{"id":436,"date":"2021-04-13T20:09:28","date_gmt":"2021-04-13T14:39:28","guid":{"rendered":"https:\/\/www.checkkerala.com\/wpcheck\/?page_id=436"},"modified":"2024-02-07T22:12:00","modified_gmt":"2024-02-07T16:42:00","slug":"registration","status":"publish","type":"page","link":"https:\/\/www.checkkerala.com\/?page_id=436","title":{"rendered":"New Membership &#8211; Registration"},"content":{"rendered":"\n<p>Registration is mandatory for <strong>New Membership<\/strong>. <br>You may be required to <strong>signing<\/strong> on a <strong>hard copy<\/strong> of a form which you may get on a <em>mail<\/em> (<em><a href=\"mailto:membership@checkkerala.com\">membership@checkkerala.com<\/a><\/em>) to <strong>confirm<\/strong> the membership.<\/p>\n\n\n<div class=\"forminator-ui forminator-custom-form forminator-custom-form-476 forminator-design--material  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-476\" data-uid=\"6a2d10fa993e3\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-476\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-476 forminator-design--material  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"476\"\n\t\t\t\t\n\t\t\t\tdata-design=\"material\"\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\tdata-grid=\"open\"\n\t\t\t\tenctype=\"multipart\/form-data\"\n\t\t\t\t\n\t\t\t\tstyle=\"display: none;\"\n\t\t\t\t\n\t\t\t\tdata-uid=\"6a2d10fa993e3\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_6a2d10fa993e3\" id=\"forminator-field-name-1_6a2d10fa993e3-label\" class=\"forminator-label\">First Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"First name\" id=\"forminator-field-name-1_6a2d10fa993e3\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><div id=\"name-2\" class=\"forminator-field-name forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-2_6a2d10fa993e3\" id=\"forminator-field-name-2_6a2d10fa993e3-label\" class=\"forminator-label\">Last Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-2\" value=\"\" placeholder=\"Second name\" id=\"forminator-field-name-2_6a2d10fa993e3\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6a2d10fa993e3\" id=\"forminator-field-email-1_6a2d10fa993e3-label\" class=\"forminator-label\">Email Address <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"Email id\" id=\"forminator-field-email-1_6a2d10fa993e3\" class=\"forminator-input forminator-email--field\" data-required=\"true\" aria-required=\"true\" \/><\/div><\/div><div id=\"number-1\" class=\"forminator-field-number forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-1_6a2d10fa993e3\" id=\"forminator-field-number-1_6a2d10fa993e3-label\" class=\"forminator-label\">Phone Number <span class=\"forminator-required\">*<\/span><\/label><input name=\"number-1\" value=\"\" placeholder=\"Contact number\" id=\"forminator-field-number-1_6a2d10fa993e3\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"1\" data-decimals=\"0\" aria-required=\"true\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" type=\"number\" step=\"any\" min=\"5\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-3\" class=\"forminator-field-name forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-3_6a2d10fa993e3\" id=\"forminator-field-name-3_6a2d10fa993e3-label\" class=\"forminator-label\">Consultancy Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-3\" value=\"\" placeholder=\"Company Name\" id=\"forminator-field-name-3_6a2d10fa993e3\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><div id=\"number-4\" class=\"forminator-field-number forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-4_6a2d10fa993e3\" id=\"forminator-field-number-4_6a2d10fa993e3-label\" class=\"forminator-label\">Year of Establishment <span class=\"forminator-required\">*<\/span><\/label><input name=\"number-4\" value=\"\" placeholder=\"Business Establishment Year\" id=\"forminator-field-number-4_6a2d10fa993e3\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"1\" data-decimals=\"0\" aria-required=\"true\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" type=\"number\" step=\"any\" min=\"1900\" max=\"2030\" \/><\/div><\/div><div id=\"url-1\" class=\"forminator-field-url forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-url-1_6a2d10fa993e3\" id=\"forminator-field-url-1_6a2d10fa993e3-label\" class=\"forminator-label\">Website<\/label><input type=\"url\" name=\"url-1\" value=\"\" placeholder=\"http:\/\/www.domain.com\" id=\"forminator-field-url-1_6a2d10fa993e3\" class=\"forminator-input forminator-website--field\" data-required=\"\" aria-required=\"false\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_6a2d10fa993e3\" id=\"forminator-field-text-1_6a2d10fa993e3-label\" class=\"forminator-label\">City <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"Current city of business\" id=\"forminator-field-text-1_6a2d10fa993e3\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"number-2\" class=\"forminator-field-number forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-2_6a2d10fa993e3\" id=\"forminator-field-number-2_6a2d10fa993e3-label\" class=\"forminator-label\">Pincode <span class=\"forminator-required\">*<\/span><\/label><input name=\"number-2\" value=\"\" placeholder=\"Area code\" id=\"forminator-field-number-2_6a2d10fa993e3\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"1\" data-decimals=\"0\" aria-required=\"true\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" type=\"number\" step=\"any\" min=\"4\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"number-3\" class=\"forminator-field-number forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-3_6a2d10fa993e3\" id=\"forminator-field-number-3_6a2d10fa993e3-label\" class=\"forminator-label\">AADHAAR #<\/label><input name=\"number-3\" value=\"\" placeholder=\"xxx xxx xxx xxx\" id=\"forminator-field-number-3_6a2d10fa993e3\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"\" data-decimals=\"0\" aria-required=\"false\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" type=\"number\" step=\"any\" min=\"\" \/><\/div><\/div><div id=\"select-2\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-476__field--select-2_6a2d10fa993e3\" id=\"forminator-form-476__field--select-2_6a2d10fa993e3-label\" class=\"forminator-label\">Blood group<\/label><select  id=\"forminator-form-476__field--select-2_6a2d10fa993e3\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"\" name=\"select-2\" data-default-value=\"\" data-placeholder=\"\" data-search=\"false\" data-search-placeholder=\"\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-476__field--select-2_6a2d10fa993e3-label\"><option value=\"\" selected=\"selected\" data-calculation=\"0\">Blood Group<\/option><option value=\"a-ve\"  data-calculation=\"0\">A +ve<\/option><option value=\"a--ve\"  data-calculation=\"0\">A -ve<\/option><option value=\"b-ve\"  data-calculation=\"0\">B +ve<\/option><option value=\"b--ve\"  data-calculation=\"0\">B -ve<\/option><option value=\"o-ve\"  data-calculation=\"0\">O +ve<\/option><option value=\"o--ve\"  data-calculation=\"0\">O -ve<\/option><option value=\"ab-ve\"  data-calculation=\"0\">AB +ve<\/option><option value=\"ab--ve\"  data-calculation=\"0\">AB -ve<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-field-textarea forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2_6a2d10fa993e3\" id=\"forminator-field-textarea-2_6a2d10fa993e3-label\" class=\"forminator-label\">Office Address <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-2\" placeholder=\"Address Line 1 Address Line 2 City, State- Pincode\" id=\"forminator-field-textarea-2_6a2d10fa993e3\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:50px;\" ><\/textarea><\/div><\/div><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_6a2d10fa993e3\" id=\"forminator-field-textarea-1_6a2d10fa993e3-label\" class=\"forminator-label\">Residence Address <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-1\" placeholder=\"Address Line 1 Address Line 2 City, State- Pincode\" id=\"forminator-field-textarea-1_6a2d10fa993e3\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:50px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-6a2d10fa993e3-label\"><span id=\"forminator-radiogroup-6a2d10fa993e3-label\" class=\"forminator-label\">Are you referred by a CHECK member? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-6a2d10fa993e3\" class=\"forminator-radio forminator-radio-inline\" title=\"Yes\"><input type=\"radio\" name=\"radio-1\" value=\"yes\" id=\"forminator-field-radio-1-1-6a2d10fa993e3\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-6a2d10fa993e3\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-1\" value=\"no\" id=\"forminator-field-radio-1-2-6a2d10fa993e3\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-1\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Referal Section<\/label><span class=\"forminator-description forminator-repeater-description\">Atleast one CHECK Member reference detail is required<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:false,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_6a2d10fa993e3\" id=\"forminator-field-text-2_6a2d10fa993e3-label\" class=\"forminator-label\">Referenced By (1) <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"Member Name (*)\" id=\"forminator-field-text-2_6a2d10fa993e3\" class=\"forminator-input forminator-name--field\" data-required=\"1\" aria-describedby=\"forminator-field-text-2_6a2d10fa993e3-description\" \/><span id=\"forminator-field-text-2_6a2d10fa993e3-description\" class=\"forminator-description\">Name of the referenced member<\/span><\/div><\/div><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_6a2d10fa993e3\" id=\"forminator-field-text-3_6a2d10fa993e3-label\" class=\"forminator-label\">Member ID<\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3_6a2d10fa993e3\" class=\"forminator-input forminator-name--field\" data-required=\"\" aria-describedby=\"forminator-field-text-3_6a2d10fa993e3-description\" \/><span id=\"forminator-field-text-3_6a2d10fa993e3-description\" class=\"forminator-description\">If you know, please enter referred member id.