{"id":5525,"date":"2024-01-10T12:07:07","date_gmt":"2024-01-10T08:37:07","guid":{"rendered":"https:\/\/ipsuss.co\/?page_id=5525"},"modified":"2024-01-10T12:12:50","modified_gmt":"2024-01-10T08:42:50","slug":"join-us","status":"publish","type":"page","link":"https:\/\/khabbaztrade.ir\/fa\/join-us\/","title":{"rendered":"\u0647\u0645\u06a9\u0627\u0631\u06cc \u0628\u0627 \u0645\u0627"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1216.8px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form fusion-form-builder fusion-form-form-wrapper fusion-form-5518\" style=\"--awb-tooltip-text-color:#ffffff;--awb-tooltip-background-color:#333333;\" data-form-id=\"5518\" 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0.05 ;mix-blend-mode:normal;\"><\/div><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_5_6 5_6 fusion-flex-column\" style=\"--awb-padding-top:50px;--awb-padding-right:50px;--awb-padding-bottom:50px;--awb-padding-left:50px;--awb-overflow:hidden;--awb-bg-color:#ffffff;--awb-bg-color-hover:#ffffff;--awb-bg-size:cover;--awb-box-shadow:0px 2px 25px 15px rgba(0,0,0,0.05);;--awb-border-radius:5px 5px 5px 5px;--awb-width-large:83.333333333333%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-margin-top-large:0px;--awb-spacing-right-large:2.304%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.304%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:0;--awb-flex-shrink-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:0;--awb-flex-shrink-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-title-center fusion-title-text fusion-title-size-one\" style=\"--awb-text-color:#022835;--awb-margin-bottom:10px;--awb-font-size:48px;\"><div class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep- sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h1 class=\"fusion-title-heading title-heading-center fusion-responsive-typography-calculated\" style=\"font-family:&quot;Montserrat&quot;;font-style:normal;font-weight:300;margin:0;text-transform:capitalize;font-size:1em;--fontSize:48;line-height:1.5;\"><span data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0647\u0645\u06a9\u0627\u0631\u06cc \u0628\u0627 \u0645\u0627<\/span><\/h1><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep- sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><\/div><div class=\"fusion-text fusion-text-1 fusion-text-no-margin\" style=\"--awb-font-size:20px;--awb-line-height:1.2;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography2-text-transform);--awb-text-color:#74bbd2;--awb-margin-bottom:30px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p style=\"text-align: right; font-family: Vazir; line-height: 30px;\" data-fusion-font=\"true\">\u0639\u0644\u0627\u0642\u0647 \u0645\u0646\u062f\u0627\u0646 \u0628\u0647 \u0647\u0645\u06a9\u0627\u0631\u06cc \u0628\u0627 \u06af\u0631\u0648\u0647 \u0628\u0627\u0632\u0631\u06af\u0627\u0646\u06cc \u062e\u0628\u0627\u0632 \u0645\u06cc\u200c\u062a\u0648\u0627\u0646\u0646\u062f \u0627\u0637\u0644\u0627\u0639\u0627\u062a \u0648 \u0631\u0632\u0648\u0645\u0647 \u06a9\u0627\u0631\u06cc \u062e\u0648\u062f \u0631\u0627 \u062f\u0631 \u0627\u06cc\u0646 \u0641\u0631\u0645 \u062b\u0628\u062a \u0648 \u0630\u062e\u06cc\u0631\u0647 \u06a9\u0631\u062f\u0647 \u062a\u0627 \u0647\u0645\u06a9\u0627\u0631\u0627\u0646 \u0645\u0627 \u062f\u0631 \u0648\u0627\u062d\u062f \u0645\u0646\u0627\u0628\u0639 \u0627\u0646\u0633\u0627\u0646\u06cc \u0645\u0648\u0631\u062f \u0628\u0631\u0631\u0633\u06cc \u0642\u0631\u0627\u0631 \u062f\u0647\u0646\u062f.