Registration | World Forum on Pharmacy & Pharmaceutical Research

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var img = document.images['captchaimg']; img.src = img.src.substring(0,img.src.lastIndexOf("?"))+"?rand="+Math.random()*1000; } </script> <script type="text/javascript"> function speaker_reg() { if (document.form1.speaker.checked == true) { document.form1.delegate.checked = false; document.form1.poster.checked = false; document.form1.student1.checked = false; // document.form1.virtual.checked = false; document.form1.platinum.checked = false; document.form1.diamond.checked = false; document.form1.gold.checked = false; document.form1.exhibition.checked = false; document.form1.addon.checked = false; document.form1.addon.disabled = false; document.form1.price.value=""; document.form1.price.value= document.form1.speaker.value; document.getElementById('lblTotalPrice').innerHTML=document.form1.price.value; var amt = document.form1.price.value; document.form1.reg_desc.value=amt; $('.green').removeClass('green'); document.getElementById("r1_"+amt).setAttribute("class", "green"); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } else { document.form1.price.value=""; document.getElementById('lblTotalPrice').innerHTML=0; document.form1.reg_desc.value=""; $('.green').removeClass('green'); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } } function delegate_reg() { if (document.form1.delegate.checked == true) { document.form1.speaker.checked = false; document.form1.poster.checked = false; document.form1.platinum.checked = false; document.form1.diamond.checked = false; document.form1.gold.checked = false; document.form1.exhibition.checked = false; document.form1.student1.checked = false; //document.form1.virtual.checked = false; document.form1.addon.checked = false; document.form1.addon.disabled = false; document.form1.price.value=""; document.form1.price.value= document.form1.delegate.value; document.getElementById('lblTotalPrice').innerHTML=document.form1.price.value; var 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= false; document.form1.price.value=""; document.form1.price.value= document.form1.poster.value; document.getElementById('lblTotalPrice').innerHTML=document.form1.price.value; var amt = document.form1.price.value; document.form1.reg_desc.value=amt; $('.green').removeClass('green'); document.getElementById("r3_"+amt).setAttribute("class", "green"); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } else { document.form1.price.value=""; document.getElementById('lblTotalPrice').innerHTML=0; document.form1.reg_desc.value=""; $('.green').removeClass('green'); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } } function student1_reg() { if (document.form1.student1.checked == true) { document.form1.delegate.checked = false; document.form1.speaker.checked = false; document.form1.poster.checked = false; //document.form1.virtual.checked = false; document.form1.diamond.checked = false; document.form1.platinum.checked = false; document.form1.gold.checked = false; document.form1.exhibition.checked = false; document.form1.addon.checked = false; document.form1.addon.disabled = false; document.form1.price.value=""; document.form1.price.value= document.form1.student1.value; document.getElementById('lblTotalPrice').innerHTML=document.form1.price.value; var amt = document.form1.price.value; document.form1.reg_desc.value=amt; $('.green').removeClass('green'); document.getElementById("r4_"+amt).setAttribute("class", "green"); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } else { document.form1.price.value=""; document.getElementById('lblTotalPrice').innerHTML=0; document.form1.reg_desc.value=""; $('.green').removeClass('green'); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } } function exhibition_reg() { if (document.form1.exhibition.checked == true) { 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$('.green').removeClass('green'); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } } function platinum_reg() { if (document.form1.platinum.checked == true) { document.form1.delegate.checked = false; document.form1.speaker.checked = false; document.form1.poster.checked = false; document.form1.exhibition.checked = false; document.form1.diamond.checked = false; document.form1.gold.checked = false; // document.form1.virtual.checked = false; document.form1.student1.checked = false; document.form1.addon.checked = false; document.form1.addon.disabled = false; document.form1.price.value=""; document.form1.price.value= document.form1.platinum.value; document.getElementById('lblTotalPrice').innerHTML=document.form1.price.value; var amt = document.form1.price.value; document.form1.reg_desc.value=amt; $('.green').removeClass('green'); document.getElementById("r6_"+amt).setAttribute("class", "green"); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } else { document.form1.price.value=""; document.getElementById('lblTotalPrice').innerHTML=0; document.form1.reg_desc.value=""; $('.green').removeClass('green'); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } } function diamond_reg() { if (document.form1.diamond.checked == true) { document.form1.delegate.checked = false; document.form1.speaker.checked = false; document.form1.poster.checked = false; document.form1.exhibition.checked = false; document.form1.platinum.checked = false; document.form1.gold.checked = false; // document.form1.virtual.checked = false; document.form1.student1.checked = false; document.form1.addon.checked = false; document.form1.addon.disabled = false; document.form1.price.value=""; document.form1.price.value= document.form1.diamond.value; document.getElementById('lblTotalPrice').innerHTML=document.form1.price.value; var amt = document.form1.price.value; document.form1.reg_desc.value=amt; $('.green').removeClass('green'); document.getElementById("r7_"+amt).setAttribute("class", "green"); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } else { document.form1.price.value=""; document.getElementById('lblTotalPrice').innerHTML=0; document.form1.reg_desc.value=""; $('.green').removeClass('green'); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } } function gold_reg() { if (document.form1.gold.checked == true) { document.form1.delegate.checked = false; document.form1.speaker.checked = false; document.form1.poster.checked = false; document.form1.exhibition.checked = false; document.form1.diamond.checked = false; document.form1.platinum.checked = false; // document.form1.virtual.checked = false; document.form1.student1.checked = false; document.form1.addon.checked = false; document.form1.addon.disabled = false; document.form1.price.value=""; document.form1.price.value= document.form1.gold.value; document.getElementById('lblTotalPrice').innerHTML=document.form1.price.value; var amt = document.form1.price.value; document.form1.reg_desc.value=amt; $('.green').removeClass('green'); document.getElementById("r8_"+amt).setAttribute("class", "green"); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } else { document.form1.price.value=""; document.getElementById('lblTotalPrice').innerHTML=0; document.form1.reg_desc.value=""; $('.green').removeClass('green'); for (var j=0; j < document.form1.accprice.length; j++) { document.form1.accprice[j].checked=false; } } } function update_price() { var price_ori=0; var add_on=0; if(document.form1.speaker.checked==true) var price_ori = document.form1.speaker.value; if(document.form1.delegate.checked==true) var price_ori = document.form1.delegate.value; if(document.form1.poster.checked==true) var price_ori = document.form1.poster.value; if(document.form1.exhibition.checked==true) var price_ori = document.form1.exhibition.value; if(document.form1.platinum.checked==true) var price_ori = document.form1.platinum.value; if(document.form1.diamond.checked==true) var price_ori = document.form1.diamond.value; if(document.form1.gold.checked==true) var price_ori = document.form1.gold.value; if(document.form1.student1.checked==true) var price_ori = document.form1.student1.value; if(document.form1.addon.checked==true) var add_on = 249; for (var i=0; i < document.form1.accprice.length; i++) { if (document.form1.accprice[i].checked==true) { document.form1.acc_desc.value = document.form1.accprice[i].value; document.getElementById('lblTotalPrice').innerHTML=parseInt(price_ori)+parseInt(document.form1.accprice[i].value)+add_on; document.form1.price.value=parseInt(price_ori)+parseInt(document.form1.accprice[i].value)+add_on; } } } function addon_reg() { /*var amount = 0; if(document.form1.price.value!