{"id":7549,"date":"2022-02-01T14:20:15","date_gmt":"2022-02-01T14:20:15","guid":{"rendered":"https:\/\/wordpress-882962-3061769.cloudwaysapps.com\/?page_id=7549"},"modified":"2022-02-01T15:13:54","modified_gmt":"2022-02-01T15:13:54","slug":"driver-registration-form","status":"publish","type":"page","link":"https:\/\/amiecabs.co.ug\/driver-registration-form\/","title":{"rendered":"Driver Registration"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"7549\" class=\"elementor elementor-7549\">\n\t\t\t\t        <section class=\"elementor-section elementor-top-section elementor-element elementor-element-72bc04d elementor-section-boxed elementor-section-height-default elementor-section-height-default ct-header-fixed-none ct-row-max-none\" data-id=\"72bc04d\" data-element_type=\"section\">\n            \n                        <div class=\"elementor-container elementor-column-gap-default \">\n                    <div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-62f82da\" data-id=\"62f82da\" data-element_type=\"column\">\n        <div class=\"elementor-widget-wrap elementor-element-populated\">\n                    \n        \t\t<div class=\"elementor-element elementor-element-ee11fe2 elementor-widget elementor-widget-shortcode\" data-id=\"ee11fe2\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\"><div class='fluentform ff-default fluentform_wrapper_10 ffs_default_wrap'><form data-form_id=\"10\" id=\"fluentform_10\" class=\"frm-fluent-form fluent_form_10 ff-el-form-top ff_form_instance_10_1 ff-form-loading ff-form-has-steps ffs_default\" data-form_instance=\"ff_form_instance_10_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">Amie Cabs LTD Drivers Registration Form<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='7549' \/><input type=\"hidden\" id=\"_fluentform_10_fluentformnonce\" name=\"_fluentform_10_fluentformnonce\" value=\"ab2d85665b\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/7549\" \/><div class='ff-step-container' data-name=\"step_start-10_4\" data-disable_auto_focus=\"no\" data-enable_auto_slider=\"no\" data-enable_step_data_persistency=\"yes\" data-enable_step_page_resume=\"yes\" data-animation_type=\"slide\" ><div class='ff-step-header'><div class='ff-el-progress-status'><\/div>\n            <div class='ff-el-progress'>\n                <div class='ff-el-progress-bar'><span><\/span><\/div>\n            <\/div>\n            <ul style='display: none' class='ff-el-progress-title'>\n                <li>Personal  Information<\/li><li>Vehicle\/Boda Information<\/li><li>Documents & Licenses Upload<\/li>\n            <\/ul><\/div><span class='ff_step_start'><\/span><div class='ff-step-body'><div class=\"fluentform-step active\" data-name=\"step_start-10_4\" data-disable_auto_focus=\"no\" data-enable_auto_slider=\"no\" data-enable_step_data_persistency=\"yes\" data-enable_step_page_resume=\"yes\" data-animation_type=\"slide\" ><div data-type=\"name-element\" data-name=\"fn_ln_names\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group  ff-el-form-top'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_10_fn_ln_names_first_name_' >First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"fn_ln_names[first_name]\" id=\"ff_10_fn_ln_names_first_name_\" class=\"ff-el-form-control\" placeholder=\"First Name\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group  ff-el-form-top'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_10_fn_ln_names_last_name_' >Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"fn_ln_names[last_name]\" id=\"ff_10_fn_ln_names_last_name_\" class=\"ff-el-form-control\" placeholder=\"Last Name\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_email' aria-label=\"Email\">Email<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email\" id=\"ff_10_email\" class=\"ff-el-form-control\" placeholder=\"Email Address\" data-name=\"email\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Birth_Date' aria-label=\"Birth Date (DOB)\">Birth Date (DOB)<\/label><\/div><div class='ff-el-input--content'><input  aria-label='Birth Date (DOB) Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"Birth_Date\" id=\"ff_10_Birth_Date\" class=\"ff-el-form-control ff-el-datepicker\" placeholder=\"Birth Date\" data-name=\"Birth_Date\"  