GU">Guam (+671)</option>
<option value="502" data-countrycode="GT">Guatemala (+502)</option>
<option value="224" data-countrycode="GN">Guinea (+224)</option>
<option value="245" data-countrycode="GW">Guinea - Bissau (+245)</option>
<option value="592" data-countrycode="GY">Guyana (+592)</option>
<option value="509" data-countrycode="HT">Haiti (+509)</option>
<option value="504" data-countrycode="HN">Honduras (+504)</option>
<option value="852" data-countrycode="HK">Hong Kong (+852)</option>
<option value="36" data-countrycode="HU">Hungary (+36)</option>
<option value="354" data-countrycode="IS">Iceland (+354)</option>
<option value="91" data-countrycode="IN">India (+91)</option>
<option value="62" data-countrycode="ID">Indonesia (+62)</option>
<option value="964" data-countrycode="IQ">Iraq (+964)</option>
<option value="98" data-countrycode="IR">Iran (+98)</option>
<option value="353" data-countrycode="IE">Ireland (+353)</option>
<option value="972" data-countrycode="IL">Israel (+972)</option>
<option value="39" data-countrycode="IT">Italy (+39)</option>
<option value="1876" data-countrycode="JM">Jamaica (+1876)</option>
<option value="81" data-countrycode="JP">Japan (+81)</option>
<option value="962" data-countrycode="JO">Jordan (+962)</option>
<option value="7" data-countrycode="KZ">Kazakhstan (+7)</option>
<option value="254" data-countrycode="KE">Kenya (+254)</option>
<option value="686" data-countrycode="KI">Kiribati (+686)</option>
<option value="850" data-countrycode="KP">Korea - North (+850)</option>
<option value="82" data-countrycode="KR">Korea - South (+82)</option>
<option value="965" data-countrycode="KW">Kuwait (+965)</option>
<option value="996" data-countrycode="KG">Kyrgyzstan (+996)</option>
<option value="856" data-countrycode="LA">Laos (+856)</option>
<option value="371" data-countrycode="LV">Latvia (+371)</option>
<option value="961" data-countrycode="LB">Lebanon (+961)</option>
<option value="266" data-countrycode="LS">Lesotho (+266)</option>
<option value="231" data-countrycode="LR">Liberia (+231)</option>
<option value="218" data-countrycode="LY">Libya (+218)</option>
<option value="417" data-countrycode="LI">Liechtenstein (+417)</option>
<option value="370" data-countrycode="LT">Lithuania (+370)</option>
<option value="352" data-countrycode="LU">Luxembourg (+352)</option>
<option value="853" data-countrycode="MO">Macao (+853)</option>
<option value="389" data-countrycode="MK">Macedonia (+389)</option>
<option value="261" data-countrycode="MG">Madagascar (+261)</option>
<option value="265" data-countrycode="MW">Malawi (+265)</option>
<option value="60" data-countrycode="MY">Malaysia (+60)</option>
<option value="960" data-countrycode="MV">Maldives (+960)</option>
<option value="223" data-countrycode="ML">Mali (+223)</option>
<option value="356" data-countrycode="MT">Malta (+356)</option>
<option value="692" data-countrycode="MH">Marshall Islands (+692)</option>
<option value="596" data-countrycode="MQ">Martinique (+596)</option>
<option value="222" data-countrycode="MR">Mauritania (+222)</option>
<option value="269" data-countrycode="YT">Mayotte (+269)</option>
<option value="52" data-countrycode="MX">Mexico (+52)</option>
<option value="691" data-countrycode="FM">Micronesia (+691)</option>
<option value="373" data-countrycode="MD">Moldova (+373)</option>
<option value="377" data-countrycode="MC">Monaco (+377)</option>
<option value="976" data-countrycode="MN">Mongolia (+976)</option>
<option value="1664" data-countrycode="MS">Montserrat (+1664)</option>
<option value="212" data-countrycode="MA">Morocco (+212)</option>
<option value="258" data-countrycode="MZ">Mozambique (+258)</option>
<option value="95" data-countrycode="MN">Myanmar (+95)</option>
<option value="264" data-countrycode="NA">Namibia (+264)</option>
