{"id":11272,"date":"2026-08-29T09:30:12","date_gmt":"2026-08-29T09:30:12","guid":{"rendered":"https:\/\/aqweldingdev.wpenginepowered.com\/?page_id=11272"},"modified":"2026-10-26T11:28:56","modified_gmt":"2026-10-26T11:28:56","slug":"pom-registration","status":"publish","type":"page","link":"https:\/\/www.aquasolwelding.com\/nl\/pom-registration","title":{"rendered":"POM Registration"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"11272\" class=\"elementor elementor-11272\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e4ccc17 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no\" data-id=\"e4ccc17\" data-element_type=\"section\" data-e-type=\"section\" id=\"pom-registration\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-16c8a2d\" data-id=\"16c8a2d\" data-element_type=\"column\" data-e-type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-333b531 elementor-widget elementor-widget-heading\" data-id=\"333b531\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">POM Registration<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bb7ae14 elementor-hidden-desktop elementor-hidden-tablet elementor-hidden-mobile elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"bb7ae14\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;button_width&quot;:&quot;20&quot;,&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"POM Registration (Test)\" aria-label=\"POM Registration (Test)\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"11272\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"bb7ae14\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"POM Registration - Aquasol Welding\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"11272\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-name elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSerial Number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" min=\"200000\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-model_number elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-model_number\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tModel Number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[model_number]\" id=\"form-field-model_number\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" value=\"POM-5B\" required=\"required\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_679c997 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_679c997\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_679c997]\" id=\"form-field-field_679c997\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_5633a9e elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5633a9e\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tJob Title\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_5633a9e]\" id=\"form-field-field_5633a9e\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_b449edd elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b449edd\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCompany Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_b449edd]\" id=\"form-field-field_b449edd\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_8d1c7ad elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8d1c7ad\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMobile Number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_8d1c7ad]\" id=\"form-field-field_8d1c7ad\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_e3eb356 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e3eb356\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tStreet Address\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_e3eb356]\" id=\"form-field-field_e3eb356\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a8289f5 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a8289f5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCity\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_a8289f5]\" id=\"form-field-field_a8289f5\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_b38c05f elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b38c05f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tState\/Province\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_b38c05f]\" id=\"form-field-field_b38c05f\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_d921f11 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d921f11\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tZip Code\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_d921f11]\" id=\"form-field-field_d921f11\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_1bd091d elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_1bd091d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCountry\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_1bd091d]\" id=\"form-field-field_1bd091d\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_ec8107d elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ec8107d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail Address\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_ec8107d]\" id=\"form-field-field_ec8107d\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_c45a1ea elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_c45a1ea\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tReceipt Upload Date\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_c45a1ea]\" id=\"form-field-field_c45a1ea\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field elementor-use-native\" required=\"required\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\" min=\"2026-08-31\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_e5caba2 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e5caba2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPurchased Date\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_e5caba2]\" id=\"form-field-field_e5caba2\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field elementor-use-native\" required=\"required\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-field_15d3ef0 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_15d3ef0\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tReceipt Upload (as attachment)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[field_15d3ef0]\" id=\"form-field-field_15d3ef0\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" required=\"required\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-20 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Register Warranty<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e2df019 elementor-widget elementor-widget-shortcode\" data-id=\"e2df019\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">            \n            <form method=\"post\" enctype=\"multipart\/form-data\">\n                <p style=\"display:none;\"><\/p>\n                <table>\n                <tr><td>\n                <p> Serial Number <\/p>\n                <p>\n                    <input type=\"number\" id=\"hit_serial_number\" name=\"hit_serial_number\" min=\"200000\" max=\"399999\" style=\"min-width:400px;\" required \/>\n                <\/p>\n                <\/td>\n                <td style=\"padding-left: 20px;\">\n                <p> Model Number<\/p>\n                <p>\n                <input type=\"text\" id=\"hit_model_number_show\" name=\"hit_model_number_show\" style=\"min-width:400px;\" required=\"true\" disabled=\"true\" \/>\n                <input type=\"hidden\" id=\"hit_model_number\" name=\"hit_model_number\" >\n                <\/p>\n        <\/td><\/tr>\n        <tr><td>\n                <p> Name<\/p>\n                <p>\n                <input type=\"text\" id=\"hit_user_name\" name=\"hit_user_name\" style=\"min-width:400px;\" required=\"true\" \/>\n                \n                <\/p>\n        <\/td><td style=\"padding-left: 20px;\">\n                <p> Job Title<\/p>\n                <p>\n                <input type=\"text\" id=\"hit_user_job\" name=\"hit_user_job\" style=\"min-width:400px;\" required=\"true\" \/>\n                \n                <\/p>\n                <\/td><\/tr><tr><td>\n                <p> Company Name<\/p>\n                <p>\n                <input type=\"text\" id=\"hit_user_company\" name=\"hit_user_company\" style=\"min-width:400px;\" required=\"true\" \/>\n                \n                <\/p>\n        <\/td><td style=\"padding-left: 20px;\">\n                <p> Mobile Number<\/p>\n                <p>\n                <input type=\"text\" id=\"hit_user_mobile\" name=\"hit_user_mobile\" style=\"min-width:400px;\" required=\"true\" \/>\n                \n                <\/p>\n                <\/td><\/tr><tr><td>\n                <p> Street Address<\/p>\n                <p>\n                <input type=\"text\" id=\"hit_user_street\" name=\"hit_user_street\" style=\"min-width:400px;\" \/>\n                \n                <\/p>\n        <\/td><td style=\"padding-left: 20px;\">\n                <p> City<\/p>\n                <p>\n                <input type=\"text\" id=\"hit_user_city\" name=\"hit_user_city\" style=\"min-width:400px;\"\/>\n                \n                <\/p>\n                <\/td><\/tr><tr><td>\n                <p> State\/Province<\/p>\n                <p>\n                <input type=\"text\" id=\"hit_user_state\" name=\"hit_user_state\" style=\"min-width:400px;\"\/>\n                \n                <\/p>\n        <\/td><td style=\"padding-left: 20px;\">\n                <p> Zip Code<\/p>\n                <p>\n                <input type=\"text\" id=\"hit_user_zip\" name=\"hit_user_zip\" style=\"min-width:400px;\" \/>\n                \n                <\/p>\n                <\/td><\/tr><tr><td>\n                <p> Country<\/p>\n                <p>\n                <select id=\"hit_user_country\" name=\"hit_user_country\" style=\"min-width:400px;\">\n                    <option value='Afghanistan'>Afghanistan<\/option><option value='Albania'>Albania<\/option><option value='Algeria'>Algeria<\/option><option value='Andorra'>Andorra<\/option><option value='Angola'>Angola<\/option><option value='Antigua and Barbuda'>Antigua and Barbuda<\/option><option value='Argentina'>Argentina<\/option><option