{"id":787,"date":"2024-07-29T04:21:29","date_gmt":"2024-07-29T04:21:29","guid":{"rendered":"https:\/\/demo.iccbrossardmosque.com\/?page_id=787"},"modified":"2024-10-02T03:02:40","modified_gmt":"2024-10-02T03:02:40","slug":"membership-form","status":"publish","type":"page","link":"https:\/\/www.cdsbalimaya.org\/en\/membership-form\/","title":{"rendered":"Registration form for CDS Balimaya activities1"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"787\" class=\"elementor elementor-787\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5f7acfbc elementor-section-boxed elementor-section-height-default elementor-section-height-default elementor-invisible\" data-id=\"5f7acfbc\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;animation&quot;:&quot;fadeIn&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2cf1afb0\" data-id=\"2cf1afb0\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6fef86fb elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"6fef86fb\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_delay&quot;:300}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\">Registration form for CDS-Balimaya language activities\n<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-262af6f envato-kit-174-form-btn-style elementor-button-align-start elementor-invisible elementor-widget elementor-widget-form\" data-id=\"262af6f\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_delay&quot;:400,&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"New Form\" aria-label=\"New Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"787\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"262af6f\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Registration form for CDS Balimaya activities1\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"787\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFirst Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"First Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-lastname elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-lastname\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tLast Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[lastname]\" id=\"form-field-lastname\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"FIRST Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-gender elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-gender\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGender\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Man\/Boy\" id=\"form-field-gender-0\" name=\"form_fields[gender][]\"> <label for=\"form-field-gender-0\">Man\/Boy<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Woman\/Girl\" id=\"form-field-gender-1\" name=\"form_fields[gender][]\"> <label for=\"form-field-gender-1\">Woman\/Girl<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-dob elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-dob\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate Of Birth\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[dob]\" id=\"form-field-dob\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"yyyy-mm-dd\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-langu elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-langu\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tLanguage\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"French                      \" id=\"form-field-langu-0\" name=\"form_fields[langu][]\"> <label for=\"form-field-langu-0\">French                      <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"English\" id=\"form-field-langu-1\" name=\"form_fields[langu][]\"> <label for=\"form-field-langu-1\">English<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Arabic\" id=\"form-field-langu-2\" name=\"form_fields[langu][]\"> <label for=\"form-field-langu-2\">Arabic<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-other_langu elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-other_langu\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tOthers( Please Enter The Language Name )\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[other_langu]\" id=\"form-field-other_langu\" class=\"elementor-field elementor-size-lg  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-lang_type elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Writing\" id=\"form-field-lang_type-0\" name=\"form_fields[lang_type][]\"> <label for=\"form-field-lang_type-0\">Writing<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Speak\" id=\"form-field-lang_type-1\" name=\"form_fields[lang_type][]\"> <label for=\"form-field-lang_type-1\">Speak<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Read\" id=\"form-field-lang_type-2\" name=\"form_fields[lang_type][]\"> <label for=\"form-field-lang_type-2\">Read<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-fathernmae elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-fathernmae\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFather' Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[fathernmae]\" id=\"form-field-fathernmae\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"First and Last Name Of Father\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-mothername elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-mothername\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMother's Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[mothername]\" id=\"form-field-mothername\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"First and Last Name of Mother\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-address elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-address\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAddress\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[address]\" id=\"form-field-address\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Address\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-city elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-city\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCity\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[city]\" id=\"form-field-city\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"City\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-province elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-province\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProvince\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[province]\" id=\"form-field-province\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Province\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-zip elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-zip\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tZip Code\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[zip]\" id=\"form-field-zip\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Zip Code\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-homePhone elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-homePhone\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHome Phone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[homePhone]\" id=\"form-field-homePhone\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Home Phone\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-CellPhone elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-CellPhone\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCell Phone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[CellPhone]\" id=\"form-field-CellPhone\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Cell Phone\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Email\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-user elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-user\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tUser\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Ancient\" id=\"form-field-user-0\" name=\"form_fields[user][]\"> <label for=\"form-field-user-0\">Ancient<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"New\" id=\"form-field-user-1\" name=\"form_fields[user][]\"> <label for=\"form-field-user-1\">New<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-childage elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-childage\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tChild Age\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[childage]\" id=\"form-field-childage\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Child Age\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-adultage elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-adultage\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAdult Age\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[adultage]\" id=\"form-field-adultage\" class=\"elementor-field elementor-size-lg  elementor-field-textual\" placeholder=\"Adult Age\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-message elementor-col-80\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-message\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tmessage\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-lg\" name=\"form_fields[message]\" id=\"form-field-message\" rows=\"7\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha elementor-field-group elementor-column elementor-field-group-field_1e7e672 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_1e7e672\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LeNU-IoAAAAAAKBDlbkZbL1_V5J68Jku2Y5wkFi\" data-type=\"v2_checkbox\" data-theme=\"light\" data-size=\"normal\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-lg elementor-animation-bob\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t\t\t\t\t\t<i class=\"fa fa-long-arrow-right\" aria-hidden=\"true\"><\/i>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">submitt Your Registration<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Registration form for CDS-Balimaya language activities<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-787","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.cdsbalimaya.org\/en\/wp-json\/wp\/v2\/pages\/787"}],"collection":[{"href":"https:\/\/www.cdsbalimaya.org\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.cdsbalimaya.org\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.cdsbalimaya.org\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.cdsbalimaya.org\/en\/wp-json\/wp\/v2\/comments?post=787"}],"version-history":[{"count":100,"href":"https:\/\/www.cdsbalimaya.org\/en\/wp-json\/wp\/v2\/pages\/787\/revisions"}],"predecessor-version":[{"id":4582,"href":"https:\/\/www.cdsbalimaya.org\/en\/wp-json\/wp\/v2\/pages\/787\/revisions\/4582"}],"wp:attachment":[{"href":"https:\/\/www.cdsbalimaya.org\/en\/wp-json\/wp\/v2\/media?parent=787"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}