{"id":35,"date":"2022-07-20T06:56:48","date_gmt":"2022-07-20T06:56:48","guid":{"rendered":"https:\/\/saverocks.org\/en\/?page_id=35"},"modified":"2022-07-20T07:04:45","modified_gmt":"2022-07-20T07:04:45","slug":"society-to-save-rocks-membership-form","status":"publish","type":"page","link":"https:\/\/saverocks.org\/en\/","title":{"rendered":"Membership Form"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-5\"><form id=\"wpforms-form-5\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"5\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/35\" data-token=\"035017a86014e22e7d402613f8ed6ce8\" data-token-time=\"1777117754\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-5-field_1-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_1\">Full Name (in Capitals) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-5-field_1\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][1]\" required><\/div><div id=\"wpforms-5-field_3-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-id=\"3\"><label class=\"wpforms-field-label\">Gender <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-5-field_3\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-5-field_3_1\" name=\"wpforms[fields][3]\" value=\"Male\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-5-field_3_1\">Male<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-5-field_3_2\" name=\"wpforms[fields][3]\" value=\"Female\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-5-field_3_2\">Female<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-5-field_3_3\" name=\"wpforms[fields][3]\" value=\"Others\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-5-field_3_3\">Others<\/label><\/li><\/ul><\/div><div id=\"wpforms-5-field_8-container\" class=\"wpforms-field wpforms-field-name wpforms-one-half wpforms-first\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_8\">Date of Birth <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-5-field_8\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][8]\" placeholder=\"DD\/MM\/YYYY\" required><\/div><div id=\"wpforms-5-field_9-container\" class=\"wpforms-field wpforms-field-name wpforms-one-half\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_9\">Occupation <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-5-field_9\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][9]\" required><\/div><div id=\"wpforms-5-field_11-container\" class=\"wpforms-field wpforms-field-textarea wpforms-one-half wpforms-first\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_11\">Address (Residence) <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-5-field_11\" class=\"wpforms-field-small wpforms-field-required wpforms-limit-characters-enabled\" data-form-id=\"5\" data-field-id=\"11\" data-text-limit=\"150\" name=\"wpforms[fields][11]\" maxlength=\"150\" required><\/textarea><\/div><div id=\"wpforms-5-field_12-container\" class=\"wpforms-field wpforms-field-textarea wpforms-one-half\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_12\">Address (Work)<\/label><textarea id=\"wpforms-5-field_12\" class=\"wpforms-field-small wpforms-limit-characters-enabled\" data-form-id=\"5\" data-field-id=\"12\" data-text-limit=\"150\" name=\"wpforms[fields][12]\" maxlength=\"150\" ><\/textarea><\/div><div id=\"wpforms-5-field_13-container\" class=\"wpforms-field wpforms-field-name wpforms-one-half wpforms-first\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_13\">Telephone (Residence)<\/label><input type=\"text\" id=\"wpforms-5-field_13\" class=\"wpforms-field-large\" name=\"wpforms[fields][13]\" ><\/div><div id=\"wpforms-5-field_14-container\" class=\"wpforms-field wpforms-field-name wpforms-one-half\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_14\">Telephone (Work)<\/label><input type=\"text\" id=\"wpforms-5-field_14\" class=\"wpforms-field-large\" name=\"wpforms[fields][14]\" ><\/div><div id=\"wpforms-5-field_15-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_15\">Mobile Phone with Country Code <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-5-field_15\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][15]\" required><\/div><div id=\"wpforms-5-field_2-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_2\">Email Address <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-5-field_2\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][2]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-5-field_16-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_16\">Type of Membership <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-5-field_16\" class=\"wpforms-field-large wpforms-field-required choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-large\" data-search-enabled=\"\" name=\"wpforms[fields][16]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Select<\/option><option value=\"Active (Single)\" >Active (Single)<\/option><option value=\"Active (Couple)\" >Active (Couple)<\/option><option value=\"Life (Single)\" >Life (Single)<\/option><option value=\"Life (Couple)\" >Life (Couple)<\/option><option value=\"Student (under 18 Years)\" >Student (under 18 Years)<\/option><option value=\"Institution\" >Institution<\/option><option value=\"Corporate\" >Corporate<\/option><\/select><div class=\"wpforms-field-description\"><br><b>FEE DETAILS:<\/b><br>\r\n<img decoding=\"async\" src=\"https:\/\/saverocks.org\/2022\/membership-fee.png\" style=\"width:100%; max-width:550px;\"><\/div><\/div><div id=\"wpforms-5-field_7-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_7\">Payment or Transaction Details (Please mention your Name)<\/label><textarea id=\"wpforms-5-field_7\" class=\"wpforms-field-small wpforms-limit-characters-enabled\" data-form-id=\"5\" data-field-id=\"7\" data-text-limit=\"200\" name=\"wpforms[fields][7]\" maxlength=\"200\" ><\/textarea><div class=\"wpforms-field-description\"><br><p style=\"color:#003399; font-size:16px; line-height:25px;\"><b style=\"font-size:20px; font-weight:600;\">Scan QR code for payment<\/b><br>\r\n<img decoding=\"async\" src=\"https:\/\/saverocks.org\/2024\/Bank-QRCode.png\"style=\"width:200px; margin-top:10px; margin-bottom:20px;\">\r\n<\/p>\r\n\r\nBank transfers can be made to:<br>\r\n<p style=\"color:#003399; font-size:16px; line-height:25px;\"><b style=\"font-size:20px; font-weight:600;\">Society to Save Rocks<\/b><br>\r\nBank of Baroda, Jubilee Hills Branch<br>\r\nAccount No <b>18090100003047<\/b><br>\r\nNEFT Code <b>BARB0JUBILE<\/b> where the fifth character is a \"zero\"<\/p>\r\n<\/div><\/div><div id=\"wpforms-5-field_4-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"4\"><label class=\"wpforms-field-label\">My\/Our Contribution. Help with: <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-5-field_4\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-5-field_4_1\" name=\"wpforms[fields][4][]\" value=\"\u2b9e organising Rock Walks and excursions\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-5-field_4_1\">\u2b9e organising Rock Walks and excursions<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-5-field_4_2\" name=\"wpforms[fields][4][]\" value=\"\u2b9e identifying special rock formations\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-5-field_4_2\">\u2b9e identifying special rock formations<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-5-field_4_3\" name=\"wpforms[fields][4][]\" value=\"\u2b9e awareness programs in schools &amp; colleges\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-5-field_4_3\">\u2b9e awareness programs in schools &amp; colleges<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"checkbox\" id=\"wpforms-5-field_4_4\" name=\"wpforms[fields][4][]\" value=\"\u2b9e administrative work\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-5-field_4_4\">\u2b9e administrative work<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"checkbox\" id=\"wpforms-5-field_4_5\" name=\"wpforms[fields][4][]\" value=\"\u2b9e fund raising and membership recruiting\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-5-field_4_5\">\u2b9e fund raising and membership recruiting<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"checkbox\" id=\"wpforms-5-field_4_6\" name=\"wpforms[fields][4][]\" value=\"\u2b9e PR activities and publicity work \" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-5-field_4_6\">\u2b9e PR activities and publicity work<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-5-field_4_7\" name=\"wpforms[fields][4][]\" value=\"\u2b9e designing of info meterial\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-5-field_4_7\">\u2b9e designing of info meterial<\/label><\/li><\/ul><\/div><div id=\"wpforms-5-field_22-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-5-field_22\">I\/we can liaise with the following Government agencies:<\/label><textarea id=\"wpforms-5-field_22\" class=\"wpforms-field-small wpforms-limit-characters-enabled\" data-form-id=\"5\" data-field-id=\"22\" data-text-limit=\"150\" name=\"wpforms[fields][22]\" maxlength=\"150\" ><\/textarea><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"5\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/saverocks.org\/en\/wp-json\/wp\/v2\/pages\/35\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-5\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/saverocks.org\/en\/wp-content\/plugins\/wpforms-lite\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-35","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/saverocks.org\/en\/wp-json\/wp\/v2\/pages\/35","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/saverocks.org\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/saverocks.org\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/saverocks.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/saverocks.org\/en\/wp-json\/wp\/v2\/comments?post=35"}],"version-history":[{"count":0,"href":"https:\/\/saverocks.org\/en\/wp-json\/wp\/v2\/pages\/35\/revisions"}],"wp:attachment":[{"href":"https:\/\/saverocks.org\/en\/wp-json\/wp\/v2\/media?parent=35"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}