value='Armenia'>Armenia<\/option><option value='Australia'>Australia<\/option><option value='Austria'>Austria<\/option><option value='Azerbaijan'>Azerbaijan<\/option><option value='Bahamas'>Bahamas<\/option><option value='Bahrain'>Bahrain<\/option><option value='Bangladesh'>Bangladesh<\/option><option value='Barbados'>Barbados<\/option><option value='Belarus'>Belarus<\/option><option value='Belgium'>Belgium<\/option><option value='Belize'>Belize<\/option><option value='Benin'>Benin<\/option><option value='Bhutan'>Bhutan<\/option><option value='Bolivia'>Bolivia<\/option><option value='Bosnia and Herzegovina'>Bosnia and Herzegovina<\/option><option value='Botswana'>Botswana<\/option><option value='Brazil'>Brazil<\/option><option value='Brunei'>Brunei<\/option><option value='Bulgaria'>Bulgaria<\/option><option value='Burkina Faso'>Burkina Faso<\/option><option value='Burundi'>Burundi<\/option><option value='Cambodia'>Cambodia<\/option><option value='Cameroon'>Cameroon<\/option><option value='Canada'>Canada<\/option><option value='Cape Verde'>Cape Verde<\/option><option value='Central African Republic'>Central African Republic<\/option><option value='Chad'>Chad<\/option><option value='Chile'>Chile<\/option><option value='China'>China<\/option><option value='Colombi'>Colombi<\/option><option value='Comoros'>Comoros<\/option><option value='Congo (Brazzaville)'>Congo (Brazzaville)<\/option><option value='Congo'>Congo<\/option><option value='Costa Rica'>Costa Rica<\/option><option value='Cote d'Ivoire'>Cote d'Ivoire<\/option><option value='Croatia'>Croatia<\/option><option value='Cuba'>Cuba<\/option><option value='Cyprus'>Cyprus<\/option><option value='Czech Republic'>Czech Republic<\/option><option value='Denmark'>Denmark<\/option><option value='Djibouti'>Djibouti<\/option><option value='Dominica'>Dominica<\/option><option value='Dominican Republic'>Dominican Republic<\/option><option value='East Timor (Timor Timur)'>East Timor (Timor Timur)<\/option><option value='Ecuador'>Ecuador<\/option><option value='Egypt'>Egypt<\/option><option value='El Salvador'>El Salvador<\/option><option value='Equatorial Guinea'>Equatorial Guinea<\/option><option value='Eritrea'>Eritrea<\/option><option value='Estonia'>Estonia<\/option><option value='Ethiopia'>Ethiopia<\/option><option value='Fiji'>Fiji<\/option><option value='Finland'>Finland<\/option><option value='France'>France<\/option><option value='Gabon'>Gabon<\/option><option value='Gambia, The'>Gambia, The<\/option><option value='Georgia'>Georgia<\/option><option value='Germany'>Germany<\/option><option value='Ghana'>Ghana<\/option><option value='Greece'>Greece<\/option><option value='Grenada'>Grenada<\/option><option value='Guatemala'>Guatemala<\/option><option value='Guinea'>Guinea<\/option><option value='Guinea-Bissau'>Guinea-Bissau<\/option><option value='Guyana'>Guyana<\/option><option value='Haiti'>Haiti<\/option><option value='Honduras'>Honduras<\/option><option value='Hungary'>Hungary<\/option><option value='Iceland'>Iceland<\/option><option value='India'>India<\/option><option value='Indonesia'>Indonesia<\/option><option value='Iran'>Iran<\/option><option value='Iraq'>Iraq<\/option><option value='Ireland'>Ireland<\/option><option value='Israel'>Israel<\/option><option value='Italy'>Italy<\/option><option value='Jamaica'>Jamaica<\/option><option value='Japan'>Japan<\/option><option value='Jordan'>Jordan<\/option><option value='Kazakhstan'>Kazakhstan<\/option><option value='Kenya'>Kenya<\/option><option value='Kiribati'>Kiribati<\/option><option value='Korea, North'>Korea, North<\/option><option value='Korea, South'>Korea, South<\/option><option value='Kuwait'>Kuwait<\/option><option value='Kyrgyzstan'>Kyrgyzstan<\/option><option value='Laos'>Laos<\/option><option value='Latvia'>Latvia<\/option><option value='Lebanon'>Lebanon<\/option><option value='Lesotho'>Lesotho<\/option><option value='Liberia'>Liberia<\/option><option value='Libya'>Libya<\/option><option value='Liechtenstein'>Liechtenstein<\/option><option value='Lithuania'>Lithuania<\/option><option value='Luxembourg'>Luxembourg<\/option><option value='Macedonia'>Macedonia<\/option><option value='Madagascar'>Madagascar<\/option><option value='Malawi'>Malawi<\/option><option value='Malaysia'>Malaysia<\/option><option value='Maldives'>Maldives<\/option><option value='Mali'>Mali<\/option><option value='Malta'>Malta<\/option><option value='Marshall Islands'>Marshall Islands<\/option><option value='Mauritania'>Mauritania<\/option><option value='Mauritius'>Mauritius<\/option><option value='Mexico'>Mexico<\/option><option value='Micronesia'>Micronesia<\/option><option value='Moldova'>Moldova<\/option><option value='Monaco'>Monaco<\/option><option value='Mongolia'>Mongolia<\/option><option value='Morocco'>Morocco<\/option><option value='Mozambique'>Mozambique<\/option><option value='Myanmar'>Myanmar<\/option><option value='Namibia'>Namibia<\/option><option value='Nauru'>Nauru<\/option><option value='Nepal'>Nepal<\/option><option value='Netherlands'>Netherlands<\/option><option value='New