{"id":237,"date":"2026-04-18T08:22:06","date_gmt":"2026-04-18T08:22:06","guid":{"rendered":"https:\/\/modibrothers.co.uk\/shop\/?page_id=237"},"modified":"2026-04-18T08:22:06","modified_gmt":"2026-04-18T08:22:06","slug":"account-form","status":"publish","type":"page","link":"https:\/\/modibrothers.co.uk\/shop\/account-form\/","title":{"rendered":"Account form"},"content":{"rendered":"        <div class=\"mta-form-container\">\r\n            <div class=\"mta-form-header\">\r\n                <h2>MODI BROTHERS UK LTD<\/h2>\r\n                <p>Trade Account Opening Form<\/p>\r\n            <\/div>\r\n            <form action=\"\" method=\"POST\" class=\"mta-trade-form\">\r\n                <input type=\"hidden\" id=\"mta_nonce\" name=\"mta_nonce\" value=\"946a99f7f5\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/shop\/wp-json\/wp\/v2\/pages\/237\" \/>                \r\n                <h3>Applicant Details<\/h3>\r\n                <div class=\"mta-grid\">\r\n                    <div class=\"mta-field\"><label>Full Name *<\/label><input type=\"text\" name=\"full_name\" required><\/div>\r\n                    <div class=\"mta-field\"><label>Company Name *<\/label><input type=\"text\" name=\"company_name\" required><\/div>\r\n                    <div class=\"mta-field mta-full\"><label>Company Address<\/label><textarea name=\"company_address\"><\/textarea><\/div>\r\n                    <div class=\"mta-field\"><label>Company Registration No.<\/label><input type=\"text\" name=\"reg_no\"><\/div>\r\n                    <div class=\"mta-field\"><label>VAT ID<\/label><input type=\"text\" name=\"vat_id\"><\/div>\r\n                    <div class=\"mta-field mta-full\"><label>Delivery Address (if diff. from above)<\/label><textarea name=\"delivery_address\"><\/textarea><\/div>\r\n                <\/div>\r\n\r\n                <h3>Nature of Business (tick applicable)<\/h3>\r\n                <div class=\"mta-checkbox-grid\">\r\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_manufacturer\" required> Manufacturer<\/label>\r\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_distributor\"> Distributor<\/label>\r\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_wholesaler\"> Wholesaler<\/label>\r\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_retailer\"> Retailer<\/label>\r\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_builder\"> Builder<\/label>\r\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_architect\"> Architect<\/label>\r\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_designer\"> Interior Designer<\/label>\r\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_contractor\"> Contractor<\/label>\r\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_others\"> Others: <input type=\"text\" name=\"business_nature_other\" class=\"mta-inline-input\"><\/label>\r\n                <\/div>\r\n\r\n                <h3>Contact Details<\/h3>\r\n                <div class=\"mta-grid\">\r\n                    <div class=\"mta-field\"><label>Phone (Work)<\/label><input type=\"text\" name=\"phone_work\"><\/div>\r\n                    <div class=\"mta-field\"><label>Phone (Mobile) *<\/label><input type=\"text\" name=\"phone_mobile\" required><\/div>\r\n                    <div class=\"mta-field\"><label>Email *<\/label><input type=\"email\" name=\"email\" required><\/div>\r\n                    <div class=\"mta-field\"><label>Website<\/label><input type=\"text\" name=\"website\"><\/div>\r\n                <\/div>\r\n\r\n                <h3>Declaration<\/h3>\r\n                <p class=\"mta-note\">I\/We confirm that the information provided is true and correct and request to open a trade account with Modi Brothers UK Limited.<\/p>\r\n                <div class=\"mta-grid\">\r\n                    <div class=\"mta-field\"><label>Authorized Name *<\/label><input type=\"text\" name=\"auth_name\" required><\/div>\r\n                    <div class=\"mta-field\"><label>Position<\/label><input type=\"text\" name=\"position\"><\/div>\r\n                    <div class=\"mta-field\"><label>Signature (Type Name) *<\/label><input type=\"text\" name=\"signature\" required><\/div>\r\n                    <div class=\"mta-field\"><label>Date *<\/label><input type=\"date\" name=\"date\" required><\/div>\r\n                <\/div>\r\n\r\n                <div class=\"mta-submit-wrap\">\r\n                    <button type=\"submit\" name=\"mta_submit\" class=\"mta-btn\">Submit Trade Application<\/button>\r\n                <\/div>\r\n            <\/form>\r\n        <\/div>\r\n        \n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-237","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/modibrothers.co.uk\/shop\/wp-json\/wp\/v2\/pages\/237","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/modibrothers.co.uk\/shop\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/modibrothers.co.uk\/shop\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/modibrothers.co.uk\/shop\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/modibrothers.co.uk\/shop\/wp-json\/wp\/v2\/comments?post=237"}],"version-history":[{"count":1,"href":"https:\/\/modibrothers.co.uk\/shop\/wp-json\/wp\/v2\/pages\/237\/revisions"}],"predecessor-version":[{"id":238,"href":"https:\/\/modibrothers.co.uk\/shop\/wp-json\/wp\/v2\/pages\/237\/revisions\/238"}],"wp:attachment":[{"href":"https:\/\/modibrothers.co.uk\/shop\/wp-json\/wp\/v2\/media?parent=237"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}