{"id":2030,"date":"2023-01-27T07:49:06","date_gmt":"2023-01-27T07:49:06","guid":{"rendered":"https:\/\/juiceupjuice.com\/?page_id=2030"},"modified":"2023-01-27T07:49:09","modified_gmt":"2023-01-27T07:49:09","slug":"customer-registration-form","status":"publish","type":"page","link":"https:\/\/juiceupjuice.com\/index.php\/customer-registration-form\/","title":{"rendered":"Customer Registration Form"},"content":{"rendered":"\n<script src=\"https:\/\/cdn02.jotfor.ms\/static\/prototype.forms.js?3.3.38897\" type=\"text\/javascript\"><\/script> <script src=\"https:\/\/cdn03.jotfor.ms\/static\/jotform.forms.js?3.3.38897\" type=\"text\/javascript\"><\/script> <script src=\"https:\/\/cdn01.jotfor.ms\/js\/vendor\/jquery-1.8.0.min.js?v=3.3.38897\" type=\"text\/javascript\"><\/script> <script defer src=\"https:\/\/cdn02.jotfor.ms\/js\/vendor\/maskedinput.min.js?v=3.3.38897\" type=\"text\/javascript\"><\/script> <script defer src=\"https:\/\/cdn03.jotfor.ms\/js\/vendor\/jquery.maskedinput.min.js?v=3.3.38897\" type=\"text\/javascript\"><\/script> <script defer src=\"https:\/\/cdnjs.cloudflare.com\/ajax\/libs\/punycode\/1.4.1\/punycode.js\"><\/script> <script type=\"text\/javascript\"> JotForm.newDefaultTheme = false; JotForm.extendsNewTheme = true; JotForm.singleProduct = false; JotForm.newPaymentUIForNewCreatedForms = false; JotForm.newPaymentUI = true; JotForm.setConditions([{\"action\":[{\"field\":\"9\",\"visibility\":\"Show\",\"id\":\"action_0_1579704830003\"}],\"id\":\"1579704830003\",\"index\":\"0\",\"link\":\"Any\",\"priority\":\"0\",\"terms\":[{\"field\":\"8\",\"operator\":\"equals\",\"value\":\"Other\"}],\"type\":\"field\"}]); JotForm.init(function(){ \/*INIT-START*\/ JotForm.setPhoneMaskingValidator( 'input_5_full', '(###) ###-####' ); setTimeout(function() { $('input_6').hint('ex: email@yahoo.com'); }, 20); if (window.JotForm && JotForm.accessible) $('input_11').setAttribute('tabindex',0); JotForm.alterTexts({\"ageVerificationError\":\"You must be older than {minAge} years old to submit this form.\",\"alphabetic\":\"This field can only contain letters\",\"alphanumeric\":\"This field can only contain letters and numbers.\",\"appointmentSelected\":\"You\u2019ve selected {time} on {date}\",\"ccDonationMinLimitError\":\"Minimum amount is {minAmount} {currency}\",\"ccInvalidCVC\":\"CVC number is invalid.\",\"ccInvalidExpireDate\":\"Expire date is invalid.\",\"ccInvalidExpireMonth\":\"Expiration month is invalid.\",\"ccInvalidExpireYear\":\"Expiration year is invalid.\",\"ccInvalidNumber\":\"Credit Card Number is invalid.\",\"ccMissingDetails\":\"Please fill up the credit card details.\",\"ccMissingDonation\":\"Please enter numeric values for donation amount.\",\"ccMissingProduct\":\"Please select at least one product.\",\"characterLimitError\":\"Too many Characters. 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href=\"https:\/\/cdn02.jotfor.ms\/themes\/CSS\/548b1325700cc48d318b4567.css?themeRevisionID=60d3156fd82983013b471ba1\"\/> <link type=\"text\/css\" rel=\"stylesheet\" href=\"https:\/\/cdn03.jotfor.ms\/css\/styles\/payment\/payment_styles.css?3.3.38897\" \/> <link type=\"text\/css\" rel=\"stylesheet\" href=\"https:\/\/cdn01.jotfor.ms\/css\/styles\/payment\/payment_feature.css?3.3.38897\" \/> <form class=\"jotform-form\" action=\"https:\/\/submit.jotform.com\/submit\/230257348975567\/\" method=\"post\" name=\"form_230257348975567\" id=\"230257348975567\" accept-charset=\"utf-8\" autocomplete=\"on\"><input type=\"hidden\" name=\"formID\" value=\"230257348975567\" \/><input type=\"hidden\" id=\"JWTContainer\" value=\"\" \/><input type=\"hidden\" id=\"cardinalOrderNumber\" value=\"\" \/> <div role=\"main\" class=\"form-all\"> <link type=\"text\/css\" rel=\"stylesheet\" media=\"all\" href=\"https:\/\/cdn.jotfor.ms\/wizards\/languageWizard\/custom-dropdown\/css\/lang-dd.css?3.3.38897\" \/> <div class=\"cont\"><input type=\"text\" id=\"input_language\" name=\"input_language\" style=\"display:none\" \/> <div class=\"language-dd\" id=\"langDd\" style=\"display:none\"> <div