Zealand'>New Zealand<\/option><option value='Nicaragua'>Nicaragua<\/option><option value='Niger'>Niger<\/option><option value='Nigeria'>Nigeria<\/option><option value='Norway'>Norway<\/option><option value='Oman'>Oman<\/option><option value='Pakistan'>Pakistan<\/option><option value='Palau'>Palau<\/option><option value='Panama'>Panama<\/option><option value='Papua New Guinea'>Papua New Guinea<\/option><option value='Paraguay'>Paraguay<\/option><option value='Peru'>Peru<\/option><option value='Philippines'>Philippines<\/option><option value='Poland'>Poland<\/option><option value='Portugal'>Portugal<\/option><option value='Qatar'>Qatar<\/option><option value='Romania'>Romania<\/option><option value='Russia'>Russia<\/option><option value='Rwanda'>Rwanda<\/option><option value='Saint Kitts and Nevis'>Saint Kitts and Nevis<\/option><option value='Saint Lucia'>Saint Lucia<\/option><option value='Saint Vincent'>Saint Vincent<\/option><option value='Samoa'>Samoa<\/option><option value='San Marino'>San Marino<\/option><option value='Sao Tome and Principe'>Sao Tome and Principe<\/option><option value='Saudi Arabia'>Saudi Arabia<\/option><option value='Senegal'>Senegal<\/option><option value='Serbia and Montenegro'>Serbia and Montenegro<\/option><option value='Seychelles'>Seychelles<\/option><option value='Sierra Leone'>Sierra Leone<\/option><option value='Singapore'>Singapore<\/option><option value='Slovakia'>Slovakia<\/option><option value='Slovenia'>Slovenia<\/option><option value='Solomon Islands'>Solomon Islands<\/option><option value='Somalia'>Somalia<\/option><option value='South Africa'>South Africa<\/option><option value='Spain'>Spain<\/option><option value='Sri Lanka'>Sri Lanka<\/option><option value='Sudan'>Sudan<\/option><option value='Suriname'>Suriname<\/option><option value='Swaziland'>Swaziland<\/option><option value='Sweden'>Sweden<\/option><option value='Switzerland'>Switzerland<\/option><option value='Syria'>Syria<\/option><option value='Taiwan'>Taiwan<\/option><option value='Tajikistan'>Tajikistan<\/option><option value='Tanzania'>Tanzania<\/option><option value='Thailand'>Thailand<\/option><option value='Togo'>Togo<\/option><option value='Tonga'>Tonga<\/option><option value='Trinidad and Tobago'>Trinidad and Tobago<\/option><option value='Tunisia'>Tunisia<\/option><option value='Turkey'>Turkey<\/option><option value='Turkmenistan'>Turkmenistan<\/option><option value='Tuvalu'>Tuvalu<\/option><option value='Uganda'>Uganda<\/option><option value='Ukraine'>Ukraine<\/option><option value='United Arab Emirates'>United Arab Emirates<\/option><option value='United Kingdom'>United Kingdom<\/option><option value='United States'>United States<\/option><option value='Uruguay'>Uruguay<\/option><option value='Uzbekistan'>Uzbekistan<\/option><option value='Vanuatu'>Vanuatu<\/option><option value='Vatican City'>Vatican City<\/option><option value='Venezuela'>Venezuela<\/option><option value='Vietnam'>Vietnam<\/option><option value='Yemen'>Yemen<\/option><option value='Zambia'>Zambia<\/option><option value='Zimbabwe'>Zimbabwe<\/option>                <\/select>           \n                <\/p>\n                <\/td><td style=\"padding-left: 20px;\">\n                <p> Email Address<\/p>\n                <p>\n                    <input type=\"email\" id=\"hit_user_email\" name=\"hit_user_email\" style=\"min-width:400px;\" required=\"true\" \/>\n                \n                <\/p>\n                <\/td><\/tr><tr><td>\n                <p> Receipt Upload Date<\/p>\n                <p>\n                    <input type=\"date\" id=\"hit_recipt_upload_date\" name=\"hit_recipt_upload_date\" value=\"2026-11-01\" style=\"min-width:400px;\" disabled=\"true\" required=\"true\" \/>\n                <\/p>\n                <\/td><td style=\"padding-left: 20px;\">\n                <p> Purchased Date<\/p>\n                <p>\n                    <input type=\"date\"  max=\"2026-11-01\" pattern=\"\\d{4}-\\d{2}-\\d{2}\" id=\"hit_user_purchased_date\" name=\"hit_user_purchased_date\" style=\"min-width:400px;\" required=\"true\" \/>\n                <\/p>\n                <\/td><\/tr><tr><td>\n                <p> Receipt Upload (as attachment)<\/p>\n                <p>\n                    <input type=\"file\"  id=\"hit_user_recipt_upload\" name=\"hit_user_recipt_upload\" style=\"min-width:400px;\" \/>\n                <\/p>\n                <\/td>\n                <td style=\"padding-left: 20px;\">\n                <\/td><\/tr><\/table>\n                <p><br\/><input type=\"submit\" id=\"hit_submit_warrenty\" name=\"hit_submit_warrenty\" value=\"Register Warranty\" style=\"background:#3161b7;color:white;padding:8px 33px;border:none;\" \/>\n                <\/p>\n                \n                <p>Already registered? <a href=\"#\" id=\"hit_checkwarrenty\">Check your warranty<\/a><\/p>\n            <\/form>\n            <form method=\"post\" enctype=\"multipart\/form-data\" id=\"check_warrenty_form\" style=\"display:none;\">\n     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