<\/p>\n<p style=\"text-align: right;\"><span data-fusion-font=\"true\" style=\"font-family: Vazir; line-height: 30px;\">\u0644\u0637\u0641\u0627 \u0628\u0647 \u0645\u0646\u0638\u0648\u0631 \u0628\u0631\u0631\u0633\u06cc \u0628\u0647\u062a\u0631 \u062f\u0631\u062e\u0648\u0627\u0633\u062a \u0634\u0645\u0627\u060c \u0645\u0648\u0627\u0631\u062f \u062e\u0648\u0627\u0633\u062a\u0647 \u0634\u062f\u0647 \u0631\u0627 \u06a9\u0627\u0645\u0644 \u0648 \u062f\u0642\u06cc\u0642 \u062a\u06a9\u0645\u06cc\u0644 \u06a9\u0646\u06cc\u062f.<\/span> <\/p>\n<\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-0 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-2 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0646\u0627\u0645<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><input type=\"text\" autocomplete=\"off\" name=\"first-name\" id=\"first-name\" value=\"\"  class=\"fusion-form-input\" placeholder=\"\u0639\u0644\u06cc \" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-1 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-3 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0646\u0627\u0645 \u062e\u0627\u0646\u0648\u0627\u062f\u06af\u06cc<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><input type=\"text\" autocomplete=\"off\" name=\"last-name\" id=\"last-name\" value=\"\"  class=\"fusion-form-input\" placeholder=\"\u0645\u0647\u0627\u062c\u0631 \" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-2 fusion_builder_column_inner_1_1 1_1 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-4 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u062f\u0631 \u0686\u0647 \u0632\u0645\u06cc\u0646\u0647 \u0627\u06cc \u062a\u0645\u0627\u06cc\u0644 \u0628\u0647 \u0647\u0645\u06a9\u0627\u0631\u06cc \u062f\u0627\u0631\u06cc\u062f\u061f<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"\" name=\"\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><option value=\"\u0628\u0627\u0632\u0627\u0631\u06cc\u0627\u0628\u06cc \u0648 \u062a\u0628\u0644\u06cc\u063a\u0627\u062a\" >\u0628\u0627\u0632\u0627\u0631\u06cc\u0627\u0628\u06cc \u0648 \u062a\u0628\u0644\u06cc\u063a\u0627\u062a<\/option><option value=\"\u062d\u0633\u0627\u0628\u062f\u0627\u0631\u06cc \u0648 \u0645\u0627\u0644\u06cc\" >\u062d\u0633\u0627\u0628\u062f\u0627\u0631\u06cc \u0648 \u0645\u0627\u0644\u06cc<\/option><option value=\"\u0641\u0631\u0648\u0634\"  selected >\u0641\u0631\u0648\u0634<\/option><option value=\"\u0628\u0627\u0632\u0631\u06af\u0627\u0646\u06cc\" >\u0628\u0627\u0632\u0631\u06af\u0627\u0646\u06cc<\/option><option value=\"\u062a\u0631\u062e\u06cc\u0635 \u0648 \u06af\u0645\u0631\u06a9\" >\u062a\u0631\u062e\u06cc\u0635 \u0648 \u06af\u0645\u0631\u06a9<\/option><option value=\"\u062d\u0642\u0648\u0642\u06cc \u0648 \u0642\u0631\u0627\u0631\u062f\u0627\u062f\u0647\u0627\" >\u062d\u0642\u0648\u0642\u06cc \u0648 \u0642\u0631\u0627\u0631\u062f\u0627\u062f\u0647\u0627<\/option><option value=\"\u0637\u0631\u0627\u062d\u06cc \u0648\u0628\u0633\u0627\u06cc\u062a\" >\u0637\u0631\u0627\u062d\u06cc \u0648\u0628\u0633\u0627\u06cc\u062a<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-3 fusion_builder_column_inner_1_1 1_1 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-5 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0646\u062d\u0648\u0647 \u0647\u0645\u06a9\u0627\u0631\u06cc<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"\" name=\"\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><option value=\"\u062a\u0645\u0627\u0645 \u0648\u0642\u062a\"  selected >\u062a\u0645\u0627\u0645 \u0648\u0642\u062a<\/option><option value=\"\u067e\u0627\u0631\u0647 \u0648\u0642\u062a\" >\u067e\u0627\u0631\u0647 \u0648\u0642\u062a<\/option><option value=\"\u0645\u0634\u0627\u0648\u0631\u0647\" >\u0645\u0634\u0627\u0648\u0631\u0647<\/option><option value=\"\u06a9\u0627\u0631\u0622\u0645\u0648\u0632\u06cc\" >\u06a9\u0627\u0631\u0622\u0645\u0648\u0632\u06cc<\/option><option value=\"\u06a9\u0627\u0631\u0645\u0632\u062f \u0627\u0632 \u0641\u0631\u0648\u0634 (\u067e\u0648\u0631\u0633\u0627\u0646\u062a\u06cc)\" >\u06a9\u0627\u0631\u0645\u0632\u062f \u0627\u0632 \u0641\u0631\u0648\u0634 (\u067e\u0648\u0631\u0633\u0627\u0646\u062a\u06cc)<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-4 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-6 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u062c\u0646\u0633\u06cc\u062a<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"\u062c\u0646\u0633\u06cc\u062a\" name=\"\u062c\u0646\u0633\u06cc\u062a\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><option value=\"\u0632\u0646\"  selected >\u0632\u0646<\/option><option value=\"15\" >\u0645\u0631\u062f<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-5 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-7 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0648\u0636\u0639\u06cc\u062a \u062a\u0627\u0647\u0644<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"\u0648\u0636\u0639\u06cc\u062a \u062a\u0627\u0647\u0644\" name=\"\u0648\u0636\u0639\u06cc\u062a \u062a\u0627\u0647\u0644\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><option value=\"\u0645\u062c\u0631\u062f\"  selected >\u0645\u062c\u0631\u062f<\/option><option value=\"\u0645\u062a\u0627\u0647\u0644\" >\u0645\u062a\u0627\u0647\u0644<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-6 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-8 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0648\u0636\u0639\u06cc\u062a \u0646\u0638\u0627\u0645 \u0648\u0638\u06cc\u0641\u0647<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above fusion-form-field-hidden\" style=\"\" data-form-id=\"5518\" data-form-element-name=\"select_5\"><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"\u0648\u0636\u0639\u06cc\u062a \u0646\u0638\u0627\u0645 \u0648\u0638\u06cc\u0641\u0647\" name=\"\u0648\u0636\u0639\u06cc\u062a \u0646\u0638\u0627\u0645 \u0648\u0638\u06cc\u0641\u0647\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><option value=\"\u0627\u062a\u0645\u0627\u0645 \u062e\u062f\u0645\u062a (\u062f\u0627\u0631\u0627\u06cc \u06a9\u0627\u0631\u062a \u067e\u0627\u06cc\u0627\u0646 \u062e\u062f\u0645\u062a)\"  selected >\u0627\u062a\u0645\u0627\u0645 \u062e\u062f\u0645\u062a (\u062f\u0627\u0631\u0627\u06cc \u06a9\u0627\u0631\u062a \u067e\u0627\u06cc\u0627\u0646 \u062e\u062f\u0645\u062a)<\/option><option value=\"\u0645\u0634\u0645\u0648\u0644\" >\u0645\u0634\u0645\u0648\u0644<\/option><option value=\"\u0645\u0639\u0627\u0641\" >\u0645\u0639\u0627\u0641<\/option><option value=\"\u062f\u0631 \u062d\u0627\u0644 \u062e\u062f\u0645\u062a\" >\u062f\u0631 \u062d\u0627\u0644 \u062e\u062f\u0645\u062a<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-7 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-9 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0634\u0647\u0631 \u0645\u062d\u0644 \u0633\u06a9\u0648\u0646\u062a<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><input type=\"text\" autocomplete=\"off\" name=\"first-name\" id=\"first-name\" value=\"\"  class=\"fusion-form-input\" placeholder=\"\u0622\u0630\u0631\u0634\u0647\u0631 \" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-8 