class=\"dd-placeholder lang-emp\">Language<\/div> <ul class=\"lang-list dn\" id=\"langList\"> <li data-lang=\"en\" class=\"en\">English (US)<\/li> <li data-lang=\"de-DE\" class=\"de-DE\">German (Germany)<\/li> <\/ul> <\/div> <\/div> <script type=\"text\/javascript\" src=\"https:\/\/cdn.jotfor.ms\/js\/formTranslation.v2.js?3.3.38897\"><\/script> <style> .form-all:before { background: none; } <\/style> <ul class=\"form-section page-section\"> <li class=\"form-line form-line-column form-col-1\" data-type=\"control_image\" id=\"id_17\"> <div id=\"cid_17\" class=\"form-input-wide\" data-layout=\"full\"> <img decoding=\"async\" alt=\"Image\" loading=\"lazy\" class=\"form-image\" style=\"border:0\" src=\"https:\/\/www.jotform.com\/uploads\/benyimafarm\/form_files\/IMG_2108.63d30ad10c78f9.80438868.png\" tabindex=\"0\" height=\"279px\" width=\"131px\" data-component=\"image\" \/> <\/div> <\/li> <li class=\"form-line form-line-column form-col-2\" data-type=\"control_text\" id=\"id_18\"> <div id=\"cid_18\" class=\"form-input-wide\" data-layout=\"full\"> <div id=\"text_18\" class=\"form-html\" data-component=\"text\" tabindex=\"0\"> <div style=\"line-height: 18px; text-align: right; padding-top: 24px;\"> <div style=\"font-size: 12pt;\"><strong>BENYIMA FARMS LIMITED<\/strong><\/div> <div style=\"font-size: 10pt;\">JUICE UP,<\/div> <div style=\"font-size: 10pt;\">112 North Legon, Accra &#8211; Ghana<\/div> <div style=\"line-height: 14px;\"> <div style=\"font-size: 8pt;\">benyimafarm@gmail.com<\/div> <div style=\"font-size: 8pt;\"><a href=\"http:\/\/www.benyimafarms.com\" target=\"_blank\" rel=\"nofollow noopener\">www.benyimafarms.com<\/a><\/div> <div style=\"font-size: 8pt;\">www.juiceupjuice.com<\/div> <div style=\"font-size: 8pt;\">(233) 509 473 479<\/div> <\/div> <\/div> <\/div> <\/div> <\/li> <li id=\"cid_1\" class=\"form-input-wide\" data-type=\"control_head\"> <div class=\"form-header-group header-default\"> <div class=\"header-text httal htvam\"> <h2 id=\"header_1\" class=\"form-header\" data-component=\"header\">Customer Details:<\/h2> <\/div> <\/div> <\/li> <li class=\"form-line jf-required\" data-type=\"control_fullname\" id=\"id_3\"><label class=\"form-label form-label-top form-label-auto\" id=\"label_3\" for=\"first_3\"> Full Name<span class=\"form-required\">*<\/span> <\/label> <div id=\"cid_3\" class=\"form-input-wide jf-required\" data-layout=\"full\"> <div data-wrapper-react=\"true\"><span class=\"form-sub-label-container\" style=\"vertical-align:top\" data-input-type=\"first\"><input type=\"text\" id=\"first_3\" name=\"q3_fullName3[first]\" class=\"form-textbox validate[required]\" data-defaultvalue=\"\" autoComplete=\"section-input_3 given-name\" size=\"10\" value=\"\" data-component=\"first\" aria-labelledby=\"label_3 sublabel_3_first\" required=\"\" \/><label class=\"form-sub-label\" for=\"first_3\" id=\"sublabel_3_first\" style=\"min-height:13px\" aria-hidden=\"false\">First Name<\/label><\/span><span class=\"form-sub-label-container\" style=\"vertical-align:top\" data-input-type=\"last\"><input type=\"text\" id=\"last_3\" name=\"q3_fullName3[last]\" class=\"form-textbox validate[required]\" data-defaultvalue=\"\" autoComplete=\"section-input_3 family-name\" size=\"15\" value=\"\" data-component=\"last\" aria-labelledby=\"label_3 sublabel_3_last\" required=\"\" \/><label class=\"form-sub-label\" for=\"last_3\" id=\"sublabel_3_last\" style=\"min-height:13px\" aria-hidden=\"false\">Last Name<\/label><\/span><\/div> <\/div> <\/li> <li class=\"form-line\" data-type=\"control_address\" id=\"id_4\" data-compound-hint=\",,,,Please Select,,Please Select,\"><label class=\"form-label form-label-top form-label-auto\" id=\"label_4\" for=\"input_4_country\"> Address <\/label> <div id=\"cid_4\" class=\"form-input-wide\" data-layout=\"full\"> <div summary=\"\" class=\"form-address-table jsTest-addressField\"> <div class=\"form-address-line-wrapper jsTest-address-line-wrapperField\" style=\"display:none\"><span class=\"form-address-line form-address-street-line