='') var amount = document.form1.price.value;*/ if(document.form1.addon.checked == true) { document.getElementById('lblTotalPrice').innerHTML=parseInt(document.form1.price.value)+249; document.form1.price.value = parseInt(document.form1.price.value)+249; document.form1.addon_desc.value=249; document.getElementById("acc_person").setAttribute("class", "green"); } else { document.getElementById('lblTotalPrice').innerHTML=parseInt(document.form1.price.value)-249; document.form1.price.value = parseInt(document.form1.price.value)-249; document.form1.addon_desc.value=0; $('#acc_person').removeClass('green'); } } function disable_box() { document.form1.addon.disabled=true; } </script> </head>  <div id="preloader-active"> <div class="preloader d-flex align-items-center justify-content-center"> <div class="preloader-inner position-relative"> <div class="preloader-circle"></div> <div class="preloader-img pere-text"> <img src="assets/img/logo/loder.png" alt=""> </div> </div> </div> </div>  <div class="slider-area2"> <div class="slider-area2 pt-45 d-flex align-items-center"> <div class="container"> <div class="row"> <div class="col-xl-12"> <div class="hero-cap text-center"> <h2>REGISTRATION</h2> </div> </div> </div> </div> </div> </div> <section id="contact" class="section-bg wow fadeInUp" style="padding: 0px; visibility: visible; animation-name: fadeInUp;"> <div class="container"> <div class="section-tittle mb-35"> </div> <div class="form"> <form action="https://pharmanexus.org/checkout" method="post" role="form" name="form1" id="form1"> <div class="form-row"> <div class="form-group col-md-6"> <select class="form-control" name="title" id="title" required=""> <option value="">Designation</option> <option value="Mr.">Mr.</option> <option value="Miss">Miss</option> <option value="Mrs.">Mrs.</option> <option value="Dr.">Dr.</option> <option value="Assist Prof">Assist Prof</option> <option value="Assoc Prof">Assoc Prof</option> <option value="Prof">Prof</option> </select> <div class="validation"></div> </div> <div class="form-group col-md-6"> <input type="text" class="form-control" name="name" id="name" placeholder="Full Name" required=""> <div class="validation"></div> </div> </div> <div class="form-row"> <div class="form-group col-md-6"> <input type="text" class="form-control" placeholder="Telephone Number" name="phno" required="" data-validation-required-message="Please enter your name."> <div class="validation"></div> </div> <div class="form-group col-md-6"> <input type="email" class="form-control brch-ctrl" name="Email" id="Email" placeholder="Email" required=""> <div class="validation"></div> </div> </div> <div class="form-row"> <div class="form-group col-md-6"> <select class="form-control" name="country" id="country" required=""> <option value="">Select Country</option> <option value="afghanistan">afghanistan</option> <option value="albania">albania</option> <option value="algeria">algeria</option> <option value="american samoa">american samoa</option> <option value="andorra">andorra</option> <option value="angola">angola</option> <option value="anguilla">anguilla</option> <option value="antigua and barbuda">antigua and barbuda</option> <option value="argentina">argentina</option> <option value="armenia">armenia</option> <option value="aruba">aruba</option> <option value="australia">australia</option> <option value="austria">austria</option> <option value="azerbaijan">azerbaijan</option> <option value="bahamas">bahamas</option> <option value="bahrain">bahrain</option> <option value="bangladesh">bangladesh</option> <option value="barbados">barbados</option> <option value="belarus">belarus</option> <option value="belgium">belgium</option> <option value="belize">belize</option> <option value="benin">benin</option> <option value="bermuda">bermuda</option> <option value="bhutan">bhutan</option> <option value="bolivia">bolivia</option> <option value="bosnia and herzegovina">bosnia and herzegovina</option> <option value="botswana">botswana</option> <option value="brazil">brazil</option> <option value="british indian ocean territory">british indian ocean territory</option> <option value="british virgin islands">british virgin islands</option> <option value="brunei">brunei</option> <option value="bulgaria">bulgaria</option> <option value="burkina faso">burkina faso</option> <option value="burundi">burundi</option> <option value="cambodia">cambodia</option> <option value="cameroon">cameroon</option> <option