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-10 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u06a9\u0634\u0648\u0631\/ \u0627\u0633\u062a\u0627\u0646<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"\" name=\"\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><option value=\"\u0622\u0630\u0631\u0628\u0627\u06cc\u062c\u0627\u0646 \u0634\u0631\u0642\u06cc\" >\u0622\u0630\u0631\u0628\u0627\u06cc\u062c\u0627\u0646 \u0634\u0631\u0642\u06cc<\/option><option value=\"\u0622\u0630\u0631\u0628\u0627\u06cc\u062c\u0627\u0646 \u063a\u0631\u0628\u06cc\" >\u0622\u0630\u0631\u0628\u0627\u06cc\u062c\u0627\u0646 \u063a\u0631\u0628\u06cc<\/option><option value=\"\u0627\u0631\u062f\u0628\u06cc\u0644\" >\u0627\u0631\u062f\u0628\u06cc\u0644<\/option><option value=\"\u0627\u0635\u0641\u0647\u0627\u0646\" >\u0627\u0635\u0641\u0647\u0627\u0646<\/option><option value=\"\u0627\u0644\u0628\u0631\u0632\" >\u0627\u0644\u0628\u0631\u0632<\/option><option value=\"\u0627\u06cc\u0644\u0627\u0645\" >\u0627\u06cc\u0644\u0627\u0645<\/option><option value=\"\u0628\u0648\u0634\u0647\u0631\" >\u0628\u0648\u0634\u0647\u0631<\/option><option value=\"\u062a\u0647\u0631\u0627\u0646\" >\u062a\u0647\u0631\u0627\u0646<\/option><option value=\"\u0686\u0647\u0627\u0631\u0645\u062d\u0627\u0644 \u0648 \u0628\u062e\u062a\u06cc\u0627\u0631\u06cc\" >\u0686\u0647\u0627\u0631\u0645\u062d\u0627\u0644 \u0648 \u0628\u062e\u062a\u06cc\u0627\u0631\u06cc<\/option><option value=\"\u062e\u0631\u0627\u0633\u0627\u0646 \u062c\u0646\u0648\u0628\u06cc\" >\u062e\u0631\u0627\u0633\u0627\u0646 \u062c\u0646\u0648\u0628\u06cc<\/option><option value=\"\u062e\u0631\u0627\u0633\u0627\u0646 \u0631\u0636\u0648\u06cc\" >\u062e\u0631\u0627\u0633\u0627\u0646 \u0631\u0636\u0648\u06cc<\/option><option value=\"\u062e\u0631\u0627\u0633\u0627\u0646 \u0634\u0645\u0627\u0644\u06cc\" >\u062e\u0631\u0627\u0633\u0627\u0646 \u0634\u0645\u0627\u0644\u06cc<\/option><option value=\"\u062e\u0648\u0632\u0633\u062a\u0627\u0646\" >\u062e\u0648\u0632\u0633\u062a\u0627\u0646<\/option><option value=\"\u0632\u0646\u062c\u0627\u0646\" >\u0632\u0646\u062c\u0627\u0646<\/option><option value=\"\u0633\u0645\u0646\u0627\u0646\" >\u0633\u0645\u0646\u0627\u0646<\/option><option value=\"\u0633\u06cc\u0633\u062a\u0627\u0646 \u0648 \u0628\u0644\u0648\u0686\u0633\u062a\u0627\u0646\" >\u0633\u06cc\u0633\u062a\u0627\u0646 \u0648 \u0628\u0644\u0648\u0686\u0633\u062a\u0627\u0646<\/option><option value=\"\u0641\u0627\u0631\u0633\" >\u0641\u0627\u0631\u0633<\/option><option value=\"\u0642\u0632\u0648\u06cc\u0646\" >\u0642\u0632\u0648\u06cc\u0646<\/option><option value=\"\u0642\u0645\" >\u0642\u0645<\/option><option value=\"\u06a9\u0631\u062f\u0633\u062a\u0627\u0646\" >\u06a9\u0631\u062f\u0633\u062a\u0627\u0646<\/option><option value=\"\u06a9\u0631\u0645\u0627\u0646\" >\u06a9\u0631\u0645\u0627\u0646<\/option><option value=\"\u06a9\u0631\u0645\u0627\u0646\u0634\u0627\u0647\" >\u06a9\u0631\u0645\u0627\u0646\u0634\u0627\u0647<\/option><option value=\"\u06a9\u0647\u06af\u06cc\u0644\u0648\u06cc\u0647 \u0648 \u0628\u0648\u06cc\u0631\u0627\u062d\u0645\u062f\" >\u06a9\u0647\u06af\u06cc\u0644\u0648\u06cc\u0647 \u0648 \u0628\u0648\u06cc\u0631\u0627\u062d\u0645\u062f<\/option><option value=\"\u06af\u0644\u0633\u062a\u0627\u0646\" >\u06af\u0644\u0633\u062a\u0627\u0646<\/option><option value=\"\u06af\u06cc\u0644\u0627\u0646\" >\u06af\u06cc\u0644\u0627\u0646<\/option><option value=\"\u0644\u0631\u0633\u062a\u0627\u0646\" >\u0644\u0631\u0633\u062a\u0627\u0646<\/option><option