{"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":"2026-06-18T07:16:05","modified_gmt":"2026-06-18T07:16:05","slug":"account-form","status":"publish","type":"page","link":"https:\/\/modibrothers.co.uk\/trade\/account-form\/","title":{"rendered":"Trade Form"},"content":{"rendered":"<h2 class=\"has-text-align-center alignwide wp-block-post-title\">Trade Form<\/h2>\n\n        <div class=\"mta-form-container\">\n            <div class=\"mta-form-header\">\n                <h2>MODI BROTHERS UK LTD<\/h2>\n                <p>Trade Account Opening Form<\/p>\n                <p style=\"margin-top:15px; font-size: 14px;\">Already have an account? <a href=\"https:\/\/modibrothers.co.uk\/trade\/my-account\/\" style=\"color: #0073aa; font-weight: bold; text-decoration: underline;\">Login here<\/a><\/p>\n            <\/div>\n            <form action=\"\" method=\"POST\" class=\"mta-trade-form\" id=\"mta-trade-form\">\n                <input type=\"hidden\" id=\"mta_nonce\" name=\"mta_nonce\" value=\"f988e00f9d\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/trade\/wp-json\/wp\/v2\/pages\/237\" \/>                \n                <h3>Applicant Details<\/h3>\n                <div class=\"mta-grid\">\n                    <div class=\"mta-field\"><label>Full Name *<\/label><input type=\"text\" name=\"full_name\" required><\/div>\n                    <div class=\"mta-field\"><label>Company Name *<\/label><input type=\"text\" name=\"company_name\" required><\/div>\n                    <div class=\"mta-field mta-full\"><label>Company Address<\/label><textarea name=\"company_address\"><\/textarea><\/div>\n                    <div class=\"mta-field\"><label>Company Registration No.<\/label><input type=\"text\" name=\"reg_no\"><\/div>\n                    <div class=\"mta-field\"><label>VAT ID<\/label><input type=\"text\" name=\"vat_id\"><\/div>\n                    <div class=\"mta-field mta-full\"><label>Delivery Address (if diff. from above)<\/label><textarea name=\"delivery_address\"><\/textarea><\/div>\n                <\/div>\n\n                <h3>Nature of Business (tick applicable)<\/h3>\n                <div class=\"mta-checkbox-grid\">\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_manufacturer\" required> Manufacturer<\/label>\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_distributor\"> Distributor<\/label>\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_wholesaler\"> Wholesaler<\/label>\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_retailer\"> Retailer<\/label>\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_builder\"> Builder<\/label>\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_architect\"> Architect<\/label>\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_designer\"> Interior Designer<\/label>\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_contractor\"> Contractor<\/label>\n                    <label><input type=\"radio\" name=\"business_nature\" value=\"trade_others\" id=\"mta_radio_others\"> Others: <input type=\"text\" name=\"business_nature_other\" id=\"mta_other_text\" class=\"mta-inline-input\"><\/label>\n                <\/div>\n\n                <h3>Contact Details<\/h3>\n                <div class=\"mta-grid\">\n                    <div class=\"mta-field\"><label>Phone (Work)<\/label><input type=\"text\" name=\"phone_work\"><\/div>\n                    <div class=\"mta-field\"><label>Phone (Mobile) *<\/label><input type=\"text\" name=\"phone_mobile\" required><\/div>\n                    <div class=\"mta-field\"><label>Email *<\/label><input type=\"email\" name=\"email\" required><\/div>\n                    <div class=\"mta-field\"><label>Website<\/label><input type=\"text\" name=\"website\"><\/div>\n                <\/div>\n\n                <h3>Declaration<\/h3>\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>\n                <div class=\"mta-grid\">\n                    <div class=\"mta-field\"><label>Authorized Name *<\/label><input type=\"text\" name=\"auth_name\" required><\/div>\n                    <div class=\"mta-field\"><label>Position<\/label><input type=\"text\" name=\"position\"><\/div>\n                    <div class=\"mta-field\"><label>Signature (Type Name) *<\/label><input type=\"text\" name=\"signature\" required><\/div>\n                    <div class=\"mta-field\"><label>Date *<\/label><input type=\"date\" name=\"date\" required><\/div>\n                <\/div>\n\n                <div class=\"mta-submit-wrap\">\n                    <button type=\"submit\" name=\"mta_submit\" class=\"mta-btn\">Submit Trade Application<\/button>\n                <\/div>\n            <\/form>\n\n            <script>\n                document.addEventListener('DOMContentLoaded', function() {\n                    const otherRadio = document.getElementById('mta_radio_others');\n                    const otherText = document.getElementById('mta_other_text');\n                    const allRadios = document.querySelectorAll('input[name=\"business_nature\"]');\n\n                    allRadios.forEach(radio => {\n                        radio.addEventListener('change', function() {\n                            if (otherRadio.checked) {\n                                otherText.required = true;\n                                otherText.focus();\n                            } else {\n                                otherText.required = false;\n                            }\n                        });\n                    });\n                });\n            <\/script>\n        <\/div>\n        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