value="canada">canada</option> <option value="cape verde">cape verde</option> <option value="cayman islands">cayman islands</option> <option value="central african republic">central african republic</option> <option value="chad">chad</option> <option value="chile">chile</option> <option value="china">china</option> <option value="christmas island">christmas island</option> <option value="cocos islands">cocos islands</option> <option value="colombia">colombia</option> <option value="comoros">comoros</option> <option value="cook islands">cook islands</option> <option value="costa rica">costa rica</option> <option value="croatia">croatia</option> <option value="cuba">cuba</option> <option value="cyprus">cyprus</option> <option value="czech republic">czech republic</option> <option value="democratic republic of the congo">democratic republic of the congo</option> <option value="denmark">denmark</option> <option value="djibouti">djibouti</option> <option value="dominica">dominica</option> <option value="dominican republic">dominican republic</option> <option value="east timor">east timor</option> <option value="ecuador">ecuador</option> <option value="egypt">egypt</option> <option value="el salvador">el salvador</option> <option value="equatorial guinea">equatorial guinea</option> <option value="eritrea">eritrea</option> <option value="estonia">estonia</option> <option value="ethiopia">ethiopia</option> <option value="falkland islands">falkland islands</option> <option value="faroe islands">faroe islands</option> <option value="fiji">fiji</option> <option value="finland">finland</option> <option value="france">france</option> <option value="french polynesia">french polynesia</option> <option value="gabon">gabon</option> <option value="gambia">gambia</option> <option value="georgia">georgia</option> <option value="germany">germany</option> <option value="ghana">ghana</option> <option value="GHANA">GHANA</option> <option value="gibraltar">gibraltar</option> <option value="greece">greece</option> <option value="greenland">greenland</option> <option value="grenada">grenada</option> <option value="guam">guam</option> <option value="guatemala">guatemala</option> <option value="guinea">guinea</option> <option value="guinea-bissau">guinea-bissau</option> <option value="guyana">guyana</option> <option value="haiti">haiti</option> <option value="honduras">honduras</option> <option value="hong kong">hong kong</option> <option value="hungary">hungary</option> <option value="iceland">iceland</option> <option value="india">india</option> <option value="indonesia">indonesia</option> <option value="iran">iran</option> <option value="iraq">iraq</option> <option value="ireland">ireland</option> <option value="isle of man">isle of man</option> <option value="israel">israel</option> <option value="italy">italy</option> <option value="ivory coast">ivory coast</option> <option value="jamaica">jamaica</option> <option value="japan">japan</option> <option value="jersey">jersey</option> <option value="jordan">jordan</option> <option value="kazakhstan">kazakhstan</option> <option value="kenya">kenya</option> <option value="kiribati">kiribati</option> <option value="kuwait">kuwait</option> <option value="kyrgyzstan">kyrgyzstan</option> <option value="laos">laos</option> <option value="latvia">latvia</option> <option value="lebanon">lebanon</option> <option value="lesotho">lesotho</option> <option value="liberia">liberia</option> <option value="libya">libya</option> <option value="liechtenstein">liechtenstein</option> <option value="lithuania">lithuania</option> <option value="luxembourg">luxembourg</option> <option value="macao">macao</option> <option value="macedonia">macedonia</option> <option value="madagascar">madagascar</option> <option value="malawi">malawi</option> <option value="malaysia">malaysia</option> <option value="maldives">maldives</option> <option value="mali">mali</option> <option value="malta">malta</option> <option value="marshall islands">marshall islands</option> <option value="mauritania">mauritania</option> <option value="mauritius">mauritius</option> <option value="mayotte">mayotte</option> <option value="mexico">mexico</option> <option value="micronesia">micronesia</option> <option value="moldova">moldova</option> <option value="monaco">monaco</option> <option value="mongolia">mongolia</option> <option