jsTest-address-lineField\"><span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input type=\"text\" id=\"input_4_addr_line1\" name=\"q4_address4[addr_line1]\" class=\"form-textbox form-address-line\" data-defaultvalue=\"\" autoComplete=\"section-input_4 address-line1\" value=\"\" data-component=\"address_line_1\" aria-labelledby=\"label_4 sublabel_4_addr_line1\" \/><label class=\"form-sub-label\" for=\"input_4_addr_line1\" id=\"sublabel_4_addr_line1\" style=\"min-height:13px\" aria-hidden=\"false\">Street Address<\/label><\/span><\/span><\/div> <div class=\"form-address-line-wrapper jsTest-address-line-wrapperField\" style=\"display:none\"><span class=\"form-address-line form-address-street-line jsTest-address-lineField\"><span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input type=\"text\" id=\"input_4_addr_line2\" name=\"q4_address4[addr_line2]\" class=\"form-textbox form-address-line\" data-defaultvalue=\"\" autoComplete=\"section-input_4 off\" value=\"\" data-component=\"address_line_2\" aria-labelledby=\"label_4 sublabel_4_addr_line2\" \/><label class=\"form-sub-label\" for=\"input_4_addr_line2\" id=\"sublabel_4_addr_line2\" style=\"min-height:13px\" aria-hidden=\"false\">Street Address Line 2<\/label><\/span><\/span><\/div> <div class=\"form-address-line-wrapper jsTest-address-line-wrapperField\" style=\"display:none\"><span class=\"form-address-line form-address-city-line jsTest-address-lineField form-address-hiddenLine\" style=\"display:none\"><span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input type=\"text\" id=\"input_4_city\" name=\"q4_address4[city]\" class=\"form-textbox form-address-city\" data-defaultvalue=\"\" autoComplete=\"section-input_4 address-level2\" value=\"\" data-component=\"city\" aria-labelledby=\"label_4 sublabel_4_city\" \/><label class=\"form-sub-label\" for=\"input_4_city\" id=\"sublabel_4_city\" style=\"min-height:13px\" aria-hidden=\"false\">City<\/label><\/span><\/span><span class=\"form-address-line form-address-state-line jsTest-address-lineField form-address-hiddenLine\" style=\"display:none\"><span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input type=\"text\" id=\"input_4_state\" name=\"q4_address4[state]\" class=\"form-textbox form-address-state\" data-defaultvalue=\"\" autoComplete=\"section-input_4 address-level1\" value=\"\" data-component=\"state\" aria-labelledby=\"label_4\" \/><\/span><\/span><\/div> <div class=\"form-address-line-wrapper jsTest-address-line-wrapperField\"><span class=\"form-address-line form-address-zip-line jsTest-address-lineField form-address-hiddenLine\" style=\"display:none\"><span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input type=\"text\" id=\"input_4_postal\" name=\"q4_address4[postal]\" class=\"form-textbox form-address-postal\" data-defaultvalue=\"\" autoComplete=\"section-input_4 postal-code\" value=\"\" data-component=\"zip\" aria-labelledby=\"label_4 sublabel_4_postal\" \/><label class=\"form-sub-label\" for=\"input_4_postal\" id=\"sublabel_4_postal\" style=\"min-height:13px\" aria-hidden=\"false\">Zip Code<\/label><\/span><\/span><span class=\"form-address-line form-address-country-line jsTest-address-lineField \"><span class=\"form-sub-label-container\" style=\"vertical-align:top\"><select class=\"form-dropdown form-address-country\" name=\"q4_address4[country]\" id=\"input_4_country\" data-component=\"country\" required=\"\" aria-labelledby=\"label_4 sublabel_4_country\" autoComplete=\"section-input_4 country\"> <option value=\"\">Please Select<\/option> <option value=\"United States\">United States<\/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=\"The Bahamas\">The 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=\"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 (Keeling) Islands\">Cocos (Keeling) Islands<\/option> <option value=\"Colombia\">Colombia<\/option> <option value=\"Comoros\">Comoros<\/option> <option value=\"Congo\">Congo<\/option> <option value=\"Cook Islands\">Cook Islands<\/option> <option value=\"Costa Rica\">Costa Rica<\/option> <option