{"id":77405,"date":"2020-01-14T18:40:26","date_gmt":"2020-01-14T13:10:26","guid":{"rendered":"https:\/\/apnlive.com\/?page_id=77405"},"modified":"2020-01-22T11:56:39","modified_gmt":"2020-01-22T06:26:39","slug":"registration-form","status":"publish","type":"page","link":"https:\/\/apnlive.com\/apn-medical-excellence-awards-2020\/registration-form\/","title":{"rendered":"Registration Form"},"content":{"rendered":"<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-77132\"><form id=\"wpforms-form-77132\" class=\"wpforms-validate wpforms-form\" data-formid=\"77132\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/wp-json\/wp\/v2\/pages\/77405\" data-token=\"d9b4997e9001e56c3d314f676dd2e482\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-77132-field_3-container\" class=\"wpforms-field wpforms-field-select\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_3\">ReRegistration <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-77132-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" required=\"required\"><option value=\"Delegate\" >Delegate<\/option><option value=\"Guest\" >Guest<\/option><option value=\"Student\" >Student<\/option><option value=\"Media\" >Media<\/option><option value=\"Other\" >Other<\/option><\/select><\/div><div id=\"wpforms-77132-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_0\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-77132-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" required><label for=\"wpforms-77132-field_0\" class=\"wpforms-field-sublabel after \">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-77132-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" required><label for=\"wpforms-77132-field_0-last\" class=\"wpforms-field-sublabel after \">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-77132-field_4-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_4\">Gender <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-77132-field_4\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-77132-field_4_1\" name=\"wpforms[fields][4][]\" value=\"Male\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-77132-field_4_1\">Male<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-77132-field_4_2\" name=\"wpforms[fields][4][]\" value=\"Female\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-77132-field_4_2\">Female<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-77132-field_4_3\" name=\"wpforms[fields][4][]\" value=\"Other\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-77132-field_4_3\">Other<\/label><\/li><\/ul><\/div><div id=\"wpforms-77132-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_5\">Date of birth<\/label><input type=\"text\" id=\"wpforms-77132-field_5\" class=\"wpforms-field-medium\" name=\"wpforms[fields][5]\" placeholder=\"Eg: mm\/dd\/yyyy\" ><\/div><div id=\"wpforms-77132-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_1\">Email<\/label><input type=\"email\" id=\"wpforms-77132-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" ><\/div><div id=\"wpforms-77132-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_6\">Nationality<\/label><input type=\"text\" id=\"wpforms-77132-field_6\" class=\"wpforms-field-medium\" name=\"wpforms[fields][6]\" ><\/div><div id=\"wpforms-77132-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_7\">From<\/label><input type=\"text\" id=\"wpforms-77132-field_7\" class=\"wpforms-field-medium\" name=\"wpforms[fields][7]\" ><\/div><div id=\"wpforms-77132-field_8-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_8\">Address<\/label><textarea id=\"wpforms-77132-field_8\" class=\"wpforms-field-medium\" name=\"wpforms[fields][8]\" ><\/textarea><\/div><div id=\"wpforms-77132-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_9\">City<\/label><input type=\"text\" id=\"wpforms-77132-field_9\" class=\"wpforms-field-medium\" name=\"wpforms[fields][9]\" ><\/div><div id=\"wpforms-77132-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_10\">State<\/label><input type=\"text\" id=\"wpforms-77132-field_10\" class=\"wpforms-field-medium\" name=\"wpforms[fields][10]\" ><\/div><div id=\"wpforms-77132-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_11\">Country<\/label><input type=\"text\" id=\"wpforms-77132-field_11\" class=\"wpforms-field-medium\" name=\"wpforms[fields][11]\" ><\/div><div id=\"wpforms-77132-field_12-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_12\">Mobile Number <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-77132-field_12\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][12]\" required><\/div><div id=\"wpforms-77132-field_13-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-77132-field_13\">Note:(Put any important note here)<\/label><textarea id=\"wpforms-77132-field_13\" class=\"wpforms-field-medium\" name=\"wpforms[fields][13]\" ><\/textarea><\/div><\/div><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-77132-field-hp\" class=\"wpforms-field-label\">Message<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-77132-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-submit-container\"><input type=\"hidden\" name=\"wpforms[id]\" value=\"77132\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"4\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-77132\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":4,"featured_media":0,"parent":77010,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_eb_attr":"","footnotes":""},"yst_prominent_words":[45415],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/apnlive.com\/wp-json\/wp\/v2\/pages\/77405"}],"collection":[{"href":"https:\/\/apnlive.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apnlive.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apnlive.com\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/apnlive.com\/wp-json\/wp\/v2\/comments?post=77405"}],"version-history":[{"count":0,"href":"https:\/\/apnlive.com\/wp-json\/wp\/v2\/pages\/77405\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/apnlive.com\/wp-json\/wp\/v2\/pages\/77010"}],"wp:attachment":[{"href":"https:\/\/apnlive.com\/wp-json\/wp\/v2\/media?parent=77405"}],"wp:term":[{"taxonomy":"yst_prominent_words","embeddable":true,"href":"https:\/\/apnlive.com\/wp-json\/wp\/v2\/yst_prominent_words?post=77405"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}<!-- 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