aria-invalid='false' aria-required=true><\/div><\/div><div class='ff-el-group ff-el-form-left'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Gender\">Gender<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=gender_319ae291dcfadd0a0630950259476d51><input  type=\"radio\" name=\"gender\" data-name=\"gender\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Male\"  id='gender_319ae291dcfadd0a0630950259476d51' aria-label='Male' aria-invalid='false' aria-required=true> <span>Male<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=gender_2c5a6d515403adb363f2302d035b5239><input  type=\"radio\" name=\"gender\" data-name=\"gender\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Female\"  id='gender_2c5a6d515403adb363f2302d035b5239' aria-label='Female' aria-invalid='false' aria-required=true> <span>Female<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_location' aria-label=\"Location\">Location<\/label><\/div><div class='ff-el-input--content'><select name=\"location\" id=\"ff_10_location\" class=\"ff-el-form-control\" data-name=\"location\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=true><option value=\"\">- Select -<\/option><option value=\"Kampala\"  >Kampala<\/option><option value=\"Entebbe\"  >Entebbe<\/option><option value=\"Nansana\"  >Nansana<\/option><option value=\"Kira\"  >Kira<\/option><option value=\"Gulu\"  >Gulu<\/option><option value=\"Mbale\"  >Mbale<\/option><option value=\"Mukono\"  >Mukono<\/option><option value=\"Jinja\"  >Jinja<\/option><option value=\"Mbarara\"  >Mbarara<\/option><option value=\"Lira\"  >Lira<\/option><option value=\"Kitgum\"  >Kitgum<\/option><option value=\"Masindi\"  >Masindi<\/option><option value=\"Lugazi\"  >Lugazi<\/option><option value=\"Masaka\"  >Masaka<\/option><option value=\"Njeru\"  >Njeru<\/option><option value=\"Mityana\"  >Mityana<\/option><option value=\"Ssabagabo\"  >Ssabagabo<\/option><\/select><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_estate_info' aria-label=\"Estate\">Estate<\/label><\/div><div class='ff-el-input--content'><textarea aria-invalid=\"false\" aria-required=true name=\"estate_info\" id=\"ff_10_estate_info\" class=\"ff-el-form-control\" placeholder=\"Estate\" rows=\"3\" cols=\"2\" data-name=\"estate_info\" ><\/textarea><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Driver_Phone_Mobile_Number' aria-label=\"Driver Phone\/Mobile Number\">Driver Phone\/Mobile Number<\/label><\/div><div class='ff-el-input--content'><input name=\"Driver_Phone_Mobile_Number\" class=\"ff-el-form-control ff-el-phone ff_el_with_extended_validation\" type=\"tel\" placeholder=\"Driver Phone\/Mobile Number\" data-name=\"Driver_Phone_Mobile_Number\" id=\"ff_10_Driver_Phone_Mobile_Number\" inputmode=\"tel\"  aria-invalid='false' aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Emergency_Phone_Mobile' aria-label=\"Emergency Phone\/Mobile\">Emergency Phone\/Mobile<\/label><\/div><div class='ff-el-input--content'><input name=\"Emergency_Phone_Mobile\" class=\"ff-el-form-control ff-el-phone ff_el_with_extended_validation\" type=\"tel\" placeholder=\"Emergency Phone\/Mobile\" data-name=\"Emergency_Phone_Mobile\" id=\"ff_10_Emergency_Phone_Mobile\" inputmode=\"tel\"  aria-invalid='false' aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Payment_Info__Mpesa_MTN__Number' aria-label=\"Payment Info (Mpesa\/MTN) Number\">Payment Info (Mpesa\/MTN) Number<\/label><\/div><div class='ff-el-input--content'><input name=\"Payment_Info__Mpesa_MTN__Number\" class=\"ff-el-form-control ff-el-phone ff_el_with_extended_validation\" type=\"tel\" placeholder=\"Payment Info (Mpesa\/MTN) Number\" data-name=\"Payment_Info__Mpesa_MTN__Number\" id=\"ff_10_Payment_Info__Mpesa_MTN__Number\" inputmode=\"tel\"  aria-invalid='false' aria-required=true><\/div><\/div><div class='step-nav ff_step_nav_last'><button  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-10_1\" ><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Registering Bike or Vehicle\">Registering Bike or Vehicle<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=Registering_Bike_or_Vehicle_11442c02e29ea3c94576233a25592b26><input  type=\"radio\" name=\"Registering_Bike_or_Vehicle\" data-name=\"Registering_Bike_or_Vehicle\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Vehicle\"  