{"id":868,"date":"2025-08-21T14:57:32","date_gmt":"2025-08-21T14:57:32","guid":{"rendered":"https:\/\/quibotlive.online\/store\/?page_id=868"},"modified":"2025-08-21T15:02:26","modified_gmt":"2025-08-21T15:02:26","slug":"eye-order-form","status":"publish","type":"page","link":"https:\/\/quibotlive.online\/store\/eye-order-form\/","title":{"rendered":"Eye Order Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"868\" class=\"elementor elementor-868\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1ffdc18c e-flex e-con-boxed e-con e-parent\" data-id=\"1ffdc18c\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1230934e elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"1230934e\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-13c40a17 elementor-widget elementor-widget-heading\" data-id=\"13c40a17\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Kindly Fill in your correct details so we can Deliver your order to you...<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-48469775 elementor-widget elementor-widget-heading\" data-id=\"48469775\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Please, Don't fill the form if you are not financially ready to receive your order<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-31bc1a07 elementor-widget elementor-widget-wpforms\" data-id=\"31bc1a07\" data-element_type=\"widget\" data-widget_type=\"wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-863\"><form id=\"wpforms-form-863\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"863\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/store\/wp-json\/wp\/v2\/pages\/868\" data-token=\"7721b9b70a7864acd06c2ccd9ad96b99\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-863-field_1-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-863-field_1\">Full Name <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-863-field_1\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][1]\" required><div class=\"wpforms-field-description\">Kindly give us your Name for the purpose of Delivery<\/div><\/div><div id=\"wpforms-863-field_3-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-863-field_3\">Contact Number <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-863-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" required><div class=\"wpforms-field-description\">Kindly provide a number we can reach you on.<\/div><\/div><div id=\"wpforms-863-field_2-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-863-field_2\">Delivery Address \/ Region <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-863-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><div class=\"wpforms-field-description\">Kindly Provide a detailed Address to enable us deliver your Purchase<\/div><\/div><div id=\"wpforms-863-field_4-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-863-field_4\">Quantity <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-863-field_4\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][4]\" required=\"required\"><option value=\"BUY ONE PACK OF EYE REMEDY TEA: 250 CEDIS ONLY (Trial Plan)\" >BUY ONE PACK OF EYE REMEDY TEA: 250 CEDIS ONLY (Trial Plan)<\/option><option value=\"BUY TWO PACKS OF EYE REMEDY TEA : 450 CEDIS ONLY (Recommended)\"  selected='selected'>BUY TWO PACKS OF EYE REMEDY TEA : 450 CEDIS ONLY (Recommended)<\/option><option value=\"BUY THREE PACKS OF EYE REMEDY TEA FOR 650 CEDIS ONLY (Highly Recommended)\" >BUY THREE PACKS OF EYE REMEDY TEA FOR 650 CEDIS ONLY (Highly Recommended)<\/option><option value=\"BUY FOUR PACKS OF EYE REMEDY TEA: 900 CEDIS ONLY (Most Recommended)\" >BUY FOUR PACKS OF EYE REMEDY TEA: 900 CEDIS ONLY (Most Recommended)<\/option><option value=\"BUY FIVE PACKS OF EYE REMEDY TEA: 1,100 CEDIS ONLY (Ultimate Bundle)\" >BUY FIVE PACKS OF EYE REMEDY TEA: 1,100 CEDIS ONLY (Ultimate Bundle)<\/option><\/select><\/div><div id=\"wpforms-863-field_5-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-863-field_5\">Customers&#039; Consent <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-863-field_5\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1 wpforms-selected\"><input type=\"radio\" id=\"wpforms-863-field_5_1\" name=\"wpforms[fields][5]\" value=\"Yes, I Agree\" required  checked='checked'><label class=\"wpforms-field-label-inline\" for=\"wpforms-863-field_5_1\">Yes, I Agree<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-863-field_5_2\" name=\"wpforms[fields][5]\" value=\"No, I Don&#039;t Consent\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-863-field_5_2\">No, I Don't Consent<\/label><\/li><\/ul><div class=\"wpforms-field-description\"> I agree that I am Intentionally Placing this order and that I am Financially ready and available to Receive my order as soon as it is brought to me.<\/div><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"863\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"1\"><button type=\"submit\" name=\"wpforms[submit]\" class=\"wpforms-submit \" id=\"wpforms-submit-863\" value=\"wpforms-submit\" aria-live=\"assertive\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\">Submit<\/button><img decoding=\"async\" src=\"https:\/\/quibotlive.online\/store\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-413d9e18 e-flex e-con-boxed e-con e-parent\" data-id=\"413d9e18\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6e4cd6fe elementor-widget elementor-widget-heading\" data-id=\"6e4cd6fe\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Thank you for your patronage; \nwe anticipate your feedback shortly!!!<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1dd06f23 elementor-widget elementor-widget-spacer\" data-id=\"1dd06f23\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Kindly Fill in your correct details so we can Deliver your order to you&#8230; Please, Don&#8217;t fill the form if you are not financially ready to receive your order Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Full Name *Kindly give us your Name for [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_canvas","meta":{"footnotes":""},"class_list":["post-868","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/quibotlive.online\/store\/wp-json\/wp\/v2\/pages\/868","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/quibotlive.online\/store\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/quibotlive.online\/store\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/quibotlive.online\/store\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/quibotlive.online\/store\/wp-json\/wp\/v2\/comments?post=868"}],"version-history":[{"count":10,"href":"https:\/\/quibotlive.online\/store\/wp-json\/wp\/v2\/pages\/868\/revisions"}],"predecessor-version":[{"id":879,"href":"https:\/\/quibotlive.online\/store\/wp-json\/wp\/v2\/pages\/868\/revisions\/879"}],"wp:attachment":[{"href":"https:\/\/quibotlive.online\/store\/wp-json\/wp\/v2\/media?parent=868"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}