<option value="674" data-countrycode="NR">Nauru (+674)</option>
<option value="977" data-countrycode="NP">Nepal (+977)</option>
<option value="31" data-countrycode="NL">Netherlands (+31)</option>
<option value="687" data-countrycode="NC">New Caledonia (+687)</option>
<option value="64" data-countrycode="NZ">New Zealand (+64)</option>
<option value="505" data-countrycode="NI">Nicaragua (+505)</option>
<option value="227" data-countrycode="NE">Niger (+227)</option>
<option value="234" data-countrycode="NG">Nigeria (+234)</option>
<option value="683" data-countrycode="NU">Niue (+683)</option>
<option value="672" data-countrycode="NF">Norfolk Islands (+672)</option>
<option value="670" data-countrycode="NP">Northern Marianas (+670)</option>
<option value="47" data-countrycode="NO">Norway (+47)</option>
<option value="968" data-countrycode="OM">Oman (+968)</option>
<option value="92" data-countrycode="PK">Pakistan (+92)</option>
<option value="680" data-countrycode="PW">Palau (+680)</option>
<option value="507" data-countrycode="PA">Panama (+507)</option>
<option value="675" data-countrycode="PG">Papua New Guinea (+675)</option>
<option value="595" data-countrycode="PY">Paraguay (+595)</option>
<option value="51" data-countrycode="PE">Peru (+51)</option>
<option value="63" data-countrycode="PH">Philippines (+63)</option>
<option value="48" data-countrycode="PL">Poland (+48)</option>
<option value="351" data-countrycode="PT">Portugal (+351)</option>
<option value="1787" data-countrycode="PR">Puerto Rico (+1787)</option>
<option value="974" data-countrycode="QA">Qatar (+974)</option>
<option value="262" data-countrycode="RE">Reunion (+262)</option>
<option value="40" data-countrycode="RO">Romania (+40)</option>
<option value="7" data-countrycode="RU">Russia (+7)</option>
<option value="250" data-countrycode="RW">Rwanda (+250)</option>
<option value="378" data-countrycode="SM">San Marino (+378)</option>
<option value="239" data-countrycode="ST">Sao Tome & Principe (+239)</option>
<option value="966" data-countrycode="SA">Saudi Arabia (+966)</option>
<option value="221" data-countrycode="SN">Senegal (+221)</option>
<option value="381" data-countrycode="CS">Serbia (+381)</option>
<option value="248" data-countrycode="SC">Seychelles (+248)</option>
<option value="232" data-countrycode="SL">Sierra Leone (+232)</option>
<option value="65" data-countrycode="SG">Singapore (+65)</option>
<option value="421" data-countrycode="SK">Slovak Republic (+421)</option>
<option value="386" data-countrycode="SI">Slovenia (+386)</option>
<option value="677" data-countrycode="SB">Solomon Islands (+677)</option>
<option value="252" data-countrycode="SO">Somalia (+252)</option>
<option value="27" data-countrycode="ZA">South Africa (+27)</option>
<option value="34" data-countrycode="ES">Spain (+34)</option>
<option value="94" data-countrycode="LK">Sri Lanka (+94)</option>
<option value="290" data-countrycode="SH">St. Helena (+290)</option>
<option value="1869" data-countrycode="KN">St. Kitts (+1869)</option>
<option value="1758" data-countrycode="SC">St. Lucia (+1758)</option>
<option value="597" data-countrycode="SR">Suriname (+597)</option>
<option value="249" data-countrycode="SD">Sudan (+249)</option>
<option value="268" data-countrycode="SZ">Swaziland (+268)</option>
<option value="46" data-countrycode="SE">Sweden (+46)</option>
<option value="41" data-countrycode="CH">Switzerland (+41)</option>
<option value="886" data-countrycode="TW">Taiwan (+886)</option>
<option value="992" data-countrycode="TJ">Tajikistan (+992)</option>
<option value="66" data-countrycode="TH">Thailand (+66)</option>
<option value="228" data-countrycode="TG">Togo (+228)</option>
<option value="676" data-countrycode="TO">Tonga (+676)</option>
<option value="1868" data-countrycode="TT">Trinidad & Tobago (+1868)</option>