id='Registering_Bike_or_Vehicle_11442c02e29ea3c94576233a25592b26' aria-label='Vehicle' aria-invalid='false' aria-required=true> <span>Vehicle<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=Registering_Bike_or_Vehicle_e8ee61b938a7a8ba90adf718129e7cb2><input  type=\"radio\" name=\"Registering_Bike_or_Vehicle\" data-name=\"Registering_Bike_or_Vehicle\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Bike\/Boda\"  id='Registering_Bike_or_Vehicle_e8ee61b938a7a8ba90adf718129e7cb2' aria-label='Bike\/Boda' aria-invalid='false' aria-required=true> <span>Bike\/Boda<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Type of Vehicle\">Type of Vehicle<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=Type_of_Vehicle_fea334003df027ce027e932a3ca05faa><input  type=\"radio\" name=\"Type_of_Vehicle\" data-name=\"Type_of_Vehicle\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Economy\"  id='Type_of_Vehicle_fea334003df027ce027e932a3ca05faa' aria-label='Economy' aria-invalid='false' aria-required=true> <span>Economy<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=Type_of_Vehicle_97d60cc081f1b579529bbf29503b5713><input  type=\"radio\" name=\"Type_of_Vehicle\" data-name=\"Type_of_Vehicle\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Standard\"  id='Type_of_Vehicle_97d60cc081f1b579529bbf29503b5713' aria-label='Standard' aria-invalid='false' aria-required=true> <span>Standard<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=Type_of_Vehicle_5fb34cb2998c96fe481021f55eff2448><input  type=\"radio\" name=\"Type_of_Vehicle\" data-name=\"Type_of_Vehicle\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Executive\"  id='Type_of_Vehicle_5fb34cb2998c96fe481021f55eff2448' aria-label='Executive' aria-invalid='false' aria-required=true> <span>Executive<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=Type_of_Vehicle_d017898e8d8b3a0b357a44bb629cd73d><input  type=\"radio\" name=\"Type_of_Vehicle\" data-name=\"Type_of_Vehicle\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Shuttle\"  id='Type_of_Vehicle_d017898e8d8b3a0b357a44bb629cd73d' aria-label='Shuttle' aria-invalid='false' aria-required=true> <span>Shuttle<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Vehicle_Model' aria-label=\"Vehicle Model\">Vehicle Model<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"Vehicle_Model\" class=\"ff-el-form-control\" placeholder=\"Vehicle Model\" data-name=\"Vehicle_Model\" id=\"ff_10_Vehicle_Model\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Bike_Model' aria-label=\"Bike Model\">Bike Model<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"Bike_Model\" class=\"ff-el-form-control\" placeholder=\"Bike Model\" data-name=\"Bike_Model\" id=\"ff_10_Bike_Model\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Vehicle_Make' aria-label=\"Vehicle Make\">Vehicle Make<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"Vehicle_Make\" class=\"ff-el-form-control\" placeholder=\"Vehicle Make\" data-name=\"Vehicle_Make\" id=\"ff_10_Vehicle_Make\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group ff-el-form-top has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Vehicle PSV Compliance\">Vehicle PSV Compliance<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=Vehicle_PSV_Compliance_cb482ada21a914961d1c98424aa23c11><input  type=\"radio\" name=\"Vehicle_PSV_Compliance\" data-name=\"Vehicle_PSV_Compliance\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"yes\"  id='Vehicle_PSV_Compliance_cb482ada21a914961d1c98424aa23c11' aria-label='Yes' aria-invalid='false' aria-required=true> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=Vehicle_PSV_Compliance_f85935acd255582e5cf1b37d8f158b5a><input  type=\"radio\" name=\"Vehicle_PSV_Compliance\" data-name=\"Vehicle_PSV_Compliance\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"no\"  id='Vehicle_PSV_Compliance_f85935acd255582e5cf1b37d8f158b5a' aria-label='No' aria-invalid='false' aria-required=true> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff-el-form-top has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Vechicle Inspection Compliance\">Vechicle Inspection Compliance<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=Vechicle_Inspection_Compliance_5dc14d8c70218e8296a994ca400a1534><input  