{"id":1425,"date":"2017-12-03T14:46:09","date_gmt":"2017-12-03T14:46:09","guid":{"rendered":"http:\/\/wmcnj.org\/?page_id=1425"},"modified":"2018-02-18T21:51:54","modified_gmt":"2018-02-18T21:51:54","slug":"xith-biennial-global-conference-online-registration-form","status":"publish","type":"page","link":"http:\/\/wmcnj.org\/index.php\/xith-biennial-global-conference-online-registration-form\/","title":{"rendered":"XIth Biennial Global Conference online registration form"},"content":{"rendered":"<p>[vc_row][vc_column]<style type=\"text\/css\">\r\n .ar_main_div_110 #heading_7929 { background-color:#ffffff; }  .ar_main_div_110 #heading_7929 h2.arf_sec_heading_field { font-family:Helvetica; font-size:16px;  font-weight:bold; font-style:normal; }<\/style>\r\n<div><script type=\"text\/javascript\" data-cfasync=\"false\">if(window['jQuery']){ if(!window['arf_cl']) window['arf_cl'] = new Array(); window['arf_cl']['tgrb02'] = { 7889 : { 'display': 'show', 'if_cond': 'all', 'field_type': 'html', 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id=\"arf_field_7888_container\" class=\"arfformfield control-group arfmainformfield  top_container \" ><div class=\"arf_htmlfield_control\"><h3 style=\"text-align: center;font-size: 22px;margin-top: 30px;margin-bottom: 50px;\">REGISTRANT DETAILS (AS IN PASSPORT)<\/h3><\/div><\/div>\n<div id=\"arf_field_7876_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired top_container frm_first_third\"  ><label for=\"field_ux46sj\" class=\"arf_main_label\">First Name<span class=\"arfcheckrequiredfield\">*<\/span><\/label>    <div class=\"controls\" >                             <input type=\"text\" id=\"field_ux46sj\" name=\"item_meta[7876]\"  class=\" arf_required\"  placeholder=\"\"   data-validation-required-message=\"This field cannot be blank.\"    \/>                       <\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7875_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_third\"  ><label 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class=\"arf_third_middle\"><\/div><div id=\"arf_field_7880_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired top_container frm_last_third\"  ><label for=\"field_ojibcq\" class=\"arf_main_label\">State<span class=\"arfcheckrequiredfield\">*<\/span><\/label>    <div class=\"controls\" >                             <input type=\"text\" id=\"field_ojibcq\" name=\"item_meta[7880]\"  class=\" arf_required\"  placeholder=\"\"   data-validation-required-message=\"This field cannot be blank.\"    \/>                       <\/div><\/div><div id=\"arf_field_7881_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired top_container frm_first_third\"  ><label for=\"field_lnci7i\" class=\"arf_main_label\">Postal<span class=\"arfcheckrequiredfield\">*<\/span><\/label>    <div class=\"controls\" ><input\t type=\"text\" id=\"field_lnci7i\" dir=\"ltr\"   name=\"item_meta[7881]\"  placeholder=\"\"   data-step=\"1\" class=\" arf_required\"    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name=\"item_meta[7885]\"  placeholder=\"\"   class=\" arf_required\"  data-validation-required-message=\"This field cannot be blank.\"  data-validation-regex-regex=\"[A-Za-z0-9._%+-]+@[A-Za-z0-9.-]+\\.[A-Za-z]+\"     data-validation-regex-message=\"Email is invalid\"    \/><\/div><\/div><div id=\"arf_field_7886_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired top_container frm_first_half\"  ><label for=\"field_9waoy8\" class=\"arf_main_label\">Emergency Contact Name<span class=\"arfcheckrequiredfield\">*<\/span><\/label>    <div class=\"controls\" >                             <input type=\"text\" id=\"field_9waoy8\" name=\"item_meta[7886]\"  class=\" arf_required\"  placeholder=\"\"   data-validation-required-message=\"This field cannot be blank.\"    \/>                       <\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7887_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired top_container frm_last_half\"  ><label for=\"field_tfcywr\" class=\"arf_main_label\">Emergency Phone & Address<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"controls\" ><textarea name=\"item_meta[7887]\" id=\"field_tfcywr\" rows=\"3\"  class=\" arf_required\" placeholder=''  data-validation-required-message=\"This field cannot be blank.\"                  ><\/textarea><\/div><\/div><div id=\"arf_field_7921_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired top_container frm_first_half\"  ><label for=\"field_sgoitc\" class=\"arf_main_label\">Associated Province Name:<span class=\"arfcheckrequiredfield\">*<\/span><\/label>    <div class=\"controls\" >                             <input type=\"text\" id=\"field_sgoitc\" name=\"item_meta[7921]\"  class=\" arf_required\"  placeholder=\"\"   data-validation-required-message=\"This field cannot be blank.