\n\t\t\t\t\t

\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t*<\/span> \u0648\u0636\u0639 \u0627\u0644\u062d\u0627\u0644\u0629:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t

<\/textarea>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t<\/div>\n<hr><BR><BR>\n  <hr>  <hr>\n\n\n\n <h4 color=\"blue\" style=\"text-align: center;\">\u062a\u0641\u0627\u0635\u064a\u0644 \u0627\u0644\u0633\u0643\u0646 \u0648\u0627\u0644\u0647\u0627\u062a\u0641<\/h4>\n  <hr>\n\t\t<div class=\"wlsm-form-section\">\n\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t    \n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_country\" class=\"wlsm-font-bold\">\n\t\t\t\t\t        \u0627\u0644\u0628\u0644\u062f:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t\t\t\t\t<select name=\"country\" class=\"form-control selectpicker\" id=\"wlsm_country\">\n\t\t\t\t\t\t\t<option value=\"\">\u0625\u062e\u062a\u0631 \u0627\u0644\u0628\u0644\u062f<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"3\">\u0627\u0644\u0639\u0631\u0627\u0642<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"4\">Australia<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"5\">\u0625\u064a\u0631\u0627\u0646<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"6\">\u0644\u0628\u0646\u0627\u0646<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"7\">\u0633\u0648\u0631\u064a\u0627<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"8\">\u0641\u0644\u0633\u0637\u064a\u0646<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/select>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t        <div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_city\" class=\"wlsm-font-bold\">\n\t\t\t\t\t        \u0627\u0644\u0645\u062d\u0627\u0641\u0638\u0629:\n\t\t\t\t\t\t<\/label>\n                        \n\t\t\t\t\t\t<select name=\"city\" class=\"wlsm-form-control\" id=\"wlsm_city\">\n\t\t\t\t\t\t\t<option>\u0625\u062e\u062a\u0631 \u0627\u0644\u0645\u062d\u0627\u0641\u0638\u0629<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"3\">\u0630\u064a \u0642\u0627\u0631<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"4\">\u0628\u063a\u062f\u0627\u062f<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"5\">\u0627\u0644\u0646\u062c\u0641<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"6\">\u0643\u0631\u0628\u0644\u0627\u0621<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"7\">\u0627\u0644\u0628\u0635\u0631\u0629<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"8\">\u0648\u0627\u0633\u0637<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"9\">\u0627\u0644\u062f\u064a\u0648\u0627\u0646\u064a\u0629<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"10\">\u0627\u0644\u0645\u062b\u0646\u0649<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"12\">\u0645\u064a\u0633\u0627\u0646<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/select>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_accomodation\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0646\u0648\u0639 \u0627\u0644\u0633\u0643\u0646:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<select name=\"accomodation\" class=\"wlsm-form-control selectpicker\" id=\"wlsm_accomodation\">\n                            <option value=\"\">\u0625\u062e\u062a\u0631 \u0646\u0648\u0639 \u0627\u0644\u0633\u0643\u0646<\/option>\n                            \t\t\t\t\t\t\t\t<option value=\"1\">\u0645\u0644\u0643<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"2\">\u0627\u064a\u062c\u0627\u0631<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"3\">\u062a\u062c\u0627\u0648\u0632<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"5\">\u0645\u0639 \u0627\u0644\u0623\u0647\u0644 \u0623\u0648 \u0627\u0644\u0623\u0642\u0627\u0631\u0628<\/option>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<option value=\"6\">\u0633\u0643\u0646 \u0632\u0631\u0627\u0639\u064a<\/option>\n\t\t\t\t\t\t\t                        <\/select>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4 wlom_accomodation_other\">\n\t\t\t\t\t\t<label