{"id":14188,"date":"2024-06-25T16:46:36","date_gmt":"2024-06-25T06:46:36","guid":{"rendered":"https:\/\/www.clenergy.com\/?page_id=14188"},"modified":"2024-06-25T16:46:36","modified_gmt":"2024-06-25T06:46:36","slug":"distributor-registry-form","status":"publish","type":"page","link":"https:\/\/www.clenergy.com\/distributor-registry-form\/","title":{"rendered":"Distributor Registry Form"},"content":{"rendered":"\t<section class=\"section sc-banner-sec\" id=\"section_675085070\">\n\t\t<div class=\"bg section-bg fill bg-fill  bg-loaded\" >\n\n\t\t\t\n\t\t\t\n\t\t\t\n\n\t\t<\/div>\n\n\t\t\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\n\n  <div class=\"banner has-hover\" id=\"banner-2028542176\">\n          <div class=\"banner-inner fill\">\n        <div class=\"banner-bg fill\" >\n            <div class=\"bg fill bg-fill \"><\/div>\n                                    \n                    <\/div>\n\t\t\n        <div class=\"banner-layers container\">\n            <div class=\"fill banner-link\"><\/div>            \n   <div id=\"text-box-1669587970\" class=\"text-box banner-layer x0 md-x0 lg-x0 y100 md-y100 lg-y100 res-text\">\n                                <div class=\"text-box-content text dark\">\n              \n              <div class=\"text-inner text-left\">\n                  \n<h1>Distributor Registry Form<\/h1>\n              <\/div>\n           <\/div>\n                            \n<style>\n#text-box-1669587970 .text-inner {\n  padding: 0px 15px 20px 15px;\n}\n#text-box-1669587970 {\n  width: 100%;\n}\n#text-box-1669587970 .text-box-content {\n  font-size: 100%;\n}\n@media (min-width:550px) {\n  #text-box-1669587970 .text-inner {\n    padding: 0px 15px 50px 15px;\n  }\n  #text-box-1669587970 {\n    width: 100%;\n  }\n}\n<\/style>\n    <\/div>\n \n        <\/div>\n      <\/div>\n\n            \n<style>\n#banner-2028542176 {\n  padding-top: 200px;\n  background-color: rgb(255,255,255);\n}\n#banner-2028542176 .bg.bg-loaded {\n  background-image: url(https:\/\/www.clenergy.com\/wp-content\/uploads\/2022\/04\/homeowner-bg.jpg);\n}\n#banner-2028542176 .bg {\n  background-position: center center;\n}\n#banner-2028542176 .ux-shape-divider--top svg {\n  height: 150px;\n  --divider-top-width: 100%;\n}\n#banner-2028542176 .ux-shape-divider--bottom svg {\n  height: 150px;\n  --divider-width: 100%;\n}\n@media (min-width:550px) {\n  #banner-2028542176 {\n    padding-top: 187px;\n  }\n}\n<\/style>\n  <\/div>\n\n\n\t\t<\/div>\n\n\t\t\n<style>\n#section_675085070 {\n  padding-top: 0px;\n  padding-bottom: 0px;\n  min-height: 150px;\n}\n#section_675085070 .ux-shape-divider--top svg {\n  height: 150px;\n  --divider-top-width: 100%;\n}\n#section_675085070 .ux-shape-divider--bottom svg {\n  height: 150px;\n  --divider-width: 100%;\n}\n@media (min-width:550px) {\n  #section_675085070 {\n    min-height: 187px;\n  }\n}\n<\/style>\n\t<\/section>\n\t\n\t<section class=\"section homeowner-registry-2-sec installer-sec reg-form-ctn\" id=\"section_199099373\">\n\t\t<div class=\"bg section-bg fill bg-fill  bg-loaded\" >\n\n\t\t\t\n\t\t\t\n\t\t\t\n\n\t\t<\/div>\n\n\t\t\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\n<div class=\"row\"  id=\"row-401800640\">\n\n\t<div id=\"col-1462853023\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n<div class=\"custom-breadcrumb\"><b><a href=\"\/solution-centre\/service-centre\/\">Service Centre<\/a> \/<\/b>  Distributor Registry Form<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n\n<style>\n#row-401800640 > .col > .col-inner {\n  padding: 0px 0px 20px 0px;\n}\n<\/style>\n<\/div>\n<div class=\"row\"  id=\"row-1641207194\">\n\n\t<div id=\"col-1999827308\" class=\"col medium-12 small-12 large-3\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n<h3>Register<\/h3>\n\t<div id=\"gap-1527263603\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-1527263603 {\n  padding-top: 20px;\n}\n@media (min-width:550px) {\n  #gap-1527263603 {\n    padding-top: 20px;\n  }\n}\n@media (min-width:850px) {\n  #gap-1527263603 {\n    padding-top: 30px;\n  }\n}\n<\/style>\n\t<\/div>\n\t\n<h6>Already have an account?