\"    \/>                       <\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_9113_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired top_container frm_last_half\"  ><label for=\"field_q0pfso\" class=\"arf_main_label\">Associated Region<span class=\"arfcheckrequiredfield\">*<\/span><\/label>    <div class=\"sltstandard_front controls\" >                                         <select name=\"item_meta[9113]\" data-validation-required-message=\"This field cannot be blank.\" id=\"field_q0pfso\"  class=\"select_controll_9113 arf_required  arf_select_controll \"  data-size=\"15\"  >                                                                        <option value=\"\" selected=\"selected\" data-content=\"Please select\"><\/option>                                                                        <option value=\"America\"  data-content=\"America\"><\/option>                                                                        <option value=\"Africa\"  data-content=\"Africa\"><\/option>                                                                        <option value=\"Europe\"  data-content=\"Europe\"><\/option>                                                                        <option value=\"FE &amp; Australia\"  data-content=\"FE &amp; Australia\"><\/option>                                                                        <option value=\"ME\"  data-content=\"ME\"><\/option>                                                                        <option value=\"India\"  data-content=\"India\"><\/option>                                        <\/select><\/div><\/div><div id=\"arf_field_7889_container\" class=\"arfformfield control-group arfmainformfield  top_container \" ><div class=\"arf_htmlfield_control\"><h3 style=\"text-align: center;font-size: 22px;margin-top: 30px;margin-bottom: 50px;\">PROVIDE PASSPORT DETAILS (ONLY IF YOU ARE NOT A RESIDENT OF USA)<\/h3><\/div><\/div>\n<div id=\"arf_field_7927_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired top_container frm_first_third\"  ><label for=\"field_yj7g15\" class=\"arf_main_label\">Nationality<span class=\"arfcheckrequiredfield\">*<\/span><\/label>    <div class=\"sltstandard_front controls\" >                                         <select name=\"item_meta[7927]\" data-validation-required-message=\"This field cannot be blank.\" id=\"field_yj7g15\"  class=\"select_controll_7927 arf_required  arf_select_controll \"  data-size=\"15\"  >                                                                        <option value=\"\" selected=\"selected\" data-content=\"Please select\"><\/option>                                                                        <option value=\"Australia\"  data-content=\"Australia\"><\/option>                                                                        <option value=\"Austria\"  data-content=\"Austria\"><\/option>                                                                        <option value=\"Canada\"  data-content=\"Canada\"><\/option>                                                                        <option value=\"France\"  data-content=\"France\"><\/option>                                                                        <option value=\"Germany\"  data-content=\"Germany\"><\/option>                                                                        <option value=\"India\"  data-content=\"India\"><\/option>                                                                        <option value=\"Italy\"  data-content=\"Italy\"><\/option>                                                                        <option value=\"Malaysia\"  data-content=\"Malaysia\"><\/option>                                                                        <option value=\"New Zealand\"  data-content=\"New Zealand\"><\/option>                                                                        <option value=\"Singapore\"  data-content=\"Singapore\"><\/option>                                                                        <option value=\"South Africa\"  data-content=\"South Africa\"><\/option>                                                                        <option value=\"Switzerland\"  data-content=\"Switzerland\"><\/option>                                                                        <option value=\"United Arab Emirates\"  data-content=\"United Arab Emirates\"><\/option>                                                                        <option value=\"United Kingdom\"  data-content=\"United Kingdom\"><\/option>                                                                        <option value=\"United States\"  data-content=\"United States\"><\/option>                                        <\/select><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7890_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_third\"  ><label for=\"field_r6ojh2\" class=\"arf_main_label\">Place Of