for=\"wlsm_specify_accomodation\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u062d\u062f\u062f \u0646\u0648\u0639 \u0627\u0644\u0633\u0643\u0646:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input type=\"text\" name=\"specify_accomodation\" class=\"wlsm-form-control selectpicker\" id=\"wlsm_specify_accomodation\" placeholder=\"\u062d\u062f\u062f \u0646\u0648\u0639 \u0627\u0644\u0633\u0643\u0646\">\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\n                    <div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_suburb\" size=\"150\">\n\t\t\t\t\t        \u0627\u0644\u0646\u0627\u062d\u064a\u0629 \u0648\u0627\u0644\u0642\u0636\u0627\u0621:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input type=\"text\" name=\"suburb\" class=\"wlsm-form-control\" id=\"wlsm_suburb\" placeholder=\"\u0627\u062f\u062e\u0644 \u0627\u0644\u0645\u062d\u0644\u0629 \u0648\u0627\u0644\u0642\u0636\u0627\u0621\">\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_nearest_point\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\u0623\u0642\u0631\u0628 \u0646\u0642\u0637\u0629 \u062f\u0627\u0644\u0629:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input type=\"text\" name=\"nearest_point\"  size=\"100\" id=\"wlsm_nearest_point\" placeholder=\"\u0623\u0643\u062a\u0628 \u0627\u0642\u0631\u0628 \u0646\u0642\u0637\u0629 \u062f\u0627\u0644\u0629\">\n\t\t\t\t\t<\/div>\n                <\/div>\t\n\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t  <div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_phone_1\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\u0631\u0642\u0645 \u0627\u0644\u0647\u0627\u062a\u0641 \u0627\u0644\u0627\u0648\u0644:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input type=\"text\" name=\"phone_1\" class=\"wlsm-form-control\" id=\"wlsm_phone_1\" placeholder=\"\u0627\u062f\u062e\u0644 \u0627\u0644\u0631\u0642\u0645\">\n\t\t\t\t\t\t<\/div>\n\t\t            <div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_phone_2\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\u0631\u0642\u0645 \u0647\u0627\u062a\u0641 \u0627\u062e\u0631:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input type=\"text\" name=\"phone_2\" class=\"wlsm-form-control\" id=\"wlsm_phone_2\" placeholder=\"\u0627\u062f\u062e\u0644 \u0627\u0644\u0631\u0642\u0645\">\n\t\t\t\t\t<\/div>\n\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\n<hr><BR><BR>\n\n\n     <h4  style=\"text-align: center;\">\u0627\u0644\u062a\u0641\u0627\u0635\u0640\u0640\u0640\u0640\u0640\u0640\u0640\u0640\u064a\u0644 \u0627\u0644\u0645\u0635\u0631\u0641\u064a\u0629<\/h4>\n  <hr>\n         \t<div class=\"wlsm-form-section\">\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_bank_card\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0647\u0644 \u0644\u062f\u064a\u0643 \u0628\u0637\u0627\u0642\u0629 \u0645\u0635\u0631\u0641\u064a\u0629:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<select name=\"bank_card\" class=\"wlsm-form-control selectpicker\" id=\"wlsm_bank_card\">\n                            <option value=\"\">\u0625\u062e\u062a\u0631<\/option>\n                                                            <option value=\"yes\">\n                                    \u0646\u0639\u0645                                <\/option>\n                                                            <option value=\"no\">\n                                    \u0643\u0644\u0627                                <\/option>\n                                                    <\/select>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n                    <div class=\"wlsm-form-group wlsm-col-4 wlom_bank_detail\">\n\t\t\t\t\t\t<label for=\"wlsm_bank_card_number\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\u0631\u0642\u0645 \u0627\u0644\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u0628\u0646\u0643\u064a\u0629:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input type=\"text\" name=\"bank_card_no\" class=\"wlsm-form-control\" id=\"wlsm_bank_card_number\" placeholder=\"\u0625\u062f\u062e\u0644 \u0631\u0642\u0645 \u0627\u0644\u0628\u0637\u0627\u0642\u0629\" value=\"\">\n\t\t\t\t\t<\/div>\n\n                    <div class=\"wlsm-form-group wlsm-col-4 wlom_bank_detail\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_photo\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0627\u0644\u0635\u0641\u062d\u0629 \u0627\u0644\u0627\u0645\u0627\u0645\u064a\u0629 \u0645\u0646 \u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u0645\u0635\u0631\u0641:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_photo\" name=\"photo\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4 wlom_bank_detail\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_photo_2\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0627\u0644\u0635\u0641\u062d\u0629 \u0627\u0644\u062e\u0644\u0641\u064a\u0629 \u0645\u0646 \u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u0645\u0635\u0631\u0641:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_photo_2\" name=\"photo_2\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n<hr><BR><BR>\n\n\n\n\n     <h4  style=\"text-align: center;\">\u062a\u0641\u0627\u0635\u0640\u0640\u0640\u0640\u0640\u0640\u0640\u0640\u064a\u0644 \u0623\u0641\u0631\u0627\u062f \u0627\u0644\u0623\u0633\u0631\u0629<\/h4>\n        <hr> <hr>\n  \n\t\t<div class=\"wlsm-form-section\">\n\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_no_of_kids\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0639\u062f\u062f \u0623\u0641\u0631\u0627\u062f \u0627\u0644\u0623\u0633\u0631\u0629:\n\t\t\t\t\t\t<\/label>\n                        \n\t\t\t\t\t\t<select name=\"no_of_kids\" class=\"wlsm-form-control selectpicker\" id=\"wlsm_no_of_kids\">\n\t\t\t\t\t\t<option value=\"\">\u0625\u062e\u062a\u0631 \u0627\u0644\u0639\u062f\u062f<\/option>\n\t\t\t\t\t\t\t<option value=\"1\">1<\/option>\n\t\t\t\t\t\t\t<option value=\"2\">2<\/option>\n\t\t\t\t\t\t\t<option value=\"3\">3<\/option>\n\t\t\t\t\t\t\t<option value=\"4\">4<\/option>\n\t\t\t\t\t\t\t<option value=\"5\">5<\/option>\n\t\t\t\t\t\t\t<option value=\"6\">6<\/option>\n\t\t\t\t\t\t\t<option value=\"7\">7<\/option>\n\t\t\t\t\t\t\t<option value=\"8\">8<\/option>\n\t\t\t\t\t\t\t<option value=\"9\">9<\/option>\n\t\t\t\t\t\t\t<option value=\"10\">10<\/option>\n\t\t\t\t\t\t\t<option value=\"11\">11<\/option>\n\t\t\t\t\t\t\t<option value=\"12\">12<\/option>\n\t\t\t\t\t\t\t<option value=\"13\">13<\/option>\n\t\t\t\t\t\t\t<option value=\"14\">14<\/option>\n\t\t\t\t\t\t\t<option value=\"15\">15<\/option>\t\n\t\t\t\t\t\t<\/select>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div id=\"kids-fields-container\"><\/div>\n\t\t\t<\/div>\n<hr><BR><BR>\n\n\t\t\t\n        \n     <h4  style=\"text-align: center;\">\u062a\u0641\u0627\u0635\u0640\u0640\u0640\u0640\u0640\u0640\u0640\u0640\u064a\u0644 \u0627\u0644\u062f\u062e\u0644 \u0627\u0644\u0634\u0647\u0631\u064a<\/h4>\n        <hr>\n  \n\t\t\t<div class=\"wlsm-form-section\">\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_no_of_incomes\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0639\u062f\u062f \u0645\u0635\u0627\u062f\u0631 \u0627\u0644\u062f\u062e\u0644(\u0631\u0648\u0627\u062a\u0628 \u0627\u0648 \u0639\u0645\u0644):\n\t\t\t\t\t\t<\/label>\n                        \n\t\t\t\t\t\t<select name=\"no_of_incomes\" class=\"wlsm-form-control selectpicker\" id=\"wlsm_no_of_incomes\">\n\t\t\t\t\t\t\t<option value=\"\">\u0625\u062e\u062a\u0631<\/option>\n\t\t\t\t\t\t\t<option value=\"\">0<\/option>\n\t\t\t\t\t\t\t<option value=\"1\">1<\/option>\n\t\t\t\t\t\t\t<option value=\"2\">2<\/option>\n\t\t\t\t\t\t\t<option value=\"3\">3<\/option>\n\t\t\t\t\t\t\t<option value=\"4\">4<\/option>\n\t\t\t\t\t\t\t<option value=\"5\">5<\/option>\n\t\t\t\t\t\t\t<option value=\"6\">6<\/option>\n\t\t\t\t\t\t\t<option value=\"7\">7<\/option>\n\t\t\t\t\t\t\t<option value=\"8\">8<\/option>\n\t\t\t\t\t\t\t<option value=\"9\">9<\/option>\n\t\t\t\t\t\t\t<option value=\"10\">10<\/option>\n\t\t\t\t\t\t\t<option value=\"11\">11<\/option>\n\t\t\t\t\t\t\t<option value=\"12\">12<\/option>\n\t\t\t\t\t\t\t<option