{"id":926,"date":"2022-11-08T05:17:54","date_gmt":"2022-11-08T05:17:54","guid":{"rendered":"https:\/\/kenyachemicalsociety.org\/?page_id=926"},"modified":"2023-02-02T11:24:03","modified_gmt":"2023-02-02T11:24:03","slug":"membership-registration","status":"publish","type":"page","link":"https:\/\/kenyachemicalsociety.org\/?page_id=926","title":{"rendered":"Membership Registration"},"content":{"rendered":"<p>Download <a href=\"https:\/\/kenyachemicalsociety.org\/wp-content\/uploads\/2023\/02\/KCSMembershipApplicationForm.pdf\">KCS Membership Application Form<\/a><\/p>\n<div class=\"cf7sg-container\"><div id=\"cf7sg-form-member-registration\" class=\"cf7-smart-grid has-date has-grid key_member-registration\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f924-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"924\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F926#wpcf7-f924-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"924\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f924-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:924,&quot;conditions&quot;:[],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false}}\" \/><input type=\"hidden\" name=\"_extcf7_conditional_options\" value=\"{&quot;form_id&quot;:924,&quot;conditions&quot;:[]}\" \/><input type=\"hidden\" name=\"_extcf7_redirect_options\" value=\"{&quot;form_id&quot;:924,&quot;redirect_options&quot;:&quot;&quot;}\" \/><input type=\"hidden\" name=\"_wpcf7_key\" value=\"member-registration\" \/><input type=\"hidden\" name=\"_cf7sg_toggles\" value=\"\" \/><input type=\"hidden\" name=\"_cf7sg_version\" value=\"4.15.8\" \/><input type=\"hidden\" name=\"_wpnonce\" value=\"e6b8b6a553\" \/>\n<\/fieldset>\n<div class=\"container\">\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Names<em>*<\/em><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"names\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"names\" \/><\/span>\n        <p class=\"info-tip\">Your Full Names<\/p>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Date of Birth<em>*<\/em><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"dob\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"dob\" \/><\/span>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Gender<em>*<\/em><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"gender\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"gender\" value=\"Male\" \/><span class=\"wpcf7-list-item-label\">Male<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"gender\" value=\"Female\" \/><span class=\"wpcf7-list-item-label\">Female<\/span><\/label><\/span><\/span><\/span>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Job Title<em>*<\/em><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"job-title\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"job-title\" \/><\/span>\n        <p class=\"info-tip\">Job Title<\/p>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Institution\/Firm<em>*<\/em><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"job-institution\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"job-institution\" \/><\/span>\n        <p class=\"info-tip\">Institution\/Firm<\/p>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Department\/Section<em>*<\/em><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"job-department\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"job-department\" \/><\/span>\n        <p class=\"info-tip\">Department\/Section<\/p>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Address<em>*<\/em><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"member-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"member-address\" \/><\/span>\n        <p class=\"info-tip\">Your Address<\/p>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Town<em>*<\/em><\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"member-town\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"member-town\" \/><\/span>\n        <p class=\"info-tip\">Town<\/p>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Email<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"member-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"member-email\" \/><\/span>\n        <p class=\"info-tip\">Your Email<\/p>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Phone<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"member-phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"member-phone\" \/><\/span>\n        <p class=\"info-tip\">Your Phone<\/p>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Education<em>*<\/em><\/label>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\" style=\"background-color: #E6E6E3;padding: 10px\">\n    <div data-wpcf7-group-id=\"education\" id=\"education-college\" tabindex=\"1\" class=\"wpcf7-field-groups \"><div class=\"wpcf7-field-group\">\n    <div class=\"row\">\n      <div class=\"columns full\">\n        <div class=\"field\"><label>College \/ University<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"education-college\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"education-college\" \/><\/span>\n          <p class=\"info-tip\">College or