value=\"Cote d&#x27;Ivoire\">Cote d&#x27;Ivoire<\/option> <option value=\"Croatia\">Croatia<\/option> <option value=\"Cuba\">Cuba<\/option> <option value=\"Cura\u00e7ao\">Cura\u00e7ao<\/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=\"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=\"The Gambia\">The Gambia<\/option> <option value=\"Georgia\">Georgia<\/option> <option value=\"Germany\">Germany<\/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=\"Guadeloupe\">Guadeloupe<\/option> <option value=\"Guam\">Guam<\/option> <option value=\"Guatemala\">Guatemala<\/option> <option value=\"Guernsey\">Guernsey<\/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=\"Israel\">Israel<\/option> <option value=\"Italy\">Italy<\/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=\"North Korea\">North Korea<\/option> <option value=\"South Korea\">South Korea<\/option> <option value=\"Kosovo\">Kosovo<\/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=\"Macau\">Macau<\/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=\"Martinique\">Martinique<\/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=\"Nagorno-Karabakh\">Nagorno-Karabakh<\/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=\"Norfolk Island\">Norfolk Island<\/option> <option value=\"Turkish Republic of Northern Cyprus\">Turkish Republic of Northern Cyprus<\/option> <option value=\"Northern Mariana\">Northern Mariana<\/option> <option value=\"Norway\">Norway<\/option> <option value=\"Oman\">Oman<\/option> <option value=\"Pakistan\">Pakistan<\/option> <option value=\"Palau\">Palau<\/option> <option value=\"Palestine\">Palestine<\/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 Islands\">Pitcairn Islands<\/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=\"Somaliland\">Somaliland<\/option> <option value=\"South Africa\">South Africa<\/option> <option value=\"South Ossetia\">South Ossetia<\/option> <option value=\"South Sudan\">South Sudan<\/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\">Svalbard<\/option> <option value=\"eSwatini\">eSwatini<\/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=\"Timor-Leste\">Timor-Leste<\/option> <option value=\"Togo\">Togo<\/option> <option value=\"Tokelau\">Tokelau<\/option> <option value=\"Tonga\">Tonga<\/option> <option value=\"Transnistria Pridnestrovie\">Transnistria Pridnestrovie<\/option> <option value=\"Trinidad and Tobago\">Trinidad and Tobago<\/option> <option value=\"Tristan da Cunha\">Tristan da Cunha<\/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=\"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=\"Uruguay\">Uruguay<\/option> <option value=\"Uzbekistan\">Uzbekistan<\/option> <option value=\"Vanuatu\">Vanuatu<\/option> <option value=\"Vatican City\">Vatican City<\/option> <option value=\"Venezuela\">Venezuela<\/option> <option value=\"Vietnam\">Vietnam<\/option> <option value=\"British Virgin Islands\">British Virgin Islands<\/option> <option value=\"Isle of Man\">Isle of Man<\/option> <option value=\"US Virgin Islands\">US Virgin Islands<\/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> <option value=\"other\">Other<\/option> <\/select><label class=\"form-sub-label\" for=\"input_4_country\" id=\"sublabel_4_country\" style=\"min-height:13px\" aria-hidden=\"false\">Country<\/label><\/span><\/span><\/div> <\/div> <\/div> <\/li> <li class=\"form-line form-line-column form-col-1 jf-required\" data-type=\"control_phone\" id=\"id_5\"><label class=\"form-label form-label-top form-label-auto\" id=\"label_5\" for=\"input_5_full\"> Phone Number<span class=\"form-required\">*<\/span> <\/label> <div id=\"cid_5\" class=\"form-input-wide jf-required\" data-layout=\"half\"> <span class=\"form-sub-label-container\" style=\"vertical-align:top\"><input type=\"tel\" id=\"input_5_full\" name=\"q5_phoneNumber5[full]\" data-type=\"mask-number\" class=\"mask-phone-number form-textbox validate[required, Fill Mask]\" data-defaultvalue=\"\" autoComplete=\"section-input_5 tel-national\" style=\"width:310px\" data-masked=\"true\" value=\"\" placeholder=\"(000) 