<option value="216" data-countrycode="TN">Tunisia (+216)</option>
<option value="90" data-countrycode="TR">Turkey (+90)</option>
<option value="993" data-countrycode="TM">Turkmenistan (+993)</option>
<option value="1649" data-countrycode="TC">Turks & Caicos Islands (+1649)</option>
<option value="688" data-countrycode="TV">Tuvalu (+688)</option>
<option value="256" data-countrycode="UG">Uganda (+256)</option>
<option value="44" data-countrycode="GB">UK (+44)</option>
<option value="380" data-countrycode="UA">Ukraine (+380)</option>
<option value="971" data-countrycode="AE">United Arab Emirates (+971)</option>
<option value="598" data-countrycode="UY">Uruguay (+598)</option>
<option value="1" data-countrycode="US">USA (+1)</option>
<option value="998" data-countrycode="UZ">Uzbekistan (+998)</option>
<option value="678" data-countrycode="VU">Vanuatu (+678)</option>
<option value="379" data-countrycode="VA">Vatican City (+379)</option>
<option value="58" data-countrycode="VE">Venezuela (+58)</option>
<option value="84" data-countrycode="VN">Vietnam (+84)</option>
<option value="1" data-countrycode="VG">Virgin Islands - British (+1)</option>
<option value="1" data-countrycode="VI">Virgin Islands - US (+1)</option>
<option value="681" data-countrycode="WF">Wallis & Futuna (+681)</option>
<option value="969" data-countrycode="YE">Yemen (North)(+969)</option>
<option value="967" data-countrycode="YE">Yemen (South)(+967)</option>
<option value="260" data-countrycode="ZM">Zambia (+260)</option>
<option value="263" data-countrycode="ZW">Zimbabwe (+263)</option>
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</div>
</div>
<div class="col-lg-4">
<label>PinCode</label>
<span id="RegularExpressionValidator4" style="color:Red;font-style:italic;display:none;">Pincode should be off 5-8 digits.</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text">
<i class="fa fa-map"></i></span>
</div>
<input name="PinCode" type="text" id="PinCode" class="form-control RequiredValid number" maxlength="8" placeholder="Enter your pincode">
</div>
</div>
<div class="row" style="margin-top: 15px">
<div class="col-lg-12">
<label>Please specify your product interest</label>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<style>
.ChkDis label {
font-weight: normal;
line-height: 17px;
max-width: 90%;
margin-left: 6px;
text-align: left;
margin-top: 10px;
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.ChkDis input[type=checkbox] {
margin: 12px 0 0;
margin-top: 1px \9;
line-height: normal;
float: left;
text-align: left;
}
</style>
<table id="ProductInterest" class="ChkDis" border="0" style="width:100%;">
<tbody>
<tr>
<td><input id="ProductInterest_0" type="checkbox" name="ProductInterest$0"><label for="ProductInterest_0">AIDC & WMS Technologies</label></td>
<td><input id="ProductInterest_4" type="checkbox" name="ProductInterest$4"><label for="ProductInterest_4">Last Mile Delivery Solutions</label></td>
<td><input id="ProductInterest_8" type="checkbox" name="ProductInterest$8"><label for="ProductInterest_8">Protective Packaging</label></td>
</tr>
<tr>
<td><input id="ProductInterest_1" type="checkbox" name="ProductInterest$1"><label for="ProductInterest_1">Commercial Vehicles</label></td>
<td><input id="ProductInterest_5" type="checkbox" name="ProductInterest$5"><label for="ProductInterest_5">Logistics & Supply Chain</label></td>
<td><input id="ProductInterest_9" type="checkbox" name="ProductInterest$9"><label for="ProductInterest_9">Warehouse Infrastructure</label></td>
</tr>
<tr>
<td><input id="ProductInterest_2" type="checkbox" name="ProductInterest$2"><label for="ProductInterest_2">Consultants, Brokers & Agencies</label></td>
<td><input id="ProductInterest_6" type="checkbox" name="ProductInterest$6"><label for="ProductInterest_6">Logistics Automation</label></td>