value=\"\u0645\u0627\u0632\u0646\u062f\u0631\u0627\u0646\" >\u0645\u0627\u0632\u0646\u062f\u0631\u0627\u0646<\/option><option value=\"\u0645\u0631\u06a9\u0632\u06cc\" >\u0645\u0631\u06a9\u0632\u06cc<\/option><option value=\"\u0647\u0631\u0645\u0632\u06af\u0627\u0646\" >\u0647\u0631\u0645\u0632\u06af\u0627\u0646<\/option><option value=\"\u0647\u0645\u062f\u0627\u0646\" >\u0647\u0645\u062f\u0627\u0646<\/option><option value=\"\u06cc\u0632\u062f\" >\u06cc\u0632\u062f<\/option><option value=\"\u062e\u0627\u0631\u062c \u0627\u0632 \u0627\u06cc\u0631\u0627\u0646\" >\u062e\u0627\u0631\u062c \u0627\u0632 \u0627\u06cc\u0631\u0627\u0646<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-9 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-11 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0622\u062f\u0631\u0633<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><input type=\"text\" autocomplete=\"off\" name=\"first-name\" id=\"first-name\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-10 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-12 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u062a\u0644\u0641\u0646 \u0647\u0645\u0631\u0627\u0647<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-phone-number-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><input type=\"tel\" autocomplete=\"off\" name=\"\" id=\"\" value=\"\"  class=\"fusion-form-input\" placeholder=\"(000) 000-0000 \" data-holds-private-data=\"false\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-11 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-13 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0627\u06cc\u0645\u06cc\u0644<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-email-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><input type=\"email\" autocomplete=\"off\" name=\"email\" id=\"email\" value=\"\"  class=\"fusion-form-input\" placeholder=\"example@domain.com \" data-holds-private-data=\"false\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-12 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-14 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u062a\u0627\u0631\u06cc\u062e \u062a\u0648\u0644\u062f<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"\" name=\"\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><option value=\"\u0641\u0631\u0648\u0631\u062f\u06cc\u0646\" >\u0641\u0631\u0648\u0631\u062f\u06cc\u0646<\/option><option value=\"\u0627\u0631\u062f\u06cc\u0628\u0647\u0634\u062a\" >\u0627\u0631\u062f\u06cc\u0628\u0647\u0634\u062a<\/option><option value=\"\u062e\u0631\u062f\u0627\u062f\" >\u062e\u0631\u062f\u0627\u062f<\/option><option value=\"\u062a\u06cc\u0631\" >\u062a\u06cc\u0631<\/option><option value=\"\u0645\u0631\u062f\u0627\u062f\" >\u0645\u0631\u062f\u0627\u062f<\/option><option value=\"\u0634\u0647\u0631\u06cc\u0648\u0631\" >\u0634\u0647\u0631\u06cc\u0648\u0631<\/option><option value=\"\u0645\u0647\u0631\" >\u0645\u0647\u0631<\/option><option value=\"\u0622\u0628\u0627\u0646\" >\u0622\u0628\u0627\u0646<\/option><option value=\"\u0622\u0630\u0631\" >\u0622\u0630\u0631<\/option><option value=\"\u062f\u06cc\" >\u062f\u06cc<\/option><option value=\"\u0628\u0647\u0645\u0646\" >\u0628\u0647\u0645\u0646<\/option><option value=\"\u0627\u0633\u0641\u0646\u062f\" >\u0627\u0633\u0641\u0646\u062f<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-13 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-15 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#ffffff;--awb-margin-bottom:0px;--awb-margin-left:15px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p>Date of