{"id":8736,"date":"2025-09-15T21:59:20","date_gmt":"2025-09-15T21:59:20","guid":{"rendered":"https:\/\/glowspecial.store\/?page_id=8736"},"modified":"2025-09-15T23:19:07","modified_gmt":"2025-09-15T23:19:07","slug":"bene-eyecare-gh-form","status":"publish","type":"page","link":"https:\/\/glowspecial.store\/?page_id=8736","title":{"rendered":"Bene-eyecare-Gh-form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"8736\" class=\"elementor elementor-8736\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c1b91d3 e-flex e-con-boxed e-con e-parent\" data-id=\"c1b91d3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-24ccdae elementor-widget elementor-widget-heading\" data-id=\"24ccdae\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">PLEASE DON\u2019T COMPLETE THIS FORM IF YOU ARE NOT FINANCIALLY READY, OR IF YOU ARE TRAVELLING, OR IF YOU ARE NOT READY TO RECEIVE THE PRODUCT. THANKS!!!!!!!<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-261719c elementor-widget elementor-widget-heading\" data-id=\"261719c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-8735\"><form id=\"wpforms-form-8735\" class=\"wpforms-validate wpforms-form\" data-formid=\"8735\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F8736\"><div class=\"wpforms-field-container\"><div id=\"wpforms-8735-field_1-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-8735-field_1\">Full Name <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-8735-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" required><\/div><div id=\"wpforms-8735-field_2-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-8735-field_2\">Address\/Region <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-8735-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/div><div id=\"wpforms-8735-field_3-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-8735-field_3\">Phone Number <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-8735-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" required><\/div><div id=\"wpforms-8735-field_4-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-8735-field_4\">WhatsApp Number<\/label><input type=\"text\" id=\"wpforms-8735-field_4\" class=\"wpforms-field-medium\" name=\"wpforms[fields][4]\" ><\/div><div id=\"wpforms-8735-field_5-container\" class=\"wpforms-field wpforms-field-select\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-8735-field_5\">Quantity  <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-8735-field_5\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][5]\" required=\"required\"><option value=\"Buy one for 250GHS\" >Buy one for 250GHS<\/option><option value=\"Buy two for 450GHS (Recommended Dosage)\"  selected='selected'>Buy two for 450GHS (Recommended Dosage)<\/option><option value=\"Buy three for 600GHS (Permanent\u00a0\u00a0Cure)\" >Buy three for 600GHS (Permanent\u00a0\u00a0Cure)<\/option><\/select><\/div><div id=\"wpforms-8735-field_6-container\" class=\"wpforms-field wpforms-field-hidden\" data-field-id=\"6\"><input type=\"hidden\" id=\"wpforms-8735-field_6\" name=\"wpforms[fields][6]\" value=\"EYECARE\"><\/div><\/div><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-8735-field-hp\" class=\"wpforms-field-label\">Email<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-8735-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"8735\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"1\"><button type=\"submit\" name=\"wpforms[submit]\" class=\"wpforms-submit \" id=\"wpforms-submit-8735\" value=\"wpforms-submit\" aria-live=\"assertive\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container --><\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>PLEASE DON\u2019T COMPLETE THIS FORM IF YOU ARE NOT FINANCIALLY READY, OR IF YOU ARE TRAVELLING, OR IF YOU ARE NOT READY TO RECEIVE THE PRODUCT. THANKS!!!!!!!<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_canvas","meta":{"footnotes":""},"class_list":["post-8736","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/glowspecial.store\/index.php?rest_route=\/wp\/v2\/pages\/8736","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glowspecial.store\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/glowspecial.store\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/glowspecial.store\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/glowspecial.store\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=8736"}],"version-history":[{"count":10,"href":"https:\/\/glowspecial.store\/index.php?rest_route=\/wp\/v2\/pages\/8736\/revisions"}],"predecessor-version":[{"id":8747,"href":"https:\/\/glowspecial.store\/index.php?rest_route=\/wp\/v2\/pages\/8736\/revisions\/8747"}],"wp:attachment":[{"href":"https:\/\/glowspecial.store\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=8736"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}