value=\"13\">13<\/option>\n\t\t\t\t\t\t\t<option value=\"14\">14<\/option>\n\t\t\t\t\t\t\t<option value=\"15\">15<\/option>\n\t\t\t\t\t\t<\/select>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div id=\"incomes-fields-container\"><\/div>\n\t\t\t<\/div>\n<hr><BR><BR>\n\n\n\n     <h4  style=\"text-align: center;\">\u062a\u0641\u0627\u0635\u0640\u0640\u0640\u0640\u0640\u0640\u0640\u0640\u064a\u0644 \u0627\u0644\u0645\u0635\u0627\u0631\u064a\u0641 \u0627\u0644\u0634\u0647\u0631\u064a\u0629 \u0627\u0644\u062b\u0627\u0628\u062a\u0629<\/h4>\n        <hr> <hr>\n        \n    \t<div class=\"wlsm-form-section\">\n\t\t\t\t\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"wlsm_no_of_expenses\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0639\u062f\u062f \u0627\u0644\u0645\u0635\u0627\u0631\u064a\u0641 \u0627\u0644\u062b\u0627\u0628\u062a\u0629:\n\t\t\t\t\t\t<\/label>\n                        \n\t\t\t\t\t\t<select name=\"no_of_expenses\" class=\"wlsm-form-control selectpicker\" id=\"wlsm_no_of_expenses\">\n\t\t\t\t\t\t\t<option value=\"\">\u0625\u062e\u062a\u0631<\/option>\n\t\t\t\t\t\t\t<option value=\"\">0<\/option>\n\t\t\t\t\t\t\t<option value=\"1\">1<\/option>\n\t\t\t\t\t\t\t<option value=\"2\">2<\/option>\n\t\t\t\t\t\t\t<option value=\"3\">3<\/option>\n\t\t\t\t\t\t\t<option value=\"4\">4<\/option>\n\t\t\t\t\t\t\t<option value=\"5\">5<\/option>\n\t\t\t\t\t\t\t<option value=\"6\">6<\/option>\n\t\t\t\t\t\t\t<option value=\"7\">7<\/option>\n\t\t\t\t\t\t\t<option value=\"8\">8<\/option>\n\t\t\t\t\t\t\t<option value=\"9\">9<\/option>\n\t\t\t\t\t\t\t<option value=\"10\">10<\/option>\n\t\t\t\t\t\t\t<option value=\"11\">11<\/option>\n\t\t\t\t\t\t\t<option value=\"12\">12<\/option>\n\t\t\t\t\t\t\t<option value=\"13\">13<\/option>\n\t\t\t\t\t\t\t<option value=\"14\">14<\/option>\n\t\t\t\t\t\t\t<option value=\"15\">15<\/option>\n\t\t\t\t\t\t<\/select>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div id=\"expenses-fields-container\"><\/div>\n\t\t\t<\/div>\n<BR><BR><BR>\n\n\t\n    <h4  style=\"text-align:center;\">\u0627\u0644\u0628\u0637\u0627\u0642\u0627\u062a \u0627\u0644\u0648\u0637\u0646\u064a\u0629 \u0644\u062c\u0645\u064a\u0639 \u0623\u0641\u0631\u0627\u062f \u0627\u0644\u0623\u0633\u0631\u0629 (\u0627\u0644\u0648\u062c\u0647\u064a\u0646) \u0648\u0634\u0627\u062f\u0627\u062a \u0627\u0644\u0648\u0641\u0627\u0629 \u0648\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u0633\u0643\u0646 \u0648\u0627\u0644\u062a\u0642\u0627\u0631\u064a\u0631 \u0627\u0646 \u0648\u062c\u062f\u062a<\/h4>\n        <hr>   <hr> \n        \t<div class=\"wlsm-form-section\">\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_1\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 1:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_1\" name=\"doc_1\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_2\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 2:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_2\" name=\"doc_2\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_3\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 3:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_3\" name=\"doc_3\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_4\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 4:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_4\" name=\"doc_4\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_5\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 5:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_5\" name=\"doc_5\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_6\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 6:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_6\" name=\"doc_6\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_7\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 7:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_7\" name=\"doc_7\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_8\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 8:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_8\" name=\"doc_8\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_9\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 9:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_9\" name=\"doc_9\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_10\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 10:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_10\" name=\"doc_10\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_11\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 11:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_11\" name=\"doc_11\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_12\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 12:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_12\" name=\"doc_12\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_13\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 13:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_13\" name=\"doc_13\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_14\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 14:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_14\" name=\"doc_14\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_15\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 15:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_15\" name=\"doc_15\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_16\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 16:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_16\" name=\"doc_16\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_17\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 17:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_17\" name=\"doc_17\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_18\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 18:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_18\" name=\"doc_18\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"wlsm-row\">\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_19\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 19:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_19\" name=\"doc_19\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<div class=\"wlsm-photo-box wlsm-mt-2\">\n\t\t\t\t\t\t\t<div class=\"wlsm-photo-section\">\n\t\t\t\t\t\t\t\t<label for=\"wlsm_doc_20\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\t\t\u0627\u0644\u0648\u062b\u064a\u0642\u0629 20:\n\t\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"custom-file mb-3\">\n\t\t\t\t\t\t\t\t\t<input type=\"file\" class=\"custom-file-input\" id=\"wlsm_doc_20\" name=\"doc_20\">\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t\t\n            <div class=\"wlsm-border-top wlsm-pt-2 wlsm-mt-1\">\n                <button class=\"button wlsm-btn btn btn-primary\" type=\"submit\" id=\"wlom-submit-family-registration-btn\">\n                    \u0625\u0631\u0633\u0644 \u0627\u0644\u0637\u0644\u0628                <\/button>\n            <\/div>\n\t    <\/form>\n    <\/div>\n<\/div>\n\n<script>\n\t\/* Member *\/\n\tdocument.addEventListener('DOMContentLoaded', () => {\n\t\tconst noOfKidsInput = document.getElementById('wlsm_no_of_kids');\n\t\tconst kidsFieldsContainer = document.getElementById('kids-fields-container');\n\n\t\tnoOfKidsInput.addEventListener('input', () => {\n\t\t\tconst numberOfKids = parseInt(noOfKidsInput.value);\n\t\t\tkidsFieldsContainer.innerHTML = ''; \/\/ Clear previous fields\n\n\t\t\tif (isNaN(numberOfKids) || numberOfKids <= 0) {\n\t\t\t\treturn; \/\/ Do nothing if input is invalid or zero\n\t\t\t}\n\n\t\t\tfor (let i = 1; i <= numberOfKids; i++) {\n\t\t\t\tconst kidField = document.createElement('div');\n\t\t\t\tkidField.classList.add('wlsm-row', 'kid-field');\n\n\t\t\t\tkidField.innerHTML = `\t\t\t\t\t\n\t\t\t\t\t<div class=\"wlsm-col-12\">\n\t\t\t\t\t\t<h5>Member ${i}<\/h5>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-6\">\n\t\t\t\t\t\t<label for=\"kid_name_${i}\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0627\u0644\u0627\u0633\u0645 \u0627\u0644\u0643\u0627\u0645\u0644 :\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input type=\"text\" name=\"kid_name_${i}\" class=\"wlsm-form-control\" id=\"kid_name_${i}\" placeholder=\"\u0625\u062f\u062e\u0644 \u0627\u0644\u0627\u0633\u0645 \u0627\u0644\u062b\u0644\u0627\u062b\u064a\">\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-6\">\n\t\t\t\t\t\t<label for=\"kid_dob_${i}\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\u062a\u0623\u0631\u064a\u062e \u0627\u0644\u0645\u064a\u0644\u0627\u062f :\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input type=\"date\" name=\"kid_dob_${i}\" class=\"wlsm-form-control\" id=\"kid_dob_${i}\">\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-6\">\n\t\t\t\t\t\t<label for=\"kid_comment_${i}\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\u0627\u0644\u0645\u0644\u0627\u062d\u0638\u0627\u062a :\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea name=\"kid_comment_${i}\" class=\"wlsm-form-control\" id=\"kid_comment_${i}\" rows=\"2\" placeholder=\"\u0625\u062f\u062e\u0644 \u0627\u0644\u0645\u0644\u0627\u062d\u0638\u0627\u062a\"><\/textarea>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-6\">\n\t\t\t\t\t\t<label class=\"wlsm-font-bold\" for=\"wlsm_gender_${i}\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0627\u0644\u062c\u0646\u0633:\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<br>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wlsm-form-check wlsm-form-check-inline\">\n\t\t\t\t\t\t\t<input class=\"wlsm-form-check-input\" type=\"radio\" name=\"kid_gender_${i}\" id=\"wlsm_gender__${i}\" value=\"male\"  checked='checked'>\n\t\t\t\t\t\t\t<label class=\"ml-1 wlsm-form-check-label wlsm-font-bold\" for=\"wlsm_gender_${i}\">\u0630\u0643\u0631<\/label>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wlsm-form-check wlsm-form-check-inline\">\n\t\t\t\t\t\t\t<input class=\"wlsm-form-check-input\" type=\"radio\" name=\"kid_gender_${i}\" id=\"wlsm_gender__${i}\" value=\"female\" >\n\t\t\t\t\t\t\t<label class=\"ml-1 wlsm-form-check-label wlsm-font-bold\" for=\"wlsm_gender_${i}\">\u0623\u0646\u062b\u0649<\/label>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t`;\n\t\t\t\tkidsFieldsContainer.appendChild(kidField);\n\t\t\t}\n\t\t});\n\t});\n\n\t\/* Income *\/\n\tdocument.addEventListener('DOMContentLoaded', () => {\n\t\tconst noOfIncomesInput = document.getElementById('wlsm_no_of_incomes');\n\t\tconst incomesFieldsContainer = document.getElementById('incomes-fields-container');\n\n\t\tconst customIncomeNames = [{\"ID\":\"1\",\"label\":\"\\u0631\\u0627\\u062a\\u0628 \\u0631\\u0639\\u0627\\u064a\\u0629\"},{\"ID\":\"2\",\"label\":\"\\u0631\\u0627\\u062a\\u0628 \\u0627\\u0644\\u0645\\u0639\\u064a\\u0644\"},{\"ID\":\"3\",\"label\":\"\\u0631\\u0627\\u062a\\u0628 \\u062a\\u0642\\u0627\\u0639\\u062f\"},{\"ID\":\"4\",\"label\":\"\\u0631\\u0627\\u062a\\u0628 \\u0645\\u0646 \\u0645\\u0624\\u0633\\u0633\\u0629 \\u0639\\u064a\\u0646\"},{\"ID\":\"5\",\"label\":\"\\u062f\\u062e\\u0644 \\u0645\\u0646 \\u0627\\u0644\\u0639\\u0645\\u0644 \\u0627\\u0648 \\u0627\\u0644\\u062a\\u062c\\u0627\\u0631\\u0629\"},{\"ID\":\"6\",\"label\":\"\\u062f\\u062e\\u0644 \\u0645\\u0646 \\u0645\\u0624\\u0633\\u0633\\u0629 \\u0623\\u062e\\u0631\\u0649\"},{\"ID\":\"7\",\"label\":\"\\u0631\\u0627\\u062a\\u0628 \\u062d\\u0643\\u0648\\u0645\\u064a \\u0627\\u062e\\u0631\"},{\"ID\":\"8\",\"label\":\"\\u0645\\u0646 \\u0627\\u0644\\u0623\\u0647\\u0644 \\u0627\\u0648 \\u0645\\u0646 \\u062c\\u0647\\u0629 \\u0623\\u062e\\u0631\\u0649\"}];\n\n\t\tnoOfIncomesInput.addEventListener('input', () => {\n\t\t\tconst numberOfIncomes = parseInt(noOfIncomesInput.value);\n\t\t\tincomesFieldsContainer.innerHTML = ''; \/\/ Clear previous fields\n\n\t\t\tif (isNaN(numberOfIncomes) || numberOfIncomes <= 0) {\n\t\t\t\treturn; \/\/ Do nothing if input is invalid or zero\n\t\t\t}\n\n\t\t\tfor (let i = 1; i <= numberOfIncomes; i++) {\n\t\t\t\tconst incomeField = document.createElement('div');\n\t\t\t\tincomeField.classList.add('wlsm-row', 'income-field');\n\n\t\t\t\t\/\/ Generate the dropdown options