<div class="page page-signup no-toolbar" data-name="signup">
  <div class="navbar navbar-large">
    <div class="navbar-bg">
    </div>
    <div class="navbar-inner">
      <div class="title">SignUp</div>
      <div class="title-large">
        <div class="title-large-text">SignUp</div>
      </div>
      <div class="right">
      </div>
    </div>
  </div>
  <div class="page-content">
    <form class="mt-40">
      <label for="username">Username/email</label>
      <input type="text" id="reg_email" name="username" placeholder="Username">
      <div class="grid grid-cols-2 grid-gap grid-no-margin">
        <div>
          <label for="firstname">First Name</label>
          <input type="text" id="reg_firstname" name="firstname" placeholder="John">
        </div>
        <div>
          <label for="lastname">Last Name</label>
          <input type="text" id="reg_lastname" name="lastname" placeholder="Doe">
        </div>
      </div>
      <label for="reg_phone">Phone/WhatsApp</label>
      <input type="text" id="reg_phone" placeholder="Phone/WhatsApp">
      <label for="password">Password</label>
      <input type="password" id="reg_password" name="password" placeholder="Strong Password">
      <label for="password-2">Repeat Password</label>
      <input type="password" id="reg_confirmpwd" name="password-2" placeholder="Repeat">
      <p>
        <label class="checkbox checkbox-inline">
          <input id="terms" value="1" type="checkbox" checked="checked">
          <i class="icon-checkbox"></i>
        </label>Accept Terms & Conditions</p>
      <a href="#" id="signup_button" class="btn btn-primary btn-block fw-700">Save</a>
    </form>
    <p class="grid grid-cols-2 grid-gap grid-buttons-demo mt-15">
      <a href="/password_forgot/" class="btn btn-primary">Forgot Password</a>
      <a href="/signin/" class="btn btn-info">SignIn</a>
    </p>
  </div>
</div>