{"id":27035,"date":"2026-03-16T16:50:58","date_gmt":"2026-03-16T16:50:58","guid":{"rendered":"https:\/\/b2b.this-1.com\/registration\/"},"modified":"2026-03-20T19:41:16","modified_gmt":"2026-03-20T19:41:16","slug":"registration","status":"publish","type":"page","link":"https:\/\/b2b.this-1.com\/en\/registration\/","title":{"rendered":"Registration"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"27035\" class=\"elementor elementor-27035 elementor-26887\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-208dcd3 e-con-full e-flex e-con e-parent\" data-id=\"208dcd3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1eae976 elementor-widget elementor-widget-shortcode\" data-id=\"1eae976\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">  <style>\n    .hr-wrap{max-width:560px;margin:0 auto;font-family:-apple-system,BlinkMacSystemFont,'Segoe UI',Roboto,sans-serif}\n    .hr-card{background:#fff;border:1.5px solid #eef0f4;border-radius:16px;padding:32px;margin-bottom:16px}\n    .hr-title{font-size:22px;font-weight:800;color:#1a2744;margin:0 0 4px;display:flex;align-items:center;gap:10px}\n    .hr-desc{font-size:13px;color:#888;margin:0 0 24px}\n    .hr-row{display:grid;grid-template-columns:1fr 1fr;gap:12px;margin-bottom:12px}\n    .hr-full{grid-column:1\/-1}\n    .hr-fg{display:flex;flex-direction:column;gap:4px}\n    .hr-fg label{font-size:11px;font-weight:700;color:#888;text-transform:uppercase;letter-spacing:.3px}\n    .hr-fg label .req{color:#dc3545}\n    .hr-fg input{padding:10px 14px;border:1.5px solid #dde2ea;border-radius:10px;font-size:14px;color:#1a2744;transition:border .15s}\n    .hr-fg input:focus{outline:none;border-color:#0f5eb8;box-shadow:0 0 0 3px rgba(15,94,184,.12)}\n    .hr-fg input::placeholder{color:#bbb}\n    .hr-btn{\n      width:100%;padding:14px;border:none;border-radius:10px;\n      background:#0f5eb8;color:#fff;font-size:15px;font-weight:700;\n      cursor:pointer;transition:all .15s;margin-top:8px;\n    }\n    .hr-btn:hover{background:#0a4a94;transform:translateY(-1px)}\n    .hr-btn:disabled{background:#ccc;cursor:not-allowed;transform:none}\n    .hr-notice{\n      margin-top:20px;padding:16px 20px;border-radius:12px;\n      background:#fef9e7;border:1px solid #fbbf24;\n      font-size:13px;color:#92400e;line-height:1.5;\n    }\n    .hr-notice strong{color:#78350f}\n    .hr-ok{\n      text-align:center;padding:40px 24px;\n      background:#e8f5ee;border-radius:16px;\n    }\n    .hr-ok-icon{font-size:48px;margin-bottom:12px}\n    .hr-ok-title{font-size:20px;font-weight:800;color:#1a6b3c;margin-bottom:8px}\n    .hr-ok-text{font-size:14px;color:#5a6a85;line-height:1.6}\n    .hr-err{padding:12px 16px;background:#fef3f3;border:1px solid #fca5a5;border-radius:10px;color:#dc2626;font-size:13px;margin-bottom:12px;display:none}\n    .hr-section{font-size:13px;font-weight:700;color:#0f5eb8;text-transform:uppercase;letter-spacing:.5px;margin:20px 0 10px;padding-top:16px;border-top:1px solid #eef0f4}\n    .hr-section:first-of-type{border-top:0;margin-top:0;padding-top:0}\n    @media(max-width:500px){\n      .hr-row{grid-template-columns:1fr}\n      .hr-card{padding:20px 16px}\n    }\n  <\/style>\n\n  <div class=\"hr-wrap\"\n    data-i18n-sending=\"\u23f3 Sending...\"\n    data-i18n-error=\"An error occurred.\"\n    data-i18n-conn-error=\"Connection error. Please try again.