Birth<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"\" name=\"\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-14 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-16 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#ffffff;--awb-margin-bottom:0px;--awb-margin-left:15px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p>Date of Birth<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"\" name=\"\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><option value=\"1402\" >1402<\/option><option value=\"1401\" >1401<\/option><option value=\"1400\" >1400<\/option><option value=\"1399\" >1399<\/option><option value=\"1398\" >1398<\/option><option value=\"1397\" >1397<\/option><option value=\"1396\" >1396<\/option><option value=\"1395\" >1395<\/option><option value=\"1394\" >1394<\/option><option value=\"1393\" >1393<\/option><option value=\"1392\" >1392<\/option><option value=\"1391\" >1391<\/option><option value=\"1390\" >1390<\/option><option value=\"1389\" >1389<\/option><option value=\"1388\" >1388<\/option><option value=\"1387\" >1387<\/option><option value=\"1386\" >1386<\/option><option value=\"1385\" >1385<\/option><option value=\"1384\" >1384<\/option><option value=\"1383\" >1383<\/option><option value=\"1382\" >1382<\/option><option value=\"1381\" >1381<\/option><option value=\"1380\" >1380<\/option><option value=\"1379\" >1379<\/option><option value=\"1378\" >1378<\/option><option value=\"1377\" >1377<\/option><option value=\"1376\" >1376<\/option><option value=\"1375\" >1375<\/option><option value=\"1374\" >1374<\/option><option value=\"1373\" >1373<\/option><option value=\"1372\" >1372<\/option><option value=\"1371\" >1371<\/option><option value=\"1370\" >1370<\/option><option value=\"1369\" >1369<\/option><option value=\"1368\" >1368<\/option><option value=\"1367\" >1367<\/option><option value=\"1366\" >1366<\/option><option value=\"1365\" >1365<\/option><option value=\"1364\" >1364<\/option><option value=\"1363\" >1363<\/option><option value=\"1362\" >1362<\/option><option value=\"1361\" >1361<\/option><option value=\"1360\" >1360<\/option><option value=\"1359\" >1359<\/option><option value=\"1358\" >1358<\/option><option value=\"1357\" >1357<\/option><option value=\"1356\" >1356<\/option><option value=\"1355\" >1355<\/option><option value=\"1354\" >1354<\/option><option value=\"1353\" >1353<\/option><option value=\"1352\" >1352<\/option><option value=\"1351\" >1351<\/option><option value=\"1350\" >1350<\/option><option value=\"1349\" >1349<\/option><option value=\"1348\" >1348<\/option><option value=\"1347\" >1347<\/option><option value=\"1346\" >1346<\/option><option value=\"1345\" >1345<\/option><option value=\"1344\" >1344<\/option><option value=\"1343\" >1343<\/option><option value=\"1342\" >1342<\/option><option value=\"1341\" >1341<\/option><option value=\"1340\" >1340<\/option><option value=\"1339\" >1339<\/option><option value=\"1338\" >1338<\/option><option value=\"1337\" >1337<\/option><option value=\"1336\" >1336<\/option><option value=\"1335\" >1335<\/option><option value=\"1334\" >1334<\/option><option value=\"1333\" >1333<\/option><option value=\"1332\" >1332<\/option><option value=\"1331\" >1331<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-15 fusion_builder_column_inner_1_1 1_1 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-17 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:20px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0646\u062d\u0648\u0647 \u0622\u0634\u0646\u0627\u06cc\u06cc \u0628\u0627 \u0634\u0631\u06a9\u062a<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-checkbox-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><fieldset><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox--1-0\" type=\"checkbox\" value=\"\u06cc\u06a9 \u0622\u0634\u0646\u0627 \u06cc\u0627 \u0647\u0645\u06a9\u0627\u0631\" name=\"[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox--1-0\">\u06cc\u06a9 \u0622\u0634\u0646\u0627 \u06cc\u0627 \u0647\u0645\u06a9\u0627\u0631<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox--1-1\" type=\"checkbox\" value=\"\u06af\u0648\u06af\u0644 \u06cc\u0627 \u062c\u0633\u062a\u062c\u0648\u06cc \u0627\u06cc\u0646\u062a\u0631\u0646\u062a\u06cc\" name=\"[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox--1-1\">\u06af\u0648\u06af\u0644 \u06cc\u0627 \u062c\u0633\u062a\u062c\u0648\u06cc \u0627\u06cc\u0646\u062a\u0631\u0646\u062a\u06cc<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox--1-2\" type=\"checkbox\" value=\"\u0641\u0636\u0627\u06cc \u0645\u062c\u0627\u0632\u06cc\" name=\"[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox--1-2\">\u0641\u0636\u0627\u06cc \u0645\u062c\u0627\u0632\u06cc<\/label><\/div><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox--1-3\" type=\"checkbox\" value=\"\u0633\u0627\u06cc\u0631\" name=\"[]\" class=\"fusion-form-input\" data-holds-private-data=\"false\"\/><label for=\"checkbox--1-3\">\u0633\u0627\u06cc\u0631<\/label><\/div><\/fieldset><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-16 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-18 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0622\u062e\u0631\u06cc\u0646 \u0645\u062f\u0631\u06a9 \u062a\u062d\u0635\u06cc\u0644\u06cc<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-select-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><div class=\"fusion-select-wrapper\"><select autocomplete=\"off\" tabindex=\"\" id=\"\" name=\"\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><option value=\"\u062f\u06cc\u067e\u0644\u0645\" >\u062f\u06cc\u067e\u0644\u0645<\/option><option value=\"\u06a9\u0627\u0631\u062f\u0627\u0646\u06cc\" >\u06a9\u0627\u0631\u062f\u0627\u0646\u06cc<\/option><option value=\"\u06a9\u0627\u0631\u0634\u0646\u0627\u0633\u06cc\"  selected >\u06a9\u0627\u0631\u0634\u0646\u0627\u0633\u06cc<\/option><option value=\"\u06a9\u0627\u0631\u0634\u0646\u0627\u0633\u06cc \u0627\u0631\u0634\u062f\" >\u06a9\u0627\u0631\u0634\u0646\u0627\u0633\u06cc \u0627\u0631\u0634\u062f<\/option><option value=\"\u062f\u06a9\u062a\u0631\u06cc\" >\u062f\u06a9\u062a\u0631\u06cc<\/option><\/select><div class=\"select-arrow\"><svg width=\"12\" height=\"8\" viewBox=\"0 0 12 8\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-17 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-19 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0631\u0634\u062a\u0647 \u062a\u062d\u0635\u06cc\u0644\u06cc<\/p>\n<\/div><div class=\"fusion-form-field fusion-form-text-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><input type=\"text\" autocomplete=\"off\" name=\"\" id=\"\" value=\"\"  class=\"fusion-form-input\" data-holds-private-data=\"false\" minlength=\"0\"\/><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-18 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-20 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0633\u0627\u0628\u0642\u0647 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xmlns=\"http:\/\/www.w3.org\/2000\/svg\"> <path d=\"M1.5 1.75L6 6.25L10.5 1.75\" stroke=\"#6D6D6D\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/> <\/svg><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-19 