value="montenegro">montenegro</option> <option value="montserrat">montserrat</option> <option value="morocco">morocco</option> <option value="mozambique">mozambique</option> <option value="myanmar">myanmar</option> <option value="namibia">namibia</option> <option value="nauru">nauru</option> <option value="nepal">nepal</option> <option value="netherlands">netherlands</option> <option value="netherlands antilles">netherlands antilles</option> <option value="new caledonia">new caledonia</option> <option value="new zealand">new zealand</option> <option value="nicaragua">nicaragua</option> <option value="niger">niger</option> <option value="nigeria">nigeria</option> <option value="niue">niue</option> <option value="north korea">north korea</option> <option value="northern mariana islands">northern mariana islands</option> <option value="norway">norway</option> <option value="oman">oman</option> <option value="pakistan">pakistan</option> <option value="palau">palau</option> <option value="panama">panama</option> <option value="papua new guinea">papua new guinea</option> <option value="paraguay">paraguay</option> <option value="peru">peru</option> <option value="philippines">philippines</option> <option value="pitcairn">pitcairn</option> <option value="poland">poland</option> <option value="portugal">portugal</option> <option value="puerto rico">puerto rico</option> <option value="qatar">qatar</option> <option value="republic of the congo">republic of the congo</option> <option value="romania">romania</option> <option value="russia">russia</option> <option value="rwanda">rwanda</option> <option value="saint barthelemy">saint barthelemy</option> <option value="saint helena">saint helena</option> <option value="saint kitts and nevis">saint kitts and nevis</option> <option value="saint lucia">saint lucia</option> <option value="saint martin">saint martin</option> <option value="saint pierre and miquelon">saint pierre and miquelon</option> <option value="saint vincent and the grenadines">saint vincent and the grenadines</option> <option value="samoa">samoa</option> <option value="san marino">san marino</option> <option value="sao tome and principe">sao tome and principe</option> <option value="saudi arabia">saudi arabia</option> <option value="senegal">senegal</option> <option value="serbia">serbia</option> <option value="seychelles">seychelles</option> <option value="sierra leone">sierra leone</option> <option value="singapore">singapore</option> <option value="slovakia">slovakia</option> <option value="slovenia">slovenia</option> <option value="solomon islands">solomon islands</option> <option value="somalia">somalia</option> <option value="south africa">south africa</option> <option value="south georgia and the south sandwich islands">south georgia and the south sandwich islands</option> <option value="south korea">south korea</option> <option value="spain">spain</option> <option value="sri lanka">sri lanka</option> <option value="sudan">sudan</option> <option value="suriname">suriname</option> <option value="svalbard and jan mayen">svalbard and jan mayen</option> <option value="swaziland">swaziland</option> <option value="sweden">sweden</option> <option value="switzerland">switzerland</option> <option value="syria">syria</option> <option value="taiwan">taiwan</option> <option value="tajikistan">tajikistan</option> <option value="tanzania">tanzania</option> <option value="thailand">thailand</option> <option value="togo">togo</option> <option value="tokelau">tokelau</option> <option value="tonga">tonga</option> <option value="trinidad and tobago">trinidad and tobago</option> <option value="tunisia">tunisia</option> <option value="turkey">turkey</option> <option value="turkmenistan">turkmenistan</option> <option value="turks and caicos islands">turks and caicos islands</option> <option value="tuvalu">tuvalu</option> <option value="u.s. virgin islands">u.s. virgin islands</option> <option value="uganda">uganda</option> <option value="ukraine">ukraine</option> <option value="united arab emirates">united arab emirates</option> <option value="united kingdom">united kingdom</option> <option value="united states">united states</option> <option value="uruguay">uruguay</option> <option value="uzbekistan">uzbekistan</option> <option value="vanuatu">vanuatu</option> <option