University Including Current enrollment<\/p>\n        <\/div>\n      <\/div>\n    <\/div>\n    <div class=\"row\">\n      <div class=\"columns full\">\n        <div class=\"field\"><label>Course<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"education-course\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"education-course\" \/><\/span>\n          <p class=\"info-tip\">Major \/ Course Title<\/p>\n        <\/div>\n      <\/div>\n    <\/div>\n    <div class=\"row\">\n      <div class=\"columns full\">\n        <div class=\"field\"><label>Dates Studied<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"education-dates\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"education-dates\" \/><\/span>\n          <p class=\"info-tip\">Dates Studied<\/p>\n        <\/div>\n      <\/div>\n    <\/div>\n    <div class=\"row\">\n      <div class=\"columns full\">\n        <div class=\"field\"><label>Award<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"education-award\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"education-award\" \/><\/span>\n          <p class=\"info-tip\">Title of Degree Received or Expected<\/p>\n        <\/div>\n      <\/div>\n    <\/div>\n    <div class=\"row\">\n      <div class=\"columns full\">\n        <div class=\"field\"><label>Graduation Year<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"education-graduation-year\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"education-graduation-year\" \/><\/span>\n          <p class=\"info-tip\">Month\/Year Received or Expected<\/p>\n        <\/div>\n      <\/div>\n    <\/div>\n    <button type='button' class='wpcf7-field-group-remove '>-<\/button><button type='button' class='wpcf7-field-group-add '>+<\/button><input type=\"hidden\" class=\"wpcf7-field-group-count\" name=\"_wpcf7_groups_count[education]\" value=\"1\" \/><\/div><\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Subscription Rate<\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"subscription-rate\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"subscription-rate\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Corporate\">Corporate<\/option><option value=\"Ordinary\">Ordinary<\/option><option value=\"Student\">Student<\/option><option value=\"Association\">Association<\/option><option value=\"Life Member\">Life Member<\/option><\/select><\/span>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns full\">\n      <div class=\"field\"><label>Deposit Slip<em>*<\/em><span class=\"wpcf7-form-control-wrap\" data-name=\"deposit-slip\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\".pdf,.jpg,.png\" aria-invalid=\"false\" type=\"file\" name=\"deposit-slip\" \/><\/span><\/label>\n      <\/div>\n    <\/div>\n  <\/div>\n  <div class=\"row\">\n    <div class=\"columns two\">\n      <div class=\"field\"><label><\/label><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/>\n        <p class=\"info-tip\"><\/p>\n      <\/div>\n    <\/div>\n  <\/div>\n<\/div>\n<div class=\"container\">\n  <div class=\"row\">\n    <div class=\"columns full\">\n    <\/div>\n  <\/div>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<div class=\"entry-summary\">\n<div class=\"entry-summary\">\nDownload KCS Membership Application Form\n<\/div>\n<div class=\"link-more-container\"><a href=\"https:\/\/kenyachemicalsociety.org\/?page_id=926\" class=\"link-more\" aria-label=\"Continue reading Membership Registration\">Continue reading&hellip;<\/a><\/div>\n<\/div>\n<div class=\"link-more-container\"><a href=\"https:\/\/kenyachemicalsociety.org\/?page_id=926\" class=\"link-more\" aria-label=\"Continue reading Membership Registration\">Continue reading&hellip;<\/a><\/div>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"templates\/no-intro.php","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","_eb_attr":"","footnotes":""},"categories":[],"tags":[],"class_list":["post-926","page","type-page","status-publish","hentry","entry","entry-type-page"],"_links":{"self":[{"href":"https:\/\/kenyachemicalsociety.org\/index.php?rest_route=\/wp\/v2\/pages\/926","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kenyachemicalsociety.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kenyachemicalsociety.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kenyachemicalsociety.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kenyachemicalsociety.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=926"}],"version-history":[{"count":3,"href":"https:\/\/kenyachemicalsociety.org\/index.php?rest_route=\/wp\/v2\/pages\/926\/revisions"}],"predecessor-version":[{"id":987,"href":"https:\/\/kenyachemicalsociety.org\/index.php?rest_route=\/wp\/v2\/pages\/926\/revisions\/987"}],"wp:attachment":[{"href":"https:\/\/kenyachemicalsociety.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=926"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kenyachemicalsociety.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=926"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kenyachemicalsociety.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=926"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}