\"\n    data-i18n-submit=\"\ud83d\udce8 Submit access request\"\n  >\n    <div class=\"hr-card\">\n      <h2 class=\"hr-title\">\ud83d\udccb Request access<\/h2>\n      <p class=\"hr-desc\">Fill in the form to request a wholesale account.<\/p>\n\n      <div id=\"hr-error\" class=\"hr-err\"><\/div>\n\n      <form id=\"hr-form\">\n        <div class=\"hr-section\">Login credentials<\/div>\n        <div class=\"hr-row\">\n          <div class=\"hr-fg\">\n            <label>E-mail <span class=\"req\">*<\/span><\/label>\n            <input type=\"email\" name=\"email\" required placeholder=\"adres@apteka.pl\">\n          <\/div>\n          <div class=\"hr-fg\">\n            <label>Password <span class=\"req\">*<\/span><\/label>\n            <input type=\"password\" name=\"password\" required placeholder=\"Min. 8 characters\" minlength=\"8\">\n          <\/div>\n        <\/div>\n\n        <div class=\"hr-section\">Company details<\/div>\n        <div class=\"hr-row\">\n          <div class=\"hr-fg hr-full\">\n            <label>Company \/ pharmacy name <span class=\"req\">*<\/span><\/label>\n            <input type=\"text\" name=\"company\" required placeholder=\"Apteka Pod Or\u0142em\">\n          <\/div>\n          <div class=\"hr-fg\">\n            <label>Tax ID (NIP) <span class=\"req\">*<\/span><\/label>\n            <input type=\"text\" name=\"nip\" required placeholder=\"000-000-00-00\" maxlength=\"13\">\n          <\/div>\n          <div class=\"hr-fg\">\n            <label>Phone <span class=\"req\">*<\/span><\/label>\n            <input type=\"tel\" name=\"phone\" required placeholder=\"600 000 000\">\n          <\/div>\n        <\/div>\n\n        <div class=\"hr-section\">Contact person<\/div>\n        <div class=\"hr-row\">\n          <div class=\"hr-fg\">\n            <label>First name <span class=\"req\">*<\/span><\/label>\n            <input type=\"text\" name=\"first_name\" required placeholder=\"Jan\">\n          <\/div>\n          <div class=\"hr-fg\">\n            <label>Last name <span class=\"req\">*<\/span><\/label>\n            <input type=\"text\" name=\"last_name\" required placeholder=\"Kowalski\">\n          <\/div>\n        <\/div>\n\n        <div class=\"hr-section\">Address<\/div>\n        <div class=\"hr-row\">\n          <div class=\"hr-fg hr-full\">\n            <label>Street and number <span class=\"req\">*<\/span><\/label>\n            <input type=\"text\" name=\"address\" required placeholder=\"ul. Apteczna 12\">\n          <\/div>\n          <div class=\"hr-fg\">\n            <label>Postal code <span class=\"req\">*<\/span><\/label>\n            <input type=\"text\" name=\"postcode\" required placeholder=\"00-000\" maxlength=\"6\">\n          <\/div>\n          <div class=\"hr-fg\">\n            <label>City <span class=\"req\">*<\/span><\/label>\n            <input type=\"text\" name=\"city\" required placeholder=\"Warszawa\">\n          <\/div>\n        <\/div>\n\n        <button type=\"submit\" class=\"hr-btn\" id=\"hr-submit\">\ud83d\udce8 Submit access request<\/button>\n      <\/form>\n\n      <div class=\"hr-notice\">\n        <strong>\u2139\ufe0f Important:<\/strong> Konto zostanie aktywowane dopiero po weryfikacji i zatwierdzeniu. Otrzymasz e-mail z potwierdzeniem aktywacji. 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