value="vatican">vatican</option> <option value="venezuela">venezuela</option> <option value="vietnam">vietnam</option> <option value="wallis and futuna">wallis and futuna</option> <option value="western sahara">western sahara</option> <option value="yemen">yemen</option> <option value="zambia">zambia</option> <option value="zimbabwe">zimbabwe</option> </select> </div> <div class="form-group col-md-6"> <input type="text" class="form-control brch-ctrl" name="org" placeholder="Company/University" required=""> </div> </div> <div class="form-row"> <div class="form-group col-md-6"> <textarea class="form-control brch-ctrl" rows="3" placeholder="Address" name="address" required=""></textarea> </div> <div class="form-group col-md-6" align="center"> <img src="https://nexusforums.net/stripe-secured.png" class="img-responsive" style="width: 240px;"> </div> </div> <div class="row"> <h3 style="padding-left: 20px">Select from various categories below</h3> <div class="table-responsive table-bordered movie-table col-md-12"> <table class="table movie-table"> <tbody> <tr> <th style="background-color: #f57c00;color: #FFF">Academic</th> <th style="background-color: #f57c00; color: #FFF">Early Bird Registration<br><i class="fa fa-calendar"></i> November 29, 2024 </th> <th style="background-color: #f57c00; color: #FFF">Standard Registration<br><i class="fa fa-calendar"></i> February 28, 2025</th> <th style="background-color: #f57c00; color: #FFF">OnSpot Registration<br><i class="fa fa-calendar"></i> March 13, 2025</th> </tr> <tr> <td> <input type="checkbox" name="speaker" id="speaker" value="749" onclick="return speaker_reg()"> Speaker Registration </td> <td id="r1_749">$ 749</td> <td id="r1_849"> $ 849</td> <td id="r1_949">$ 949</td> </tr> <tr> <td><input type="checkbox" name="delegate" id="delegate" value="899" onclick="return delegate_reg()"> Delegate Registration</td> <td id="r2_899"> $ 899 </td> <td id="r2_999"> $ 999 </td> <td id="r2_1099"> $ 1099 </td> </tr> <tr> <td><input type="checkbox" name="poster" id="poster" value="449" onclick="return poster_reg()"> Poster Registration</td> <td id="r3_449"> $ 449 </td> <td id="r3_549"> $ 549 </td> <td id="r3_649"> $ 649 </td> </tr> <tr> <td> <input type="checkbox" name="student1" id="student1" value="299" onclick="return student1_reg()"> Student </td> <td id="r4_299"> $ 299 </td> <td id="r4_399"> $ 399 </td> <td id="r4_499"> $ 499 </td> </tr>  <tr> <th style="background-color: #f57c00;color: #FFF;text-align: center;font-size: 19px;" colspan="4">Add-On's</th> </tr> <tr> <td><input type="checkbox" name="addon" id="addon" value="249" onclick="return addon_reg()"> Accompanying Person</td> <td id="acc_person" colspan="3"> $ 249 </td> </tr> <tr> <th style="background-color: #f57c00;color: #FFF;text-align: center;font-size: 19px;" colspan="4"> Business</th> </tr> <tr> <td id="r5_4999"><input type="checkbox" name="platinum" id="platinum" value="4999" onclick="return platinum_reg()"> Platinum $ 4999</td> <td id="r6_3999"><input type="checkbox" name="diamond" id="diamond" value="3999" onclick="return diamond_reg()"> Diamond $ 3999</td> <td id="r7_2999"><input type="checkbox" name="gold" id="gold" value="2999" onclick="return gold_reg()"> Gold $ 2999</td> <td id="r8_1999"><input type="checkbox" name="exhibition" id="exhibition" value="1999" onclick="return exhibition_reg()"> Exhibition $ 1999</td> </tr> <tr> <th style="background-color: #f57c00;color: #FFF;text-align: center;font-size: 19px;" colspan="4"> Accommodation </th> </tr> <tr> <td colspan="4"> <table class="table movie-table"> <tbody><tr> <th class="text-center" colspan="2"> 2 Nights </th> <th class="text-center" colspan="2"> 3 Nights </th> <th class="text-center" colspan="2"> 4 Nights </th> <th class="text-center" colspan="2"> 5 Nights </th> </tr> <tr> <td>Single Occupancy</td> <td> <input type="radio" name="accprice" id="accprice" value="400" onclick="return update_price()"> $ 400 </td> <td>Single Occupancy</td> <td> <input type="radio" name="accprice" id="accprice" value="600" onclick="return update_price()"> $ 600 </td> <td>Single Occupancy</td> <td> <input type="radio" name="accprice" id="accprice" value="800" onclick="return update_price()"> $ 800 </td> <td>Single Occupancy</td> <td> <input type="radio" name="accprice" id="accprice" value="1000" onclick="return update_price()"> $ 1000 </td> </tr> <tr> <td>Double