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:3.84%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-21 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u062d\u062f\u0627\u0642\u0644 \u062d\u0642\u0648\u0642 \u062f\u0631\u062e\u0648\u0627\u0633\u062a\u06cc<\/p>\n<\/div><div class=\"fusion-text fusion-text-22 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir; font-size: 11px;\">\u0627\u06cc\u0646 \u0639\u062f\u062f \u0646\u0634\u0627\u0646 \u062f\u0647\u0646\u062f\u0647 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style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-23 fusion-text-no-margin\" style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0622\u067e\u0644\u0648\u062f 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style=\"--awb-font-size:18px;--awb-line-height:1.5;--awb-letter-spacing:0px;--awb-text-transform:var(--awb-typography4-text-transform);--awb-text-color:#022835;--awb-margin-bottom:0px;--awb-text-font-family:&quot;Montserrat&quot;;--awb-text-font-style:normal;--awb-text-font-weight:400;\"><p data-fusion-font=\"true\" style=\"font-family: Vazir;\">\u0645\u062a\u0646 \u067e\u06cc\u0627\u0645 \u062e\u0648\u062f \u0631\u0627 \u0628\u0646\u0648\u06cc\u0633\u06cc\u062f<\/p>\n<\/div>\n<div class=\"fusion-form-field fusion-form-textarea-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><textarea cols=\"40\" autocomplete=\"off\"  minlength=\"0\"  rows=\"4\" tabindex=\"\" id=\"\" name=\"\" class=\"fusion-form-input\" data-holds-private-data=\"false\"><\/textarea><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-22 fusion_builder_column_inner_1_1 1_1 fusion-flex-column\" style=\"--awb-padding-top:30px;--awb-bg-size:cover;--awb-border-color:#efefef;--awb-border-top:1px;--awb-border-style:solid;--awb-width-large:100%;--awb-margin-top-large:30px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-checkbox-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><fieldset><div class=\"fusion-form-checkbox\"><input tabindex=\"\" id=\"checkbox--2-0\" type=\"checkbox\" value=\"\u0635\u062d\u062a \u062a\u0645\u0627\u0645\u06cc \u0645\u0648\u0627\u0631\u062f \u0630\u06a9\u0631 \u0634\u062f\u0647 \u062f\u0631 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style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-form-field fusion-form-submit-field fusion-form-label-above\" style=\"\" data-form-id=\"5518\"><div style=\"text-align:center;\"><button type=\"submit\" class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-2 fusion-button-span-yes  button-default form-form-submit\" style=\"--button_accent_color:#ffffff;--button_accent_hover_color:#ffffff;--button_border_hover_color:#ffffff;--button-border-radius-top-left:0px;--button-border-radius-top-right:0px;--button-border-radius-bottom-right:0px;--button-border-radius-bottom-left:0px;--button_gradient_top_color:#ef476f;--button_gradient_bottom_color:#ef476f;--button_gradient_top_color_hover:#326779;--button_gradient_bottom_color_hover:#326779;--button_text_transform:capitalize;--button_font_size:20px;--button_line_height:1.2;--button_padding-top:20px;--button_padding-bottom:20px;--button_typography-letter-spacing:0px;--button_typography-font-family:&quot;Vazir&quot;;--button_typography-font-style:normal;--button_typography-font-weight:400;--button_margin-top:10px;\" data-form-number=\"5518\" tabindex=\"\"><span class=\"fusion-button-text awb-button__text awb-button__text--default\">\u062b\u0628\u062a \u0641\u0631\u0645 \u0648 \u0627\u0631\u0633\u0627\u0644 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