<\/span><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_6a2d10fa993e3\" id=\"forminator-field-text-4_6a2d10fa993e3-label\" class=\"forminator-label\">Referenced By (2)<\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"Member Name (*)\" id=\"forminator-field-text-4_6a2d10fa993e3\" class=\"forminator-input forminator-name--field\" data-required=\"\" aria-describedby=\"forminator-field-text-4_6a2d10fa993e3-description\" \/><span id=\"forminator-field-text-4_6a2d10fa993e3-description\" class=\"forminator-description\">Name of the referenced member<\/span><\/div><\/div><div id=\"text-5\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-5_6a2d10fa993e3\" id=\"forminator-field-text-5_6a2d10fa993e3-label\" class=\"forminator-label\">Member ID<\/label><input type=\"text\" name=\"text-5\" value=\"\" placeholder=\"\" id=\"forminator-field-text-5_6a2d10fa993e3\" class=\"forminator-input forminator-name--field\" data-required=\"\" aria-describedby=\"forminator-field-text-5_6a2d10fa993e3-description\" \/><span id=\"forminator-field-text-5_6a2d10fa993e3-description\" class=\"forminator-description\">If you know, please enter referred member id.<\/span><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-1\" class=\"forminator-field-upload forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-1_6a2d10fa993e3\" id=\"forminator-field-upload-1_6a2d10fa993e3-label\" class=\"forminator-label\">Upload Profile Pictures <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-file-upload \" data-element=\"upload-1_6a2d10fa993e3\" aria-describedby=\"forminator-field-upload-1_6a2d10fa993e3-description\"><input type=\"file\" name=\"upload-1\" id=\"forminator-field-upload-1_6a2d10fa993e3\" class=\"forminator-input-file-required do-validate\" accept=\".heic,.jpg,.jpeg,.jpe,.png\"><button id=\"forminator-field-upload-1_6a2d10fa993e3_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-1_6a2d10fa993e3\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><span id=\"forminator-field-upload-1_6a2d10fa993e3-description\" class=\"forminator-description\">Passport size photo is required (.jpg\/.png  with max of 10MB Size)<\/span><\/div><\/div><div id=\"html-1\" class=\"forminator-field-html forminator-col forminator-col-6 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-1\"><label class=\"forminator-label\">Fees<\/label><p><strong>New Membership<\/strong>: Rs. 25,000\/-<br><strong>Annual Subscription<\/strong>: Rs. 1,000\/-<br><br><\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"gdprcheckbox-1\" class=\"forminator-field-gdprcheckbox forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-gdprcheckbox-1_6a2d10fa993e3\" id=\"forminator-field-gdprcheckbox-1_6a2d10fa993e3-label\" class=\"forminator-label\">GDPR <span class=\"forminator-required\">*<\/span><\/label><label for=\"forminator-field-gdprcheckbox-1_6a2d10fa993e3\" class=\"forminator-checkbox\"><input type=\"checkbox\" name=\"gdprcheckbox-1\" value=\"true\" id=\"forminator-field-gdprcheckbox-1_6a2d10fa993e3\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Yes, I agree with the privacy policy and terms and conditions.<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"captcha-1\" class=\"forminator-field-captcha forminator-col forminator-col-12 \"><div class=\"forminator-captcha-left forminator-g-recaptcha\" data-theme=\"light\"  data-sitekey=\"6LdzfqgaAAAAAFMuhMAKaouau1HCdYGms5FSHVaM\" data-size=\"normal\"><\/div> <\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\"><span>Send Message<\/span><span aria-hidden=\"true\"><\/span><\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"6edbe42d95\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F436\" \/><input type=\"hidden\" name=\"form_id\" value=\"476\"><input type=\"hidden\" name=\"page_id\" value=\"436\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/www.checkkerala.com\/?page_id=436\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Registration is mandatory for New Membership. You may be required to signing on a hard copy of a form which you may get on a mail (membership@checkkerala.com) to confirm the membership.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"full-width-template.php","meta":{"pgc_sgb_lightbox_settings":"","footnotes":""},"class_list":["post-436","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.checkkerala.com\/index.php?rest_route=\/wp\/v2\/pages\/436"}],"collection":[{"href":"https:\/\/www.checkkerala.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.checkkerala.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.checkkerala.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.checkkerala.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=436"}],"version-history":[{"count":9,"href":"https:\/\/www.checkkerala.com\/index.php?rest_route=\/wp\/v2\/pages\/436\/revisions"}],"predecessor-version":[{"id":2126,"href":"https:\/\/www.checkkerala.com\/index.php?rest_route=\/wp\/v2\/pages\/436\/revisions\/2126"}],"wp:attachment":[{"href":"https:\/\/www.checkkerala.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=436"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}