<\/h6>\n<div><a href=\"\/solution-centre\/service-centre\/\" class=\"role-btn\">Login here<\/a><\/div>\n\t<div id=\"gap-309590412\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-309590412 {\n  padding-top: 20px;\n}\n@media (min-width:550px) {\n  #gap-309590412 {\n    padding-top: 20px;\n  }\n}\n@media (min-width:850px) {\n  #gap-309590412 {\n    padding-top: 30px;\n  }\n}\n<\/style>\n\t<\/div>\n\t\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n\n\t<div id=\"col-1038991189\" class=\"col medium-12 small-12 large-9\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n<div><div class=\"woocommerce-notices-wrapper\"><\/div> \n    <form method=\"post\" class=\"woocommerce-form woocommerce-form-register register\"  >\n\t\t\t\t\n\t\t<div class=\"field-ctn\">\n\t\t\t<label>User Email<span class=\"mark\">*<\/span><\/label>\n\t\t\t<input type=\"email\" name=\"email\" placeholder=\"User Email\" \/>\n\t\t<\/div>\n\t\t<div class=\"field-ctn\">\n\t\t\t<label>Password<span class=\"mark\">*<\/span><\/label>\n\t\t\t<input type=\"password\" name=\"password\" placeholder=\"Password\" \/>\n\t\t<\/div>\n\t\t<div class=\"field-ctn\">\n\t\t    <label>Retype Password<span class=\"mark\">*<\/span><\/label>\n\t\t\t<input type=\"password\" name=\"password2\" placeholder=\"Retype Password\" \/>\n\t\t<\/div>\n\t    \n\t    <div class=\"field-ctn\">\n\t        <label>First Name<span class=\"mark\">*<\/span><\/label>\n\t\t\t<input type=\"text\" name=\"billing_first_name\" placeholder=\"First Name\" \/>\n        <\/div>\n        <div class=\"field-ctn\">\n            <label>Last Name<span class=\"mark\">*<\/span><\/label>\n\t\t\t<input type=\"text\" name=\"billing_last_name\" placeholder=\"Last Name\" \/>\n        <\/div>\n        <div class=\"field-ctn\">\n            <label>Mobile<span class=\"mark\">*<\/span><\/label>\n\t\t\t<input type=\"text\" name=\"billing_phone\" placeholder=\"Mobile\" \/>\n\t\t<\/div>\n\t\t\n\t\t    \t\t<div class=\"field-ctn\">\n                <label>Job Title<span class=\"mark\">*<\/span><\/label>\n    \t\t\t<input type=\"text\" name=\"job_title\" placeholder=\"Job Title\" \/>\n    \t\t<\/div>\n\t\t\t\t\n\t\t<div class=\"field-ctn\">\n            <label>Company Name<span class=\"mark\">*<\/span><\/label>\n\t\t\t<input type=\"text\" name=\"billing_company\" placeholder=\"Company\" \/>\n\t\t<\/div>\n\t\t<div class=\"field-ctn\">\n            <label>City<span class=\"mark\">*<\/span><\/label>\n\t\t\t<input type=\"text\" name=\"billing_city\" placeholder=\"City\" \/>\n\t\t<\/div>\n\t\t<div class=\"field-ctn\">\n            <label>State<span class=\"mark\">*<\/span><\/label>\n\t\t\t<input type=\"text\" name=\"billing_state\" placeholder=\"State\" \/>\n\t\t<\/div>\n        \n        <div class=\"field-ctn\">\n            <label>Postcode<span class=\"mark\">*<\/span><\/label>\n\t\t\t<input type=\"text\" name=\"billing_postcode\" placeholder=\"Postcode\" \/>\n\t\t<\/div>\n\t\t\n\t\t<div class=\"field-ctn\">\n            <label>Country\/Region<span class=\"mark\">*<\/span><\/label>\n\t\t\t<select name=\"user_country\">\n                <option value=\"\">Please select a country<\/option>\n                <option value=\"Australia\">Australia<\/option>\n                <option value=\"Canada\">Canada<\/option>\n                <option value=\"China\">China<\/option>\n                <option value=\"Europe\">Europe<\/option>\n                <option value=\"Germany\">Germany<\/option>\n                <option value=\"Indonesia\">Indonesia<\/option>\n                <option value=\"Japan\">Japan<\/option>\n                <option value=\"Malaysia\">Malaysia<\/option>\n                <option value=\"Middle East & Africa\">Middle East & Africa<\/option>\n                <option value=\"New Zealand\">New Zealand<\/option>\n                <option value=\"Philippines\">Philippines<\/option>\n                <option value=\"Singapore\">Singapore<\/option>\n                <option value=\"Thailand\">Thailand<\/option>\n                <option value=\"United Kingdom\">United Kingdom<\/option>\n                <option value=\"South Africa\">South Africa<\/option>\n            <\/select>\n            \n\t\t<\/div>\n\t\t\n\t\t    \t\t\n    \t    \t\n    \t    <div class=\"field-ctn\">\n                <label>Your Company Number<\/label>\n    \t\t\t<input type=\"text\" name=\"company_number\" placeholder=\"Your Company Number\" \/>\n    \t\t<\/div>\n    \t\t\n    \t\t<div class=\"field-ctn\">\n                <label>Your Distributor\/Supplier Name(s)<\/label>\n    \t\t\t<input type=\"text\" name=\"distributor_names\" placeholder=\"Your Distributor\/Supplier Name(s)\" \/>\n    \t\t<\/div>\n    \t\t\n    \t\t<div class=\"field-ctn\">\n                <label>Number of Your Employees<\/label>\n        \t\t\t<select name=\"employee_number\">\n                    <option value=\"\">Please select a number<\/option>\n                    <option value=\"1-10\">1-10<\/option>\n                    <option value=\"11-50\">11-50<\/option>\n                    <option value=\"51-100\">51-100<\/option>\n                    <option value=\"Above 100\">Above 100<\/option>\n                <\/select>\n    \t\t<\/div>\n    \t\t\n    \t\t<div class=\"field-ctn checkbox-ctn\">\n                <label>Your Business Sector<\/label>\n                <ul>\n                    <li>\n                        <input type=\"checkbox\" name=\"business_sector[]\" value=\"Residential\" \/>\n                        <span>Residential<\/span>\n                    <\/li>\n                    <li>\n                        <input type=\"checkbox\" name=\"business_sector[]\" value=\"Commercial\" \/>\n                        <span>Commercial<\/span>\n                    <\/li>\n                    <li>\n                        <input type=\"checkbox\" name=\"business_sector[]\" value=\"Utility\" \/>\n                        <span>Utility<\/span>\n                    <\/li>\n                <\/ul>\n    \t\t<\/div>\n    \t\t\n\t\t\t    \n\t    <div class=\"field-ctn full-width\">\n\t        <input type=\"hidden\" name=\"role\" id=\"reg_role\" value=\"distributor\">\n    \t    <input type=\"checkbox\" name=\"agree_to_terms\" required>\n    \t    <span class=\"privacy-link\">I agree to Clenergy <a href=\"\/privacy-policy\/\" target=\"_blank\">terms of service & Privacy Policy<\/a><\/span>\n\t    <\/div>\n\t    \n\t    <wc-order-attribution-inputs><\/wc-order-attribution-inputs><div class=\"woocommerce-privacy-policy-text\"><\/div>\t\t\t<div class=\"btn-ctn\">\n\t\t\t    <input type=\"hidden\" id=\"woocommerce-register-nonce\" name=\"woocommerce-register-nonce\" value=\"ff2adbe93c\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/14188\" \/>\t\t\t    <button type=\"submit\" name=\"register\" value=\"Register\">Register<\/button>\n\t\t    <\/div>\n\t\t\t<\/form>\n \n    <\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n<\/div>\n\t\t<\/div>\n\n\t\t\n<style>\n#section_199099373 {\n  padding-top: 20px;\n  padding-bottom: 20px;\n  background-color: rgb(246, 246, 246);\n}\n#section_199099373 .ux-shape-divider--top svg {\n  height: 150px;\n  --divider-top-width: 100%;\n}\n#section_199099373 .ux-shape-divider--bottom svg {\n  height: 150px;\n  --divider-width: 100%;\n}\n@media (min-width:550px) {\n  #section_199099373 {\n    padding-top: 40px;\n    padding-bottom: 40px;\n  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