type=\"radio\" name=\"Vechicle_Inspection_Compliance\" data-name=\"Vechicle_Inspection_Compliance\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"yes\"  id='Vechicle_Inspection_Compliance_5dc14d8c70218e8296a994ca400a1534' aria-label='Yes' aria-invalid='false' aria-required=true> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=Vechicle_Inspection_Compliance_2ea743027b3ae01c33c58486f69b81ef><input  type=\"radio\" name=\"Vechicle_Inspection_Compliance\" data-name=\"Vechicle_Inspection_Compliance\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"no\"  id='Vechicle_Inspection_Compliance_2ea743027b3ae01c33c58486f69b81ef' aria-label='No' aria-invalid='false' aria-required=true> <span>No<\/span><\/label><\/div><\/div><\/div><div data-name=\"ff_cn_id_1\"  class='ff-t-container ff-column-container ff_columns_total_2  '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Driver_License_Photo_1' aria-label=\"Driver License Photo\">Driver License Photo<\/label><\/div><div class='ff-el-input--content'><label for='ff_10_Driver_License_Photo_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File<\/span> <input type=\"file\" name=\"Driver_License_Photo\" id=\"ff_10_Driver_License_Photo_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"Driver_License_Photo\" multiple=\"1\"  aria-invalid='false' aria-required=true><\/label><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_License_Expiration_Date' aria-label=\"License Expiration Date\">License Expiration Date<\/label><\/div><div class='ff-el-input--content'><input  aria-label='License Expiration Date Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"License_Expiration_Date\" id=\"ff_10_License_Expiration_Date\" class=\"ff-el-form-control ff-el-datepicker\" placeholder=\"License Expiration Date\" data-name=\"License_Expiration_Date\"  aria-invalid='false' aria-required=true><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_2\"  class='ff-t-container ff-column-container ff_columns_total_1  '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 100%;'><div class='ff-el-group ff-el-form-left'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_National_ID_Photo_1' aria-label=\"National ID Photo\">National ID Photo<\/label><\/div><div class='ff-el-input--content'><label for='ff_10_National_ID_Photo_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File<\/span> <input type=\"file\" name=\"National_ID_Photo\" id=\"ff_10_National_ID_Photo_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"National_ID_Photo\" multiple=\"1\"  aria-invalid='false' aria-required=true><\/label><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_3\"  class='ff-t-container ff-column-container ff_columns_total_2  '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_10_TLB_Sticker_Photo_1' aria-label=\"TLB Sticker Photo (Optional)\">TLB Sticker Photo (Optional)<\/label><\/div><div class='ff-el-input--content'><label for='ff_10_TLB_Sticker_Photo_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File<\/span> <input type=\"file\" name=\"TLB_Sticker_Photo\" id=\"ff_10_TLB_Sticker_Photo_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"TLB_Sticker_Photo\" multiple=\"1\"  aria-invalid='false' aria-required=false><\/label><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_10_TLB_Sticker_Expiration_Date' aria-label=\"TLB Sticker Expiration Date (Optional)\">TLB Sticker Expiration Date (Optional)<\/label><\/div><div class='ff-el-input--content'><input  aria-label='TLB Sticker Expiration Date (Optional) Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"TLB_Sticker_Expiration_Date\" id=\"ff_10_TLB_Sticker_Expiration_Date\" class=\"ff-el-form-control ff-el-datepicker\" placeholder=\"TLB Sticker Expiration Date (Optional)\" data-name=\"TLB_Sticker_Expiration_Date\"  aria-invalid='false' aria-required=false><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_4\"  class='ff-t-container ff-column-container ff_columns_total_2  '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_10_KCCA_Permit_1' aria-label=\"KCCA Permit (Optional)\">KCCA Permit (Optional)<\/label><\/div><div class='ff-el-input--content'><label for='ff_10_KCCA_Permit_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File<\/span> <input