{"id":1276,"date":"2012-11-01T18:31:11","date_gmt":"2012-11-01T18:31:11","guid":{"rendered":"http:\/\/www.ivsalumni.com\/ivs\/?page_id=1276"},"modified":"2012-11-03T21:26:20","modified_gmt":"2012-11-03T21:26:20","slug":"registration-form-2","status":"publish","type":"page","link":"http:\/\/www.ivsalumni.com\/ivs\/?page_id=1276","title":{"rendered":"Registration Form"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f216-o1\" lang=\"\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/ivs\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F1276#wpcf7-f216-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"216\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.8.3\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f216-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<table width=\"100%\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\" class=\"registration-form\">\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<h3>Personal information\n\t\t\t<\/h3>\n\t\t<hr \/>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p>Full Name:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"name\"><input size=\"90\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Marital Status:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"marital-status\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"marital-status\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Married\">Married<\/option><option value=\"Single\">Single<\/option><\/select><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p>Date of Birth:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"date-of-birth\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"dd\/mm\/yyyy\" value=\"\" type=\"text\" name=\"date-of-birth\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Email Address:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email1\"><input size=\"40\" 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=\"email1\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p>Secondary Email Address:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email2\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email2\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Telephone:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"telephone\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"telephone\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p>Cell :\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cell\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"cell\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<table width=\"100%\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\">\n\t\t\t\t<tr>\n\t\t\t\t\t<td width=\"36%\" class=\"registration-form\">\n\t\t\t\t\t\t<p>Year of Graduation \/ Years Attended\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"graduation-year\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"graduation-year\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"2012\">2012<\/option><option value=\"2011\">2011<\/option><option value=\"2010\">2010<\/option><option value=\"2009\">2009<\/option><option value=\"2008\">2008<\/option><option value=\"2007\">2007<\/option><option value=\"2006\">2006<\/option><option value=\"2005\">2005<\/option><option value=\"2004\">2004<\/option><option value=\"2003\">2003<\/option><option value=\"2002\">2002<\/option><option value=\"2001\">2001<\/option><option value=\"2000\">2000<\/option><option value=\"1999\">1999<\/option><option value=\"1998\">1998<\/option><option value=\"1997\">1997<\/option><option value=\"1996\">1996<\/option><option value=\"1995\">1995<\/option><\/select><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/td>\n\t\t\t\t\t<td width=\"34%\" class=\"registration-form\">\n\t\t\t\t\t\t<p>Department:\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"department\"><input size=\"25\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"department\" \/><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/td>\n\t\t\t\t\t<td width=\"30%\">\n\t\t\t\t\t\t<p>Program Attended:\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"program\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"program\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Degree\">Degree<\/option><option value=\"PGD\">PGD<\/option><option value=\"Diploma\">Diploma<\/option><\/select><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\t\t\t<\/table>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p>Home Address:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><input size=\"90\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<h3>CAREER INFORMATION\n\t\t\t<\/h3>\n\t\t<hr \/>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Currently Employed:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"company\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Company name \/ Self-Employed\" value=\"\" type=\"text\" name=\"company\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p>Designation:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"designation\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"designation\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>Email Address:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email-office\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email-office\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p>Telephone:\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"telephone-office\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"telephone-office\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p>Portfolio\/Weblink (this information will be shared in our professional directory on our website):\n\t\t\t<\/p>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"weblink\"><input size=\"90\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"weblink\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<h3>Personal information\n\t\t\t<\/h3>\n\t\t<hr \/>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<table width=\"100%\" border=\"0\" align=\"left\" cellpadding=\"0\" cellspacing=\"0\">\n\t\t\t\t<td width=\"86%\" valign=\"middle\">\n\t\t\t\t\t<p>Share my information with my fellow alumni.