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<div class="form-group row "> <label class="col-md-3 form-control-label required"> Select Group </label> <div class="col-md-6"> <select id="customer_groups" onchange="checkval(this.value)" class="form-control" name="customer_groups" autocomplete="off" required=""> <option value="">Select Group</option> <option value="4">Customer Resale</option> <option value="5">Cliente Final</option> <option value="6">International Reseller Client</option> </select> <p id="auto-find" class="alert alert-warning" style="display: none">users are required to be manually approved.</p> </div> </div> <div class="form-group row "> <label class="col-md-3 form-control-label required"> Request Message </label> <div class="col-md-6"> <textarea id="request_message" class="form-control" name="request_message" autocomplete="off" ></textarea> </div> </div> <script type="text/javascript"> var autogroups = "5"; function checkval(val){ var autogroupsarray = autogroups.split(","); var end = val; if (autogroupsarray.includes(end) || end=='') { document.getElementById("auto-find").style.display='none'; } else if (autogroupsarray == end) { document.getElementById("auto-find").style.display='none'; } else { document.getElementById("auto-find").style.display='block'; } } </script>

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Social title

Sr.

Sra.

First name *

Only letters and the dot (.) character, followed by a space, are allowed.

Last name *

Only letters and the dot (.) character, followed by a space, are allowed.

Company

Identification number *

Email *

Password *

Birthdate

(E.g.: 05/31/1970)

Receive offers from our partners

I agree to the terms and conditions and the privacy policy

Select Group

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