dynamically\n\t\t\t\tconst incomeOptions = customIncomeNames\n\t\t\t\t\t.map(income => `<option value=\"${income.id}\">${income.label}<\/option>`)\n\t\t\t\t\t.join('');\n\n\t\t\t\tincomeField.innerHTML = `\t\t\t\t\t\n\t\t\t\t\t<div class=\"wlsm-col-12\">\n\t\t\t\t\t\t<h5>\u0627\u0644\u062f\u062e\u0640\u0640\u0640\u0640\u0640\u0640\u0644 ${i}<\/h5>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"income_name_${i}\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0646\u0648\u0639 \u0627\u0644\u062f\u062e\u0644 :\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<select name=\"income_name_${i}\" class=\"wlsm-form-control\" id=\"income_name_${i}\">\n\t\t\t\t\t\t\t<option value=\"\">\u0625\u062e\u062a\u0631 \u0646\u0648\u0639 \u0627\u0644\u062f\u062e\u0644<\/option>\n\t\t\t\t\t\t\t${incomeOptions}\n\t\t\t\t\t\t<\/select>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"income_amount_${i}\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0627\u0644\u0645\u0628\u0644\u063a \u0628\u062f\u0648\u0646 \u0627\u0635\u0641\u0627\u0631(\u0645\u062b\u0627\u0644 120) :\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input type=\"text\" name=\"income_amount_${i}\" class=\"wlsm-form-control\" id=\"income_amount_${i}\" placeholder=\"\u0627\u0643\u062a\u0628 \u0627\u0644\u0645\u0628\u0644\u063a\">\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"income_description_${i}\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\u0627\u0644\u0645\u0644\u0627\u062d\u0638\u0627\u062a :\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea name=\"income_description_${i}\" class=\"wlsm-form-control\" id=\"income_description_${i}\" rows=\"2\" placeholder=\"\u0625\u062f\u062e\u0644 \u0627\u0644\u0645\u0644\u0627\u062d\u0638\u0627\u062a\"><\/textarea>\n\t\t\t\t\t<\/div>\n\t\t\t\t`;\n\t\t\t\tincomesFieldsContainer.appendChild(incomeField);\n\t\t\t}\n\t\t});\n\t});\n\n\t\/* Expense *\/\n\tdocument.addEventListener('DOMContentLoaded', () => {\n\t\tconst noOfExpensesInput = document.getElementById('wlsm_no_of_expenses');\n\t\tconst expensesFieldsContainer = document.getElementById('expenses-fields-container');\n\n\t\tconst customExpenseNames = [{\"ID\":\"1\",\"label\":\"\\u0627\\u064a\\u062c\\u0627\\u0631\"},{\"ID\":\"2\",\"label\":\"\\u0639\\u0644\\u0627\\u062c\"},{\"ID\":\"3\",\"label\":\"\\u062f\\u0641\\u0639 \\u0627\\u0642\\u0633\\u0627\\u0637 \\u0634\\u0647\\u0631\\u064a\\u0629\"},{\"ID\":\"4\",\"label\":\"\\u0645\\u0635\\u0627\\u0631\\u064a\\u0641 \\u0627\\u062e\\u0631\\u0649 - \\u0648\\u0636\\u0651\\u062d\\u061f\"}];\n\n\t\tnoOfExpensesInput.addEventListener('input', () => {\n\t\t\tconst numberOfExpenses = parseInt(noOfExpensesInput.value);\n\t\t\texpensesFieldsContainer.innerHTML = ''; \/\/ Clear previous fields\n\n\t\t\tif (isNaN(numberOfExpenses) || numberOfExpenses <= 0) {\n\t\t\t\treturn; \/\/ Do nothing if input is invalid or zero\n\t\t\t}\n\n\t\t\tfor (let i = 1; i <= numberOfExpenses; i++) {\n\t\t\t\tconst expenseField = document.createElement('div');\n\t\t\t\texpenseField.classList.add('wlsm-row', 'expense-field');\n\n\t\t\t\t\/\/ Generate the dropdown options dynamically\n\t\t\t\tconst expenseOptions = customExpenseNames\n\t\t\t\t\t.map(expense => `<option value=\"${expense.id}\">${expense.label}<\/option>`)\n\t\t\t\t\t.join('');\n\n\t\t\t\texpenseField.innerHTML = `\t\t\t\t\t\n\t\t\t\t\t<div class=\"wlsm-col-12\">\n\t\t\t\t\t\t<h5>\u0627\u0644\u0645\u0635\u0631\u0641 \u0627\u0644\u0634\u0647\u0631 \u0627\u0644\u0645\u0646\u062a\u0638\u0645 ${i}<\/h5>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"expense_name_${i}\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0627\u0644\u0645\u0635\u0631\u0641 :\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<select name=\"expense_name_${i}\" class=\"wlsm-form-control\" id=\"expense_name_${i}\">\n\t\t\t\t\t\t\t<option value=\"\">\u0627\u062e\u062a\u0631 \u0646\u0648\u0639 \u0627\u0644\u0645\u0635\u0631\u0648\u0641<\/option>\n\t\t\t\t\t\t\t${expenseOptions}\n\t\t\t\t\t\t<\/select>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"expense_amount_${i}\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> \u0627\u0644\u0645\u0628\u0644\u063a \u0628\u062f\u0648\u0646 \u0627\u0635\u0641\u0627\u0631 (\u0645\u062b\u0627\u0644 70)\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<input type=\"text\" name=\"expense_amount_${i}\" class=\"wlsm-form-control\" id=\"expense_amount_${i}\" placeholder=\"\u0627\u0644\u0645\u0628\u0644\u063a\">\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\t\t\t\t\t<label for=\"expense_description_${i}\" class=\"wlsm-font-bold\">\n\t\t\t\t\t\t\t\u0627\u0644\u0645\u0644\u0627\u062d\u0638\u0627\u062a :\n\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea name=\"expense_description_${i}\" class=\"wlsm-form-control\" id=\"expense_description_${i}\" rows=\"2\" placeholder=\"\u0627\u0644\u0645\u0644\u0627\u062d\u0638\u0627\u062a\"><\/textarea>\n\t\t\t\t\t<\/div>\n\t\t\t\t`;\n\t\t\t\texpensesFieldsContainer.appendChild(expenseField);\n\t\t\t}\n\t\t});\n\t});\n\n\n\t\/* Accomodation *\/\n\t\/\/ document.addEventListener('DOMContentLoaded', () => {\n\t\/\/ \tconst noOfAccomodationsInput = document.getElementById('wlsm_no_of_accomodations');\n\t\/\/ \tconst accomodationsFieldsContainer = document.getElementById('accomodations-fields-container');\n\n\t\/\/ \tnoOfAccomodationsInput.addEventListener('input', () => {\n\t\/\/ \t\tconst numberOfAccomodations = parseInt(noOfAccomodationsInput.value);\n\t\/\/ \t\taccomodationsFieldsContainer.innerHTML = ''; \/\/ Clear previous fields\n\n\t\/\/ \t\tif (isNaN(numberOfAccomodations) || numberOfAccomodations <= 0) {\n\t\/\/ \t\t\treturn; \/\/ Do nothing if input is invalid or zero\n\t\/\/ \t\t}\n\n\t\/\/ \t\tfor (let i = 1; i <= numberOfAccomodations; i++) {\n\t\/\/ \t\t\tconst accomodationField = document.createElement('div');\n\t\/\/ \t\t\taccomodationField.classList.add('wlsm-row', 'accomodation-field');\n\n\t\/\/ \t\t\taccomodationField.innerHTML = `\t\t\t\t\t\n\t\/\/ \t\t\t\t<div class=\"wlsm-col-12\">\n\t\/\/ \t\t\t\t\t<h5>Accomodation ${i}<\/h5>\n\t\/\/ \t\t\t\t<\/div>\n\n\t\/\/ \t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\/\/ \t\t\t\t\t<label for=\"accomodation_name_${i}\" class=\"wlsm-font-bold\">\n\t\/\/ \t\t\t\t\t\t<span class=\"wlsm-important\">*<\/span> Name :\n\t\/\/ \t\t\t\t\t<\/label>\n\t\/\/ \t\t\t\t\t<input type=\"text\" name=\"accomodation_name_${i}\" class=\"wlsm-form-control\" id=\"accomodation_name_${i}\" placeholder=\"Enter accomodation name\">\n\t\/\/ \t\t\t\t<\/div>\n\n\t\/\/ \t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\/\/ \t\t\t\t\t<label for=\"accomodation_amount_${i}\" class=\"wlsm-font-bold\">\n\t\/\/ \t\t\t\t\t\tAmount :\n\t\/\/ \t\t\t\t\t<\/label>\n\t\/\/ \t\t\t\t\t<input type=\"text\" name=\"accomodation_amount_${i}\" class=\"wlsm-form-control\" id=\"accomodation_amount_${i}\" placeholder=\"Enter accomodation amount\">\n\t\/\/ \t\t\t\t<\/div>\n\n\t\/\/ \t\t\t\t<div class=\"wlsm-form-group wlsm-col-4\">\n\t\/\/ \t\t\t\t\t<label for=\"accomodation_description_${i}\" class=\"wlsm-font-bold\">\n\t\/\/ \t\t\t\t\t\tDescription :\n\t\/\/ \t\t\t\t\t<\/label>\n\t\/\/ \t\t\t\t\t<textarea name=\"accomodation_description_${i}\" class=\"wlsm-form-control\" id=\"accomodation_description_${i}\" rows=\"2\" placeholder=\"Enter accomodation description\"><\/textarea>\n\t\/\/ \t\t\t\t<\/div>\n\t\/\/ \t\t\t`;\n\t\/\/ \t\t\taccomodationsFieldsContainer.appendChild(accomodationField);\n\t\/\/ \t\t}\n\t\/\/ \t});\n\t\/\/ 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\u0637\u0644\u0628 \u0645\u0633\u0627\u0639\u062f\u0629 \u0644\u0645\u0631\u0629 \u0648\u0627\u062d\u062f\u0629 \u0623\u0648 \u0631\u0627\u062a\u0628 \u0645\u0633\u062a\u0645\u0631 \u0623\u0648 \u062a\u062d\u062f\u064a\u062b \u0628\u064a\u0627\u0646\u0627\u062a <\/h2>\n \n\n\n\t

\u0637\u0644\u0628 \u0645\u0633\u0627\u0639\u062f\u0629 \u0644\u0645\u0631\u0629 \u0648\u0627\u062d\u062f\u0629 \u0623\u0648 \u0631\u0627\u062a\u0628 \u0645\u0633\u062a\u0645\u0631 \u0623\u0648 \u062a\u062d\u062f\u064a\u062b \u0628\u064a\u0627\u0646\u0627\u062a <\/h2>\n

\n\n\n\t