000-0000\" data-component=\"phone\" aria-labelledby=\"label_5\" required=\"\" \/><label class=\"form-sub-label is-empty\" for=\"input_5_full\" id=\"sublabel_5_masked\" style=\"min-height:13px\" aria-hidden=\"false\"><\/label><\/span> <\/div> <\/li> <li class=\"form-line form-line-column form-col-2\" data-type=\"control_email\" id=\"id_6\"><label class=\"form-label form-label-top form-label-auto\" id=\"label_6\" for=\"input_6\"> E-mail <\/label> <div id=\"cid_6\" class=\"form-input-wide\" data-layout=\"half\"> <input type=\"email\" id=\"input_6\" name=\"q6_email6\" class=\"form-textbox validate[Email]\" data-defaultvalue=\"\" style=\"width:310px\" size=\"310\" value=\"\" placeholder=\"ex: email@yahoo.com\" data-component=\"email\" aria-labelledby=\"label_6\" \/> <\/div> <\/li> <li class=\"form-line\" data-type=\"control_divider\" id=\"id_16\"> <div id=\"cid_16\" class=\"form-input-wide\" data-layout=\"full\"> <div class=\"divider\" data-component=\"divider\" style=\"border-bottom-width:1px;border-bottom-style:solid;border-color:#ecedf3;height:1px;margin-left:0px;margin-right:0px;margin-top:5px;margin-bottom:5px\"><\/div> <\/div> <\/li> <li class=\"form-line\" data-type=\"control_textarea\" id=\"id_11\"><label class=\"form-label form-label-top form-label-auto\" id=\"label_11\" for=\"input_11\"> Feedback about us: <\/label> <div id=\"cid_11\" class=\"form-input-wide\" data-layout=\"full\"> <textarea id=\"input_11\" class=\"form-textarea\" name=\"q11_feedbackAbout11\" style=\"width:648px;height:163px\" data-component=\"textarea\" aria-labelledby=\"label_11\"><\/textarea> <\/div> <\/li> <li class=\"form-line\" data-type=\"control_button\" id=\"id_2\"> <div id=\"cid_2\" class=\"form-input-wide\" data-layout=\"full\"> <div data-align=\"center\" class=\"form-buttons-wrapper form-buttons-center jsTest-button-wrapperField\"><button id=\"input_2\" type=\"submit\" class=\"form-submit-button form-submit-button-black_blue submit-button jf-form-buttons jsTest-submitField\" data-component=\"button\" data-content=\"\">Submit<\/button><\/div> <\/div> <\/li> <li style=\"display:none\">Should be Empty: <input type=\"text\" name=\"website\" value=\"\" \/><\/li> <\/ul> <\/div> <script> JotForm.showJotFormPowered = \"new_footer\"; <\/script> <script> JotForm.poweredByText = \"Powered by Jotform\"; <\/script><input type=\"hidden\" class=\"simple_spc\" id=\"simple_spc\" name=\"simple_spc\" value=\"230257348975567\" \/> <script type=\"text\/javascript\"> var all_spc = document.querySelectorAll(\"form[id='230257348975567'] .si\" + \"mple\" + \"_spc\"); for (var i = 0; i < all_spc.length; i++) { all_spc[i].value = \"230257348975567-230257348975567\"; }  <script src=\"https:\/\/cdn.jotfor.ms\/\/js\/errorNavigation.js?v=3.3.38897\"><\/script>\n","protected":false},"excerpt":{"rendered":"<p>Language English (US) German (Germany) BENYIMA FARMS LIMITED JUICE UP, 112 North Legon, Accra &#8211; Ghana benyimafarm@gmail.com www.benyimafarms.com www.juiceupjuice.com (233) 509 473 479 Customer Details: Full Name* First NameLast Name Address Street Address Street Address Line 2 City Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-2030","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/juiceupjuice.com\/index.php\/wp-json\/wp\/v2\/pages\/2030","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/juiceupjuice.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/juiceupjuice.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/juiceupjuice.com\/index.php\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/juiceupjuice.com\/index.php\/wp-json\/wp\/v2\/comments?post=2030"}],"version-history":[{"count":2,"href":"https:\/\/juiceupjuice.com\/index.php\/wp-json\/wp\/v2\/pages\/2030\/revisions"}],"predecessor-version":[{"id":2032,"href":"https:\/\/juiceupjuice.com\/index.php\/wp-json\/wp\/v2\/pages\/2030\/revisions\/2032"}],"wp:attachment":[{"href":"https:\/\/juiceupjuice.com\/index.php\/wp-json\/wp\/v2\/media?parent=2030"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}