<td><input id="ProductInterest_10" type="checkbox" name="ProductInterest$10"><label for="ProductInterest_10">Safety & security solutions</label></td>
</tr>
<tr>
<td><input id="ProductInterest_3" type="checkbox" name="ProductInterest$3"><label for="ProductInterest_3">Industrial Parks</label></td>
<td><input id="ProductInterest_7" type="checkbox" name="ProductInterest$7"><label for="ProductInterest_7">Material Handling, Picking & Storage</label></td>
<td><input id="ProductInterest_11" type="checkbox" name="ProductInterest$11"><label for="ProductInterest_11">Cold Chain Solution</label></td>
</tr>
</tbody>
</table>
<span id="cvmodulelist" style="color:Red;font-style:italic;visibility:hidden;">Please select atleast one product</span>
</div>
</div>
<div class="col-lg-4">
<label>Which sector or industry do you represent?</label><span id="RequiredFieldValidator16" style="color:Red;font-style:italic;display:none;">Required!</span>
<div class="input-group mb-2">
<div class="input-group-prepend">
<span class="input-group-text"><i class="fa fa-check"></i></span>
</div>
<select name="Industry" id="Industry" class="form-control">
<option value="">--Select--</option>
<option value="3PL/4PL/5PL companies">3PL/4PL/5PL companies</option>
<option value="Automobile and automotive components">Automobile and automotive components</option>
<option value="Builders and developers">Builders and developers</option>
<option value="Bulk drugs and pharmaceuticals">Bulk drugs and pharmaceuticals</option>
<option value="Cement and building materials">Cement and building materials</option>
<option value="Chemicals, pesticides and fertilizers">Chemicals, pesticides and fertilizers</option>
<option value="Consultants, brokers and agents">Consultants, brokers and agents</option>
<option value="Consumer electronics">Consumer electronics</option>
<option value="e-Commerce and online companies">e-Commerce and online companies</option>
<option value="Equipment rental companies">Equipment rental companies</option>
<option value="FMCG">FMCG</option>
<option value="Food and beverages">Food and beverages</option>
<option value="Freight forwarders">Freight forwarders</option>
<option value="Garments and textiles">Garments and textiles</option>
<option value="Glass">Glass</option>
<option value="Home Decor">Home Decor</option>
<option value="IT and software solutions">IT and software solutions</option>
<option value="Liquor and wine">Liquor and wine</option>
<option value="Logistic service providers">Logistic service providers</option>
<option value="OEM, manufacturing and heavy machinery">OEM, manufacturing and heavy machinery</option>
<option value="Paints, oils and lubricants">Paints, oils and lubricants</option>
<option value="Paper">Paper</option>
<option value="Petrochemicals">Petrochemicals</option>
<option value="Retail">Retail</option>
<option value="Rubber and tyres">Rubber and tyres</option>
<option value="Shipping companies">Shipping companies</option>
<option value="Steel and other metals">Steel and other metals</option>
<option value="Structural engineering and architecture">Structural engineering and architecture</option>
<option value="Supply chain companies">Supply chain companies</option>
<option value="Supply chain consultancy">Supply chain consultancy</option>
<option value="Transporters and fleet companies">Transporters and fleet companies</option>
<option value="Warehouse maintainence">Warehouse maintainence</option>
<option value="Warehouse owners">Warehouse owners</option>
<option value="Other">Other</option>
</select>
</div>
</div>
<div class="row">
<div class="col-lg-12 f-14 mb-0 mt-2">
<p class="mb-1">To help support your event experience, India Warehousing and Logistics Show and RX India would like to contact you with updates and information about this and other relevant events and services.</p>
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</div>
