{"id":15983,"date":"2024-02-26T22:46:44","date_gmt":"2024-02-27T03:46:44","guid":{"rendered":"https:\/\/rch.ca\/?page_id=15983"},"modified":"2024-03-01T21:45:11","modified_gmt":"2024-03-02T02:45:11","slug":"membership-form","status":"publish","type":"page","link":"https:\/\/rch.ca\/en\/membership\/membership-form\/","title":{"rendered":"Membership form"},"content":{"rendered":"<form id=\"association_adhesion_form\" class=\"c-form ajax \"  data-redirect=\"\" method=\"POST\" enctype=\"multipart\/form-data\" ><div class=\"c-form__messages\" ><div class=\"c-form__messages-inner\"><\/div><\/div><div class=\"c-form__fields cols c-hgap-2 c-vgap-2\"><h3 style=\"margin-top:0; text-align:center;\" class=\"c-100\" >Membership form<\/h3><fieldset class=\"c-form__input-ctn input-ctn giant-radio\"><label class=\"c-form__input-label\" ><input type=\"radio\" name=\"membership_request[]\" value=\"Membership application (lifetime member, $150)\" required><span><h4>Membership application (lifetime member, $150)<\/h4><p>Upon approval by the committee, please send your check to the address below or by <a href=\"https:\/\/rch.ca\/en\/membership\/\" >online payment<\/a><\/p><p><small>Association RCH<br>Adh\u00e9sions \/ Memberships<br>4185 C\u00f4tes-des-neiges, Montreal, H3H 1X2<\/small><\/p><\/span><\/label><label class=\"c-form__input-label\" ><input type=\"radio\" name=\"membership_request[]\" value=\"Updating my personal information\" required><span><h4>Updating my personal information<\/h4><\/span><\/label><span class=\"c-form__input-message\"><\/span><\/fieldset><h3 class=\"c-100\" style=\"text-align:center;\" >Personal information<\/h3><div class=\"c-form__input-ctn input-ctn c-6 c-sm-12\"><label class=\"c-form__label\" for=\"association_adhesion_form-first_name\">First name<span class=\"c-form__label-required\" >*<\/span><\/label><input \n        id=\"association_adhesion_form-first_name\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"first_name\"  required ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn c-6 c-sm-12\"><label class=\"c-form__label\" for=\"association_adhesion_form-last_name\">Last name<span class=\"c-form__label-required\" >*<\/span><\/label><input \n        id=\"association_adhesion_form-last_name\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"last_name\"  required ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn c-6 c-sm-12\"><label class=\"c-form__label\" for=\"association_adhesion_form-rank\">Rank<\/label><input \n        id=\"association_adhesion_form-rank\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"rank\"   ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn c-6 c-sm-12\"><label class=\"c-form__label\" for=\"association_adhesion_form-spouse_full_name\">Spouse name\/first-name<\/label><input \n        id=\"association_adhesion_form-spouse_full_name\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"spouse_full_name\"   ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn input-ctn--select-ctn c-6 c-sm-12\"><label class=\"c-form__label\" for=\"association_adhesion_form-status\">Status<span class=\"c-form__label-required\" >*<\/span><\/label><select id=\"association_adhesion_form-status\" class=\"c-form__field \" name=\"status[]\" required ><option value=\"\" selected disabled selected>Make a selection<\/option><option value=\"Honorary\">Honorary<\/option><option value=\"Veteran\">Veteran<\/option><option value=\"In service\">In service<\/option><option value=\"Former member\">Former member<\/option><option value=\"Friend Association\">Friend Association<\/option><option value=\"Other\">Other<\/option><\/select><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__group c-6 c-sm-12\" ><label class=\"c-form__label\" >Date of service<\/label><div class=\"cols c-hgap-2 c-vgap-2\" ><div class=\"c-form__input-ctn input-ctn c-6\"><label class=\"c-form__label\" for=\"association_adhesion_form-date_of_service_from\">From<\/label><input \n        id=\"association_adhesion_form-date_of_service_from\" \n        class=\"c-form__field flatpickr\" \n        type=\"text\" \n        name=\"date_of_service_from\"   ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn c-6\"><label class=\"c-form__label\" for=\"association_adhesion_form-date_of_service_to\">To<\/label><input \n        id=\"association_adhesion_form-date_of_service_to\" \n        class=\"c-form__field flatpickr\" \n        type=\"text\" \n        name=\"date_of_service_to\"   ><span class=\"c-form__input-message\"><\/span><\/div><\/div><\/div><div class=\"c-form__input-ctn input-ctn\"><label class=\"c-form__label\" for=\"association_adhesion_form-info\">Information about you \/ Suggested activities<\/label><textarea data-lenis-prevent id=\"association_adhesion_form-info\" class=\"c-form__textarea \" rows=\"9\" name=\"info\"maxlength=\"1024\" ><\/textarea><span class=\"c-form__input-message\"><\/span><\/div><fieldset class=\"c-form__input-ctn input-ctn c-12\"><label class=\"c-form__input-label\" ><input type=\"checkbox\" name=\"share_info_auth[]\" value=\"I authorize the display of my email and the greater region where I live on the members page.