Members Registration
Published May 9, 2025
<h1>Members Registration</h1> <form id="wpforms-form-3921" data-formid="3921" method="post" enctype="multipart/form-data" action="/wp-admin/admin-ajax.php" data-token="f16d41c3046e4dde3ad4d64ab51b3e0f" data-token-time="1746784137"><noscript>Please enable JavaScript in your browser to complete this form.</noscript>Please enable JavaScript in your browser to complete this form.<label for="wpforms-3921-field_15">Full name *</label><input type="text" id="wpforms-3921-field_15" name="wpforms[fields][15]" aria-errormessage="wpforms-3921-field_15-error" required><label for="wpforms-3921-field_22">Email *</label><input type="email" id="wpforms-3921-field_22" name="wpforms[fields][22]" spellcheck="false" aria-errormessage="wpforms-3921-field_22-error" required><label for="wpforms-3921-field_25">Country *</label><input type="text" id="wpforms-3921-field_25" name="wpforms[fields][25]" aria-errormessage="wpforms-3921-field_25-error" required><label for="wpforms-3921-field_27"> Are you a student or employee ? *</label><select id="wpforms-3921-field_27" name="wpforms[fields][27]" required="required"><option value="student" >student</option><option value="employee" >employee</option></select><label for="wpforms-3921-field_21">Company/Organization Name *</label><input type="text" id="wpforms-3921-field_21" name="wpforms[fields][21]" aria-errormessage="wpforms-3921-field_21-error" required><label for="wpforms-3921-field_23">Telephone Number *</label>
<input type="text" placeholder="" value="" readonly>
<label for="wpforms-3921-field_24">Who introduced you to NRS? *</label><input type="text" id="wpforms-3921-field_24" name="wpforms[fields][24]" aria-errormessage="wpforms-3921-field_24-error" required><label for="wpforms-3921-field_28">What membership you want to sign up ? *</label><select id="wpforms-3921-field_28" name="wpforms[fields][28]" required="required"><option value="Normal Member" >Normal Member</option><option value="Network Member" >Network Member</option></select><fieldset><legend>Choice *</legend><ul id="wpforms-3921-field_35"><li><input type="radio" id="wpforms-3921-field_35_1" name="wpforms[fields][35]" value="I agree to the general <a style="color:#3078bf;text-decoration: underline;" target="_blank" href="/terms-and-conditions/"> Terms and Conditions </a>" aria-errormessage="wpforms-3921-field_35_1-error" required ><label for="wpforms-3921-field_35_1">I agree to the general <a style="color:#3078bf;text-decoration: underline" target="_blank" href="/terms-and-conditions/"> Terms and Conditions </a></label></li></ul></fieldset><!-- .wpforms-field-container --><input type="hidden" name="wpforms[id]" value="3921"> <input
type="hidden"
name="wpforms[nonce]"
value="7daedec02f"
/>
<input type="hidden" name="page_title" value="{page_title}"><input type="hidden" name="page_url" value="http://page_url"><input type="hidden" name="url_referer" value="http://url_referer"><button type="submit" name="wpforms[submit]" id="wpforms-submit-3921" data-alt-text="Sending..." data-submit-text="Submit" aria-live="assertive" value="wpforms-submit">Submit</button><img src="https://nrs.help/wp-content/plugins/wpforms/assets/images/submit-spin.svg" style="display: none;" width="26" height="26" alt="Loading"></form> <!-- .wpforms-container -->