type=\"file\" name=\"KCCA_Permit\" id=\"ff_10_KCCA_Permit_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"KCCA_Permit\" multiple=\"1\"  aria-invalid='false' aria-required=false><\/label><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_10_KCCA_Permit_Expiration_Date' aria-label=\"KCCA Permit Expiration Date (Optional)\">KCCA Permit Expiration Date (Optional)<\/label><\/div><div class='ff-el-input--content'><input  aria-label='KCCA Permit Expiration Date (Optional) Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"KCCA_Permit_Expiration_Date\" id=\"ff_10_KCCA_Permit_Expiration_Date\" class=\"ff-el-form-control ff-el-datepicker\" placeholder=\"KCCA Permit Expiration Date (Optional)\" data-name=\"KCCA_Permit_Expiration_Date\"  aria-invalid='false' aria-required=false><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_5\"  class='ff-t-container ff-column-container ff_columns_total_2  '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_PSV_Insurance_Sticker_Photo_1' aria-label=\"PSV Insurance Sticker Photo\">PSV Insurance Sticker Photo<\/label><\/div><div class='ff-el-input--content'><label for='ff_10_PSV_Insurance_Sticker_Photo_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File<\/span> <input type=\"file\" name=\"PSV_Insurance_Sticker_Photo\" id=\"ff_10_PSV_Insurance_Sticker_Photo_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"PSV_Insurance_Sticker_Photo\" multiple=\"1\"  aria-invalid='false' aria-required=true><\/label><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_PSV_Insurance_Expiration_Date' aria-label=\"PSV Insurance Expiration Date\">PSV Insurance Expiration Date<\/label><\/div><div class='ff-el-input--content'><input  aria-label='PSV Insurance Expiration Date Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"PSV_Insurance_Expiration_Date\" id=\"ff_10_PSV_Insurance_Expiration_Date\" class=\"ff-el-form-control ff-el-datepicker\" placeholder=\"PSV Insurance Expiration Date\" data-name=\"PSV_Insurance_Expiration_Date\"  aria-invalid='false' aria-required=true><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_6\"  class='ff-t-container ff-column-container ff_columns_total_1  '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 100%;'><div class='ff-el-group ff-el-form-left'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Certificate_of_Good_Conduct_1_1' aria-label=\"Certificate of Good Conduct\">Certificate of Good Conduct<\/label><\/div><div class='ff-el-input--content'><label for='ff_10_Certificate_of_Good_Conduct_1_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File<\/span> <input type=\"file\" name=\"Certificate_of_Good_Conduct_1\" id=\"ff_10_Certificate_of_Good_Conduct_1_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"Certificate_of_Good_Conduct_1\" multiple=\"1\"  aria-invalid='false' aria-required=true><\/label><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Driver_Passport_Selfie_Photo_1' aria-label=\"Driver Passport\/Selfie Photo\">Driver Passport\/Selfie Photo<\/label><\/div><div class='ff-el-input--content'><label for='ff_10_Driver_Passport_Selfie_Photo_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File<\/span> <input type=\"file\" name=\"Driver_Passport_Selfie_Photo\" id=\"ff_10_Driver_Passport_Selfie_Photo_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"Driver_Passport_Selfie_Photo\" multiple=\"1\"  aria-invalid='false' aria-required=true><\/label><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Car_Side_View_1' aria-label=\"Car Side View\">Car Side View<\/label><\/div><div class='ff-el-input--content'><label for='ff_10_Car_Side_View_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File<\/span> <input type=\"file\" name=\"Car_Side_View\" id=\"ff_10_Car_Side_View_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"Car_Side_View\" multiple=\"1\"  aria-invalid='false' aria-required=true><\/label><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Car_Front_View_1' aria-label=\"Car Front View\">Car Front View<\/label><\/div><div class='ff-el-input--content'><label for='ff_10_Car_Front_View_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File<\/span> <input type=\"file\" name=\"Car_Front_View\" id=\"ff_10_Car_Front_View_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"Car_Front_View\" multiple=\"1\"  