{"id":1952,"date":"2020-09-08T05:22:34","date_gmt":"2020-09-08T05:22:34","guid":{"rendered":"https:\/\/www.zoopfs.co.za\/?page_id=1952"},"modified":"2020-09-09T13:01:20","modified_gmt":"2020-09-09T13:01:20","slug":"agent-form","status":"publish","type":"page","link":"https:\/\/www.zoopfs.co.za\/consumer\/agent-form\/","title":{"rendered":"Agent Form"},"content":{"rendered":"<h3><label> Independent Agent<\/label><\/h3>\n<h3><label>Registration Form<\/label><\/h3>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1954-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1954\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/consumer\/wp-json\/wp\/v2\/pages\/1952#wpcf7-f1954-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1954\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1954-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:1954,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;technical-support-selected&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;support-type&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Senior Agent&quot;}]},{&quot;then_field&quot;:&quot;sales-support-selected&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;support-type&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Agent&quot;}]},{&quot;then_field&quot;:&quot;os-selected&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;operating-system&quot;,&quot;operator&quot;:&quot;not equals&quot;,&quot;if_value&quot;:&quot;&quot;},{&quot;if_field&quot;:&quot;operating-system&quot;,&quot;operator&quot;:&quot;not equals&quot;,&quot;if_value&quot;:&quot;Other&quot;}]},{&quot;then_field&quot;:&quot;os-android&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;operating-system&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Android&quot;}]},{&quot;then_field&quot;:&quot;os-iOS&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;operating-system&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;iOS&quot;}]},{&quot;then_field&quot;:&quot;os-linux&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;operating-system&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Linux&quot;}]},{&quot;then_field&quot;:&quot;os-windows&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;operating-system&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Windows&quot;}]},{&quot;then_field&quot;:&quot;os-other-selected&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;operating-system&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Other&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false}}\" \/>\n<\/fieldset>\n<p>Position:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"support-type\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"support-type\"><option value=\"\">-- Choose Position --<\/option><option value=\"Branch Manager\">Branch Manager<\/option><option value=\"Senior Agent\">Senior Agent<\/option><option value=\"Agent\">Agent<\/option><option value=\"I&#039;m not sure\">I&#039;m not sure<\/option><\/select><\/span>\n<\/p>\n<div data-id=\"technical-support-selected\" data-orig_data_id=\"technical-support-selected\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t<p>To which branch do you report: <span class=\"wpcf7-form-control-wrap\" data-name=\"operating-system\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"operating-system\"><option value=\"\">-- To which branch do you report --<\/option><option value=\"Afri-Logic\">Afri-Logic<\/option><option value=\"Western Cape Truter\">Western Cape Truter<\/option><option value=\"Gauteng Hollenbach\">Gauteng Hollenbach<\/option><option value=\"Gauteng Head Office\">Gauteng Head Office<\/option><\/select><\/span>\n\t<\/p>\n\t<div data-id=\"os-selected\" data-orig_data_id=\"os-selected\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t<\/div>\n\t<div data-id=\"os-other-selected\" data-orig_data_id=\"os-other-selected\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t<\/div>\n<\/div>\n<div data-id=\"sales-support-selected\" data-orig_data_id=\"sales-support-selected\"  class=\"\" data-class=\"wpcf7cf_group\">\n\t<p>To which branch do you report: <span class=\"wpcf7-form-control-wrap\" data-name=\"continent\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"continent\"><option value=\"\">-- To which branch do you report:  --<\/option><option value=\"Afri-Logic\">Afri-Logic<\/option><option value=\"Western Cape Truter\">Western Cape Truter<\/option><option value=\"Gauteng Hollenbach\">Gauteng Hollenbach<\/option><option value=\"Gauteng Head Office\">Gauteng Head Office<\/option><\/select><\/span>\n\t<\/p>\n<\/div>\n<p><label>Will you be issued with a mobile POS device?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Mobile-POS\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"Mobile-POS\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"Mobile-POS\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"Mobile-POS\" value=\"I&#039;m not sure\" \/><span class=\"wpcf7-list-item-label\">I&#039;m not sure<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label>Name and Surname:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"First-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"First-name\" \/><\/span>\n<\/p>\n<p><label>Nationality:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"nationality\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nationality\" \/><\/span>\n<\/p>\n<p><label>ID Number:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ID\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"ID\" \/><\/span>\n<\/p>\n<p><label>Attach Copy of ID Document (pdf|jpg|jpeg|png)<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ID-doc\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\".pdf,.jpg,.jpeg,.png\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"ID-doc\" \/><\/span>\n<\/p>\n<p><label>If not South African Resident - Passport & Work Permit Number<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Not-resident\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"Not-resident\" \/><\/span>\n<\/p>\n<p><label>Physical Address<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"phyiscal-address\"><textarea cols=\"20\" rows=\"4\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"phyiscal-address\"><\/textarea><\/span>\n<\/p>\n<p><label>Personal Contact Number:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"contact\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"contact\" \/><\/span>\n<\/p>\n<p><label>Emergency Contact Number:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"contact-emergency\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"contact-emergency\" \/><\/span>\n<\/p>\n<p><label>Email:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n<\/p>\n<p><label>Please select which device you will be using to download your Mobiloan application:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"which-device-dl\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"which-device-dl\"><option value=\"Mobile Device (smartphone or tablet\">Mobile Device (smartphone or tablet<\/option><option value=\"Desktop or Laptop\">Desktop or Laptop<\/option><\/select><\/span>\n<\/p>\n<p><label>Area of Work:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"area-of-work\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"area-of-work\" \/><\/span>\n<\/p>\n<p><label>BANK ACCOUNT DETAILS WHERE YOUR COMISSION WILL BE PAID INTO<\/label>\n<\/p>\n<p><label>Account Name:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"account-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"account-name\" \/><\/span>\n<\/p>\n<p><label>Bank:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"bank-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"bank-name\" \/><\/span>\n<\/p>\n<p><label>Bank Account Number:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"bank-account-no\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"bank-account-no\" \/><\/span>\n<\/p>\n<p><label>Branch:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"branch\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"branch\" \/><\/span>\n<\/p>\n<p><label>Branch Code:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"branch-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"branch-code\" \/><\/span>\n<\/p>\n<p>[anr_nocaptcha g-recaptcha-response]<br \/>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"Independent Agent Registration Form Position: -- Choose Position --Branch ManagerSenior AgentAgentI&#039;m not sure To which branch do you report: -- To which branch do you report --Afri-LogicWestern Cape TruterGauteng HollenbachGauteng Head Office To which branch do you report: -- To which branch do you report: --Afri-LogicWestern Cape TruterGauteng HollenbachGauteng Head Office Will you be issued [...]","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1952","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Agent Form - Zoop Financial Services<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, 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