Occupancy</td> <td> <input type="radio" name="accprice" id="accprice" value="460" onclick="return update_price()"> $ 460 </td> <td>Double Occupancy</td> <td> <input type="radio" name="accprice" id="accprice" value="690" onclick="return update_price()"> $ 690 </td> <td>Double Occupancy</td> <td> <input type="radio" name="accprice" id="accprice" value="920" onclick="return update_price()"> $ 920 </td> <td>Double Occupancy</td> <td> <input type="radio" name="accprice" id="accprice" value="1150" onclick="return update_price()"> $ 1150 </td> </tr> </tbody></table> </td> </tr> </tbody> </table> </div> </div> <div class="row"> <div class="col-md-6 text-right"><label><strong>TOTAL PRICE($) :</strong> </label></div> <div class="col-md-6"><label name="lblTotalPrice" id="lblTotalPrice">0</label><input type="hidden" name="price" id="price"><input type="hidden" name="reg_desc" id="reg_desc"><input type="hidden" name="addon_desc"><input type="hidden" name="offline1_desc"><input type="hidden" name="offline2_desc"><input type="hidden" name="acc_desc"> <input type="hidden" name="currency" value="USD"> </div>  </div> <div class="row"> <div class="col-md-3"> </div> <div style="padding: 20px;" class="col-md-6 text-center"><input type="checkbox" name="accept" required=""> I've read and accept the <a style="color: #f57c00;" href="terms-conditions" target="_blank">terms & conditions</a>.</div> <div class="col-md-3"> </div> <div class="col-md-3"> </div> <div align="center" class="col-md-6"> <table align="center" class=""> <tbody><tr> <td colspan="2" align="center" valign="top"></td> </tr> <tr> <td align="right" valign="top"> Validation code:</td> <td><img src="https://pharmanexus.org/captcha.php?rand=1245567575" id="captchaimg"><br> <label for="message">Enter the code above here :</label> <br> <input id="captcha_code" name="captcha_code" type="text" required=""> <br> Can't read the image? click <a href="javascript: refreshCaptcha();" style="color:#f57c00;">here</a> to refresh.</td> </tr> </tbody></table> </div> <div class="col-md-3"> </div> </div> <div style="padding: 20px; color: red" class="text-center">Note: 5% of processing charges will be applicable.</div> <div class="text-center"> <button type="submit" name="submit" class="btn">Register Now</button>  <button type="reset" class="btn">Reset</button> </div> </form> </div> </div>    </main> <footer>  <div class="footer-area footer-area pb-25 pt-25"> <div class="container"> <div class="row d-flex justify-content-between"> <div class="col-xl-3 col-lg-3 col-md-4 col-sm-6"> <div class="single-footer-caption mb-50"> <div class="single-footer-caption mb-30"> <div class="footer-tittle"> <div class="footer-pera"> <img src="assets/img/logo/logo-bottom-1.png" alt="" style="width:200px;"> </div> </div> </div> </div> </div> <div class="col-xl-3 col-lg-3 col-md-4 col-sm-5"> <div class="single-footer-caption mb-50"> <div class="footer-tittle"> <h4>Contact Info</h4> <ul>  <li><a href="#"><b style="color: white;">Email :</b> secretary@pharmanexus.org</a></li> </ul> </div> </div> </div>--> <div class="col-xl-3 col-lg-3 col-md-4 col-sm-5"> <div class="single-footer-caption mb-50"> <div class="footer-tittle"> <h4>Important Link</h4> <ul> <li><a href="/abstract-submission"> Submit 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src="assets/img/gallery/form.png" alt=""></button> </div> <div class="mt-10 info"></div> </form> </div> </div> </div> </div> </div> </div>  <div class="row justify-content-between"> <div class="col-xl-3 col-lg-3 col-md-4 col-sm-5"> <div class="footer-tittle-bottom"> <span>100+</span> <p>Speakers</p> </div> </div> <div class="col-xl-3 col-lg-3 col-md-4 col-sm-5"> <div class="footer-tittle-bottom"> <span>100+</span> <p>Attendees</p> </div> </div> <div class="col-xl-3 col-lg-3 col-md-4 col-sm-5"> <div class="footer-tittle-bottom"> <span>451</span> <p>Sessions</p> </div> </div> <div class="col-xl-3 col-lg-3 col-md-4 col-sm-5">  <div class="footer-tittle-bottom"> <span>120</span> <p>Countries</p> </div> </div> </div> <div class="footer-bottom-area footer-bg"> <div class="container"> <div class="footer-border"> <div class="row d-flex justify-content-between align-items-center"> <div class="col-xl-10 col-lg-8 "> <div class="footer-copy-right"> <p style="text-align: center;"> Copyright 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