<!--js functions are include in 'public/js/registrationFunctions.js'-->
<div class="section">
    <div class="wraper">
        <div class="sectionform">
            <div class="secgap">
                <div class="sectionform_left">
                    <div class="secgap">
                        <h1>Sourcing Redefined!</h1>
                        <ul>
                            <li>Need best global travel deals?</li>
                            <li>Want highest commissions on travel insurance?</li>
                            <li>Want to manage your customers?</li>
                            <a href="#"><span class="manymore">And many <strong>more...</strong></span></a>
                        </ul>
                    </div>
                </div>
                <div class="sectionform_right">
                    <div class="secgapright">
                        <div class="sectionform_right-top">
                            <div class="topcontent"><span>Get <strong>free</strong> 30 days</span> priority access to </div>
                            <div class="bottomcontent">Global <strong>Travel</strong> Exchange.com</div>
                        </div>
                        <div class="sectionform_right-bottom">
                            <div class="registerform">
                                <h2>
                                    Register now 
                                </h2>

                                <div class="innergap">
                                    <div id="dispMessage"></div>
                                    <form id="AgencyRegisterForm" action="#" method="POST" autocomplete="off">

                                        <table cellpadding="0" cellspacing="0">
                                            <tr>
                                                <td colspan="2">
                                                    <input name="agencyName" type="text" placeholder="Agency Name" value="" maxlength="85">
                                                </td>
                                            </tr>

                                            <tr>
<!--                                                <td>
                                                    <div class="selectdrop">
                                                        <select id="selectCountry" name="selectCountry" onchange="getCity();">
                                                            <option value="">Select Country</option>
                                                            <?php
//                                                            foreach ($this->countryListArray as $countryData) { //print_r($countryData);
//                                                                echo "<option value='" . $countryData['ContId'] . "'>" . $countryData['Title'] . "</option>";
//                                                            }
                                                            ?>
                                                        </select>
                                                    </div>
                                                </td>-->
                                                <td><input name="selectCountry" id="selectCountry" type="text" placeholder="Country Name" value=""></td>
<!--                                                <td>
                                                    <div class="selectdrop" id="selectStateDIv">
                                                        <select id="selectState" name="selectState" onchange="getCity();">
                                                            <option value="">Select State</option>
                                                        </select>
                                                    </div>
                                                </td>-->
                                            </tr> 
                                            <tr>
                                                <td>
                                                    <div class="selectdrop" id="selectCityDIv">
                                                        <select id="selectCity" name="selectCity">
                                                            <option value="">Select City</option>
                                                        </select>
                                                    </div>
                                                </td>
                                                <td>
                                                    <input type="text" name="contactName" placeholder="Contact Name" value="" maxlength="50">
                                                </td>
                                            </tr>



                                            <tr>
                                                <td>
                                                    <input type="text" name="emailId" id="emailId" placeholder="Email ID" value="" maxlength="75">
                                                </td>
                                                <td>
                                                    <input type="text" name="mobileNo" placeholder="Mobile Number" value="" maxlength="11">
                                                </td>
                                            </tr>
                                            <tr>
                                                <td colspan="2">
                                                    <textarea name="shortDetail" cols="" rows="" placeholder=" Here about  your self"></textarea>
                                                </td>
                                            </tr>

                                            <tr>
                                                <td>
                                                    <input name="captcha" id="captcha" type="text" placeholder="Captcha" maxlength="8">
                                                </td>
                                                <td>
                                                    <!--<img src="<?php //echo $this->baseUrl('public/images/captcha.png');    ?>" ></td>-->
                                                    <div style="margin-top:5px;width:285px;">    
                                                        <img src="<?php echo $this->baseUrl(); ?>/public/captcha/captcha.php" alt="CAPTCHA code" id="captcha_one" height="50" style="float:left;">
                                                        <a  href="javascript:void(0);" onclick="
                                                                document.getElementById('captcha_one').src = '<?php echo $this->baseUrl(); ?>/public/captcha/captcha.php?' + Math.random();
                                                                document.getElementById('captcha').focus();"
                                                            id="change-image"> <img src="<?php echo $this->baseUrl('public/images/refresh.png'); ?>" alt="Refresh image" border="0" width="24" title="Refresh" style="margin-top:10px;">
                                                        </a>

                                                    </div> 
                                            </tr>
                                            <tr>
                                                <td>&nbsp;</td>
                                                <td>
                                                    <input type="hidden" name="hidden_selected_country_id" id="hidden_selected_country_id"/>
                                                    <input name="submit" type="submit" id="submit" value="Join Us">
                                                </td>
                                            </tr>

                                        </table>
                                    </form>
                                </div>
                                <div class="cl"></div>
                            </div>

                            <div class="registermessage">
                                <!--                                Congratulations, You have successfully registered as a Partner with us. 
                                                                We have sent you an email for your id verification, please check your email to verify-->
                               
                                <p>Congratulations, You have <span>successfully </span> registered as a Partner with us. </br>
                                    We have sent you an email for your id verification, </br>
                                    please check your email to verify!</p>
                            </div>
                        </div>
                    </div>
                </div>

                <div class="cl"></div>
            </div>
        </div>
    </div>
</div>
<script src="<?php echo $this->baseUrl('public/js/jquery.min.js'); ?>"></script>
 <script src="<?php echo $this->baseUrl('public/assets/js/jquery-ui.js'); ?>"></script>
<script src="<?php echo $this->baseUrl('public/js/jquery.validate.min.js'); ?>"></script>

<!--include custom js functions-->
<script src="<?php echo $this->baseUrl('public/js/registrationFunctions.js'); ?>"></script>
<script type="text/javascript">
        $().ready(function() { 
        $("input[name=selectCountry]").autocomplete({
            source: '/register/autosuggest',
            
            focus: function (event, ui) {
                event.preventDefault();
                $("#tags").val(ui.item.label);
            },

            select: function (event, ui) {
                event.preventDefault();


                $("input[name=selectCountry]").val(ui.item.label);
                $("#hidden_selected_country_id").val(ui.item.value).trigger('change');
                
            }
        });
        
        
    });
$(function () {
    $('.registermessage').hide();
});
</script>