aria-invalid='false' aria-required=true><\/label><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_10_Car_Back_View_1' aria-label=\"Car Back View\">Car Back View<\/label><\/div><div class='ff-el-input--content'><label for='ff_10_Car_Back_View_1' class='ff_file_upload_holder'><span class='ff_upload_btn ff-btn' tabindex='0'>Choose File<\/span> <input type=\"file\" name=\"Car_Back_View\" id=\"ff_10_Car_Back_View_1\" class=\"ff-el-form-control  ff-screen-reader-element\" accept=\"image\/*\" data-name=\"Car_Back_View\" multiple=\"1\"  aria-invalid='false' aria-required=true><\/label><\/div><\/div><div class='ff-el-group  ff-custom_html' data-name=\"custom_html-10_2\" ><p><strong>REFERRED BY:<\/strong><\/p><\/div><div data-type=\"name-element\" data-name=\"Referrer_Name\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group  ff-el-form-top'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_10_Referrer_Name_first_name_' >First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"Referrer_Name[first_name]\" id=\"ff_10_Referrer_Name_first_name_\" class=\"ff-el-form-control\" placeholder=\"First Name\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group  ff-el-form-top'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_10_Referrer_Name_last_name_' >Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"Referrer_Name[last_name]\" id=\"ff_10_Referrer_Name_last_name_\" class=\"ff-el-form-control\" placeholder=\"Last Name\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_10_referrer_phone_number' aria-label=\"Phone\/Mobile\">Phone\/Mobile<\/label><\/div><div class='ff-el-input--content'><input name=\"referrer_phone_number\" class=\"ff-el-form-control ff-el-phone ff_el_with_extended_validation\" type=\"tel\" placeholder=\"Mobile Number\" data-name=\"referrer_phone_number\" id=\"ff_10_referrer_phone_number\" inputmode=\"tel\"  aria-invalid='false' aria-required=false><\/div><\/div><div class='step-nav ff_step_nav_last'><button  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><button  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Next<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-10_3\" ><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_10_Terms_and_Conditions' aria-label=\"Terms and Conditions\">Terms and Conditions<\/label><\/div><div class='ff-el-input--content'><textarea aria-invalid=\"false\" aria-required=false name=\"Terms_and_Conditions\" id=\"ff_10_Terms_and_Conditions\" class=\"ff-el-form-control\" placeholder=\"You consent Amie Cabs LTD and It&#039;s Group of company&#039;s holding and processing data related to you for legal administrative and management purpose and in particulare to the processing of any &quot;Sensitive Personal Data&quot; defined in the Data Proection Act.\" rows=\"3\" cols=\"2\" data-name=\"Terms_and_Conditions\" ><\/textarea><\/div><\/div><div class='ff-el-group    ff-el-input--content'><div class='ff-el-form-check ff-el-tc'><label aria-label='I consent to have this website store my submitted information so they can process to my application form' class='ff-el-form-check-label ff_tc_label' for=gdpr-agreement_e745448cb82d130f6088970b869cd57e><span class='ff_tc_checkbox'><input type=\"checkbox\" name=\"gdpr-agreement\" class=\"ff-el-form-check-input ff_gdpr_field\" data-name=\"gdpr-agreement\" id=\"gdpr-agreement_e745448cb82d130f6088970b869cd57e\"  value='on' aria-invalid='false' aria-required=true><\/span> <div class='ff_t_c'>I consent to have this website store my submitted information so they can process to my application form<\/div><\/label><\/div><\/div>        <div class=\"ff-step-t-container ff-inner_submit_container ff-column-container ff_columns_total_2\">\n            <div class=\"ff-t-cell ff-t-column-1\"><div class='step-nav ff_step_nav_last'><button  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Previous<\/button><\/div><\/div>\n            <div class=\"ff-t-cell ff-t-column-2\">\n                <div class='ff-el-group ff-text-left ff_submit_btn_wrapper'><button type=\"submit\" class=\"ff-btn ff-btn-submit ff-btn-md ff_btn_style\" >Click To Submit Form<\/button><\/div>            <\/div>\n        <\/div>\n        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