</div>
<div id="Notification" class="row">
<div class="col-lg-2 f-14 mb-1 text-left">
<label>India Warehousing and Logistics Show 2024</label>
</div>
<div class="col-lg-8 f-14 mb-1">
<table id="chkNotification" class="ChkDis" border="0" style="width:100%;">
<tbody>
<tr>
<td><input id="chkNotification_0" type="checkbox" name="chkNotification$0"><label for="chkNotification_0">Email</label></td>
<td><input id="chkNotification_1" type="checkbox" name="chkNotification$1"><label for="chkNotification_1">Mail (Post)</label></td>
<td><input id="chkNotification_2" type="checkbox" name="chkNotification$2"><label for="chkNotification_2">Phone (Voice)</label></td>
<td><input id="chkNotification_3" type="checkbox" name="chkNotification$3"><label for="chkNotification_3">SMS (Text)</label></td>
<td><input id="chkNotification_4" type="checkbox" name="chkNotification$4"><label for="chkNotification_4">Opt-Out to all the above</label></td>
</tr>
</tbody>
</table>
</div>
</div>
<div class="row">
<div class="col-lg-2 f-14 mb-1 text-left m-mb-15">
<label>RX India:</label>
</div>
<div class="col-lg-8 f-14 mb-1">
<table id="chkRxNoti" class="ChkDis" border="0" style="width:100%;">
<tbody>
<tr>
<td><input id="chkRxNoti_0" type="checkbox" name="chkRxNoti$0"><label for="chkRxNoti_0">Email</label></td>
<td><input id="chkRxNoti_1" type="checkbox" name="chkRxNoti$1"><label for="chkRxNoti_1">Mail (Post)</label></td>
<td><input id="chkRxNoti_2" type="checkbox" name="chkRxNoti$2"><label for="chkRxNoti_2">Phone (Voice)</label></td>
<td><input id="chkRxNoti_3" type="checkbox" name="chkRxNoti$3"><label for="chkRxNoti_3">SMS (Text)</label></td>
<td><input id="chkRxNoti_4" type="checkbox" name="chkRxNoti$4"><label for="chkRxNoti_4">Opt-Out to all the above</label></td>
</tr>
</tbody>
</table>
<div class="col-lg-2 f-14 mb-4 text-center">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12 f-14 ">
<span disabled="disabled"><input id="CheckBox1" type="checkbox" name="CheckBox1" checked="checked" disabled="disabled"></span> RX India may share your contact details entered above (including telephone and email address, as
applicable) with India Warehousing and Logistics Show 2024 <a href="https://iwlseshop.rxindiaservices.com/exhibitorlist" target="_blank">exhibitors</a>,
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time.
</div>
</div>
<div class="row">
<div class="col-lg-12 f-14 mb-4">
<span disabled="disabled"><input id="CheckBox2" type="checkbox" name="CheckBox2" checked="checked" disabled="disabled"></span> * I confirm that I have read and agree to the
<a href="https://privacy.rxglobal.com/" target="_blank">privacy policy</a>.
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<label>
<b style="font-size: 24px;">
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</div>
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<input name="TextCaptcha" type="text" id="TextCaptcha" class="form-control RequiredValid number" autocomplete="off" maxlength="6" placeholder="Type the number from the image">
<span id="RequiredFieldValidator10" style="color:Red;font-style:italic;display:none;">Enter number from the image!</span>
<span id="RegularExpressionValidator10" style="color:Red;font-style:italic;display:none;">Incorrect number!</span>
</div>
<div class="col-lg-3 text-center">
<input type="submit" name="btnSubmit" value="Submit" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("btnSubmit", "", true, "", "", false, false))"
id="btnSubmit" class="btn btn-primary btn-lg btn-submit">
</div>
</div>
<div class="row">
<div class="col-lg-12">
<span id="ShowNotify" style="color:Red;"></span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</section>
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<div class="container">
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