{"id":779,"date":"2010-05-19T21:49:32","date_gmt":"2010-05-19T21:49:32","guid":{"rendered":"http:\/\/profconsure.co.za\/?page_id=779"},"modified":"2010-06-19T10:56:29","modified_gmt":"2010-06-19T10:56:29","slug":"application-form","status":"publish","type":"page","link":"http:\/\/profconsure.co.za\/?page_id=779","title":{"rendered":"Application Form"},"content":{"rendered":"<p><strong>\u00a0SUPPORTING DOCUMENTS FOR MEMBERSHIP with\u00a0APPLICATION<\/strong><\/p>\n<p><strong>1. Identification document (Copy) of main member and dependants (ID or birth certificates)<\/strong><\/p>\n<p><strong>2. Cheque or\u00a0bank statement to confirm banking details (Copy)<\/strong><\/p>\n<p><strong>3. Affidavit when registering common law spouse or partner<\/strong><\/p>\n<p><strong>4. Marriage certificate when registering a spouse with diffrent surname on ID<\/strong><\/p>\n<p><strong>Please fill in this form in order to download the Application Form:<\/strong><\/p>\n\n\t\t<div id=\"usermessage10a\" class=\"cf_info \"><\/div>\n\t\t<form enctype=\"multipart\/form-data\" action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F779#usermessage10a\" method=\"post\" class=\"cform\" id=\"cforms10form\">\n\t\t<fieldset class=\"cf-fs1\">\n\t\t<legend>My personal details:<\/legend>\n\t\t<ol class=\"cf-ol\">\n\t\t\t<li id=\"li-10-2\"><label for=\"cf10_field_2\"><span>Your Name<\/span><\/label><input type=\"text\" name=\"cf10_field_2\" id=\"cf10_field_2\" class=\"single fldrequired\" value=\"\" onfocus=\"clearField(this)\" onblur=\"setField(this)\"\/><span class=\"reqtxt\">(required)<\/span><\/li>\n\t\t\t<li id=\"li-10-3\"><label for=\"cf10_field_3\"><span>Email<\/span><\/label><input type=\"text\" name=\"cf10_field_3\" id=\"cf10_field_3\" class=\"single fldemail fldrequired\" value=\"\"\/><span class=\"emailreqtxt\">(valid email required)<\/span><\/li>\n\t\t\t<li id=\"li-10-4\"><label for=\"cf10_field_4\"><span>Contact Number<\/span><\/label><input type=\"text\" name=\"cf10_field_4\" id=\"cf10_field_4\" class=\"single\" value=\"\"\/><\/li>\n\t\t\t<li id=\"li-10-5\"><label for=\"cf10_field_5\"><span>Who Referred You?<\/span><\/label><input type=\"text\" name=\"cf10_field_5\" id=\"cf10_field_5\" class=\"single\" value=\"\"\/><\/li>\n\t\t\t<li id=\"li-10-6\"><label for=\"cf10_field_6\" class=\"cf-before\"><span>I have read and understand the disclaimer as listed at the bottom of this website.<\/span><\/label><input type=\"checkbox\" name=\"cf10_field_6\" id=\"cf10_field_6\" class=\"cf-box-b fldrequired\"\/><\/li>\n\t\t\t<li id=\"li-10-7\"><label for=\"cf10_field_7\"><span>May we contact you?<\/span><\/label><select name=\"cf10_field_7\" id=\"cf10_field_7\" class=\"cformselect fldrequired\" >\n\t\t\t\t<option value=\"Yes\">Yes<\/option>\n\t\t\t\t<option value=\"No\">No<\/option>\n\t\t\t<\/select><span class=\"reqtxt\">(required)<\/span><\/li>\n\t\t<\/ol>\n\t\t<\/fieldset>\n\t\t<fieldset class=\"cf_hidden\">\n\t\t\t<legend>&nbsp;<\/legend>\n\t\t\t<input type=\"hidden\" name=\"cf_working10\" id=\"cf_working10\" value=\"One%20moment%20please...\"\/>\n\t\t\t<input type=\"hidden\" name=\"cf_failure10\" id=\"cf_failure10\" value=\"Please%20fill%20in%20all%20the%20required%20fields.\"\/>\n\t\t\t<input type=\"hidden\" name=\"cf_codeerr10\" id=\"cf_codeerr10\" value=\"Please%20double-check%20your%20verification%20code.\"\/>\n\t\t\t<input type=\"hidden\" name=\"cf_customerr10\" id=\"cf_customerr10\" value=\"yyy\"\/>\n\t\t\t<input type=\"hidden\" name=\"cf_popup10\" id=\"cf_popup10\" value=\"nn\"\/>\n\t\t<\/fieldset>\n\t\t<p class=\"cf-sb\"><input type=\"submit\" name=\"sendbutton10\" id=\"sendbutton10\" class=\"sendbutton\" value=\"Submit\"\/><\/p>\n\t\t<\/form>\n\t\t<p class=\"linklove\" id=\"ll10\"><a href=\"http:\/\/www.deliciousdays.com\/cforms-plugin\"><em>cforms<\/em> contact form by delicious:days<\/a><\/p>\t\t<div id=\"usermessage10b\" class=\"cf_info \" ><\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>\u00a0SUPPORTING DOCUMENTS FOR MEMBERSHIP with\u00a0APPLICATION 1. Identification document (Copy) of main member and dependants (ID or birth certificates) 2. Cheque or\u00a0bank statement to confirm banking details (Copy) 3. Affidavit when registering common law spouse or partner 4. Marriage certificate when registering a spouse with diffrent surname on ID Please fill in this form in order [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":673,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"http:\/\/profconsure.co.za\/index.php?rest_route=\/wp\/v2\/pages\/779"}],"collection":[{"href":"http:\/\/profconsure.co.za\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/profconsure.co.za\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/profconsure.co.za\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/profconsure.co.za\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=779"}],"version-history":[{"count":5,"href":"http:\/\/profconsure.co.za\/index.php?rest_route=\/wp\/v2\/pages\/779\/revisions"}],"predecessor-version":[{"id":953,"href":"http:\/\/profconsure.co.za\/index.php?rest_route=\/wp\/v2\/pages\/779\/revisions\/953"}],"up":[{"embeddable":true,"href":"http:\/\/profconsure.co.za\/index.php?rest_route=\/wp\/v2\/pages\/673"}],"wp:attachment":[{"href":"http:\/\/profconsure.co.za\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=779"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}