\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/td>\n\t\t\t\t<td width=\"14%\" valign=\"middle\">\n\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"share\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><span class=\"wpcf7-list-item-label\">Yes<\/span><input type=\"checkbox\" name=\"share[]\" value=\"Yes\" \/><\/span><\/span><\/span>\n\t\t\t\t\t<\/p>\n\t\t\t\t<\/td>\n\t\t\t\t<tr>\n\t\t\t\t\t<td valign=\"middle\">\n\t\t\t\t\t\t<p>Please keep me informed of Alumni activities via email.\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/td>\n\t\t\t\t\t<td valign=\"middle\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"inform\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><span class=\"wpcf7-list-item-label\">Yes<\/span><input type=\"checkbox\" name=\"inform[]\" value=\"Yes\" \/><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\t\t\t<\/table>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<table width=\"94%\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\">\n\t\t\t\t<tr>\n\t\t\t\t\t<td width=\"36%\" bgcolor=\"#CCCCCC\">\n\t\t\t\t\t\t<h4>TYPE OF MEMBERSHIP:\n\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t<\/td>\n\t\t\t\t\t<td width=\"28%\" valign=\"middle\" bgcolor=\"#CCCCCC\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"membership\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first last\"><input type=\"radio\" name=\"membership\" value=\"Lifetime\" \/><span class=\"wpcf7-list-item-label\">Lifetime<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/td>\n\t\t\t\t\t<td width=\"36%\" valign=\"middle\" bgcolor=\"#CCCCCC\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"membership\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first last\"><input type=\"radio\" name=\"membership\" value=\"Friends (Affililiate membership)\" \/><span class=\"wpcf7-list-item-label\">Friends (Affililiate membership)<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\t\t\t<\/table>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<h3>Payment Mode\n\t\t\t<\/h3>\n\t\t<hr \/>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<table width=\"100%\" border=\"0\" cellpadding=\"0\" cellspacing=\"0\">\n\t\t\t\t<tr>\n\t\t\t\t\t<td width=\"25%\" valign=\"top\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"payment-method\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first last\"><input type=\"radio\" name=\"payment-method\" value=\"Cheque\" \/><span class=\"wpcf7-list-item-label\">Cheque<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/td>\n\t\t\t\t\t<td width=\"50%\" valign=\"top\">\n\t\t\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"payment-method\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first last\"><input type=\"radio\" name=\"payment-method\" value=\"Cash\" \/><span class=\"wpcf7-list-item-label\">Cash<\/span><\/span><\/span><\/span>\n\t\t\t\t\t\t<\/p>\n\t\t\t\t\t<\/td>\n\t\t\t\t<\/tr>\n\t\t\t<\/table>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td>\n\t\t\t<p>&nbsp;\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p>&nbsp;\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit or Print\" \/>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table><p style=\"display: none !important;\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"208\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n<a href=\"http:\/\/www.ivsalumni.com\/ivs\/?page_id=1276&amp;print=1\" title=\"Print This Post\" rel=\"nofollow\"><img decoding=\"async\" class=\"WP-PrintIcon\" src=\"http:\/\/www.ivsalumni.com\/ivs\/wp-content\/plugins\/wp-print\/images\/print.gif\" alt=\"Print This Post\" title=\"Print This Post\" style=\"border: 0px;\" \/><\/a>&nbsp;<a href=\"http:\/\/www.ivsalumni.com\/ivs\/?page_id=1276&amp;print=1\" title=\"Print This Post\" rel=\"nofollow\">Print This Post<\/a>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":9,"comment_status":"closed","ping_status":"open","template":"","meta":{"ngg_post_thumbnail":0,"jetpack_post_was_ever_published":false,"footnotes":""},"acf":[],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/P2RaLp-kA","_links":{"self":[{"href":"http:\/\/www.ivsalumni.com\/ivs\/index.php?rest_route=\/wp\/v2\/pages\/1276"}],"collection":[{"href":"http:\/\/www.ivsalumni.com\/ivs\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/www.ivsalumni.com\/ivs\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/www.ivsalumni.com\/ivs\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.ivsalumni.com\/ivs\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1276"}],"version-history":[{"count":18,"href":"http:\/\/www.ivsalumni.com\/ivs\/index.php?rest_route=\/wp\/v2\/pages\/1276\/revisions"}],"predecessor-version":[{"id":1297,"href":"http:\/\/www.ivsalumni.com\/ivs\/index.php?rest_route=\/wp\/v2\/pages\/1276\/revisions\/1297"}],"wp:attachment":[{"href":"http:\/\/www.ivsalumni.com\/ivs\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1276"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}