\"><span>I authorize the display of my email and the greater region where I live on the members page.<\/span><\/label><span class=\"c-form__input-message\"><\/span><\/fieldset><h3 class=\"c-100\" style=\"text-align:center;\" >Communication<\/h3><fieldset class=\"c-form__input-ctn input-ctn\"><legend class=\"c-form__label\">Communication preference<span class=\"c-form__label-required\" >*<\/span><\/legend><label class=\"c-form__input-label\" ><input type=\"radio\" name=\"communication_preference[]\" value=\"email\" required><span>By email<\/span><\/label><label class=\"c-form__input-label\" ><input type=\"radio\" name=\"communication_preference[]\" value=\"phone\" required><span>By phone<\/span><\/label><label class=\"c-form__input-label\" ><input type=\"radio\" name=\"communication_preference[]\" value=\"post\" required><span>By post<\/span><\/label><span class=\"c-form__input-message\"><\/span><\/fieldset><div class=\"c-form__input-ctn input-ctn c-6 c-sm-12\"><label class=\"c-form__label\" for=\"association_adhesion_form-phone\">Phone number<\/label><input \n        id=\"association_adhesion_form-phone\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"phone\"   ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn c-6 c-sm-12\"><label class=\"c-form__label\" for=\"association_adhesion_form-email\">Email<\/label><input \n        id=\"association_adhesion_form-email\" \n        class=\"c-form__field \" \n        type=\"email\" \n        name=\"email\"   ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__group\" ><label class=\"c-form__label\" >Address<\/label><div class=\"cols c-hgap-2 c-vgap-2\" ><div class=\"c-form__input-ctn input-ctn c-9 c-sm-12\"><label class=\"c-form__label\" for=\"association_adhesion_form-address_1\">Address Line 1<\/label><input \n        id=\"association_adhesion_form-address_1\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"address_1\"   ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn c-3 c-sm-12\"><label class=\"c-form__label\" for=\"association_adhesion_form-address_2\">Address Line 2<\/label><input \n        id=\"association_adhesion_form-address_2\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"address_2\"   ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn c-3 c-sm-6\"><label class=\"c-form__label\" for=\"association_adhesion_form-city\">City<\/label><input \n        id=\"association_adhesion_form-city\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"city\"   ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn c-3 c-sm-6\"><label class=\"c-form__label\" for=\"association_adhesion_form-province\">Province<\/label><input \n        id=\"association_adhesion_form-province\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"province\"   ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn c-3 c-sm-6\"><label class=\"c-form__label\" for=\"association_adhesion_form-country\">Country<\/label><input \n        id=\"association_adhesion_form-country\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"country\"   ><span class=\"c-form__input-message\"><\/span><\/div><div class=\"c-form__input-ctn input-ctn c-3 c-sm-6\"><label class=\"c-form__label\" for=\"association_adhesion_form-postal_code\">Postal code<\/label><input \n        id=\"association_adhesion_form-postal_code\" \n        class=\"c-form__field \" \n        type=\"text\" \n        name=\"postal_code\"   ><span class=\"c-form__input-message\"><\/span><\/div><\/div><\/div><\/div><div class=\"c-form__submit-button-container \" ><button type=\"button\" class=\"c-form__submit-btn c-cta \">Send<\/button><\/div><input type=\"hidden\" name=\"action\" value=\"association_adhesion_form\"><\/form>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1001002,"featured_media":0,"parent":255,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-15983","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/rch.ca\/en\/wp-json\/wp\/v2\/pages\/15983","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rch.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/rch.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/rch.ca\/en\/wp-json\/wp\/v2\/users\/1001002"}],"replies":[{"embeddable":true,"href":"https:\/\/rch.ca\/en\/wp-json\/wp\/v2\/comments?post=15983"}],"version-history":[{"count":1,"href":"https:\/\/rch.ca\/en\/wp-json\/wp\/v2\/pages\/15983\/revisions"}],"predecessor-version":[{"id":15993,"href":"https:\/\/rch.ca\/en\/wp-json\/wp\/v2\/pages\/15983\/revisions\/15993"}],"up":[{"embeddable":true,"href":"https:\/\/rch.ca\/en\/wp-json\/wp\/v2\/pages\/255"}],"wp:attachment":[{"href":"https:\/\/rch.ca\/en\/wp-json\/wp\/v2\/media?parent=15983"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}