Issue:<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"controls\" >                             <input type=\"text\" id=\"field_r6ojh2\" name=\"item_meta[7890]\"   placeholder=\"\"       \/>                       <\/div><\/div><div class=\"arf_third_middle\"><\/div><div id=\"arf_field_7892_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_last_third\"  ><label for=\"field_cp3xut\" class=\"arf_main_label\">Date Of Issue:<span class=\"arfcheckrequiredfield\"><\/span><\/label><div class=\"controls arf_date_main_controls arf_cal_theme_default_theme\" ><input type=\"text\" id=\"field_cp3xut\" name=\"item_meta[7892]\"  class=\" frm_date\"  placeholder=\"\"     \/><\/div><\/div><div id=\"arf_field_7893_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_first_third\"  ><label for=\"field_uimge9\" class=\"arf_main_label\">Valid Until:<span class=\"arfcheckrequiredfield\"><\/span><\/label><div class=\"controls arf_date_main_controls arf_cal_theme_default_theme\" ><input type=\"text\" id=\"field_uimge9\" name=\"item_meta[7893]\"  class=\" frm_date\"  placeholder=\"\"     \/><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7928_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_third\"  ><label for=\"field_zr58d9\" class=\"arf_main_label\">Passport No<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"controls\" >                             <input type=\"text\" id=\"field_zr58d9\" name=\"item_meta[7928]\"   placeholder=\"\"       \/>                       <\/div><\/div><div class=\"arf_third_middle\"><\/div><div id=\"arf_field_7919_container\" class=\"arfformfield control-group arfmainformfield  top_container \" ><div class=\"arf_htmlfield_control\"><h3 style=\"text-align: center;font-size: 22px;margin-top: 30px;margin-bottom: 50px;\">FAMILY DETAILS (WHO WILL BE ACCOMPANYING YOU)<\/h3><\/div><\/div>\n<div id=\"arf_field_7895_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_first_third\"  ><label for=\"field_nrlmno\" class=\"arf_main_label\">Spouse (Delegate):<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"controls\" >                             <input type=\"text\" id=\"field_nrlmno\" name=\"item_meta[7895]\"   placeholder=\"\"       \/>                       <\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7896_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_third\"  ><label for=\"field_bjwguk\" class=\"arf_main_label\">Age<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"controls\" ><input\t type=\"text\" id=\"field_bjwguk\" dir=\"ltr\"   name=\"item_meta[7896]\"  placeholder=\"\"   data-step=\"1\"      onkeydown=\"arfvalidatenumber(this,event);\"  \/><\/div><\/div><div class=\"arf_third_middle\"><\/div><div id=\"arf_field_7897_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_last_third\"  ><label for=\"field_kj2k54\" class=\"arf_main_label\">Gender<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"sltstandard_front controls\" >                                         <select name=\"item_meta[7897]\"  id=\"field_kj2k54\"   data-size=\"15\"  >                                                                        <option value=\"\" selected=\"selected\" data-content=\"Please select\"><\/option>                                                                        <option value=\"Male\"  data-content=\"Male\"><\/option>                                                                        <option value=\"Female\"  data-content=\"Female\"><\/option>                                        <\/select><\/div><\/div><div id=\"arf_field_7891_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_first_third\"  ><label for=\"field_84gsfz\" class=\"arf_main_label\">Child Name:<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"controls\" >                             <input type=\"text\" id=\"field_84gsfz\" name=\"item_meta[7891]\"   placeholder=\"\"       \/>                       <\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7898_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_third\"  ><label for=\"field_sxr3i2\" class=\"arf_main_label\">Age<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"controls\" ><input\t type=\"text\" id=\"field_sxr3i2\" dir=\"ltr\"   name=\"item_meta[7898]\"  placeholder=\"\"   data-step=\"1\"      onkeydown=\"arfvalidatenumber(this,event);\"  \/><\/div><\/div><div class=\"arf_third_middle\"><\/div><div id=\"arf_field_7899_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_last_third\"  ><label for=\"field_u8ekxe\" class=\"arf_main_label\">Gender<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"sltstandard_front controls\" >                                         <select name=\"item_meta[7899]\"  id=\"field_u8ekxe\"   data-size=\"15\"  >                                                                        <option value=\"\" selected=\"selected\" data-content=\"Please select\"><\/option>                                                                        <option value=\"Male\"  data-content=\"Male\"><\/option>                                                                        <option value=\"Female\"  data-content=\"Female\"><\/option>                                        <\/select><\/div><\/div><div id=\"arf_field_7900_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_first_third\"  ><label for=\"field_95kkdd\" class=\"arf_main_label\">Child Name:<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"controls\" >                             <input type=\"text\" id=\"field_95kkdd\" name=\"item_meta[7900]\"   placeholder=\"\"       \/>                       <\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7901_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_third\"  ><label for=\"field_vmc3fl\" class=\"arf_main_label\">Age<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"controls\" ><input\t type=\"text\" id=\"field_vmc3fl\" dir=\"ltr\"   name=\"item_meta[7901]\"  placeholder=\"\"   data-step=\"1\"      onkeydown=\"arfvalidatenumber(this,event);\"  \/><\/div><\/div><div class=\"arf_third_middle\"><\/div><div id=\"arf_field_7902_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_last_third\"  ><label for=\"field_l5kzqa\" class=\"arf_main_label\">Gender<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"sltstandard_front controls\" >                                         <select name=\"item_meta[7902]\"  id=\"field_l5kzqa\"   data-size=\"15\"  >                                                                        <option value=\"\" selected=\"selected\" data-content=\"Please select\"><\/option>                                                                        <option value=\"Male\"  data-content=\"Male\"><\/option>                                                                        <option value=\"Female\"  data-content=\"Female\"><\/option>                                        <\/select><\/div><\/div><div id=\"arf_field_7894_container\" class=\"arfformfield control-group arfmainformfield  top_container \" ><div class=\"arf_htmlfield_control\"><h3 style=\"text-align: center;font-size: 22px;margin-top: 30px;margin-bottom: 50px;\">ITINERARY DETAILS<\/h3><\/div><\/div>\n<div id=\"arf_field_7909_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio top_container frm_first_third\"  ><label  class=\"arf_main_label\">Already Have a Valid U.S. Visa:<span class=\"arfcheckrequiredfield\"><\/span><\/label><div class=\"setting_checkbox controls\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7909-0\"><label for=\"field_7909-0\"><input type=\"checkbox\" name=\"item_meta[7909][]\" id=\"field_7909-0\" value=\"Yes\"    style=\" \" data-change=\"\" \/>Yes<\/label>                                                                                                        <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7909-1\"><label for=\"field_7909-1\"><input type=\"checkbox\" name=\"item_meta[7909][]\" id=\"field_7909-1\" value=\"No\"    style=\" \" data-change=\"\" \/>No<\/label>                                                                                                        <\/div><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7910_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_third\"  ><label for=\"field_cg226z\" class=\"arf_main_label\">Date Of Arrival<span class=\"arfcheckrequiredfield\"><\/span><\/label><div class=\"controls arf_date_main_controls arf_cal_theme_default_theme\" ><input type=\"text\" id=\"field_cg226z\" name=\"item_meta[7910]\"  class=\" frm_date\"  placeholder=\"\"     \/><\/div><\/div><div class=\"arf_third_middle\"><\/div><div id=\"arf_field_7911_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_last_third\"  ><label for=\"field_legfef\" class=\"arf_main_label\">Time Of Arrrrival<span class=\"arfcheckrequiredfield\"><\/span><\/label><div class=\"sltstandard_time controls arf_time_main_controls arf_cal_theme_default_theme \" ><input type=\"text\" name=\"item_meta[7911]\" class=\"arf_timepciker\" id=\"field_legfef\" value=\"\"   \/><\/div><\/div><div id=\"arf_field_7912_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_first_half\"  ><label for=\"field_tu8hmo\" class=\"arf_main_label\">Date Of Departure<span class=\"arfcheckrequiredfield\"><\/span><\/label><div class=\"controls arf_date_main_controls arf_cal_theme_default_theme\" ><input type=\"text\" id=\"field_tu8hmo\" name=\"item_meta[7912]\"  class=\" frm_date\"  placeholder=\"\"     \/><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7913_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_last_half\"  ><label for=\"field_qi918y\" class=\"arf_main_label\">Time Of Departure<span class=\"arfcheckrequiredfield\"><\/span><\/label><div class=\"sltstandard_time controls arf_time_main_controls arf_cal_theme_default_theme \" ><input type=\"text\" name=\"item_meta[7913]\" class=\"arf_timepciker\" id=\"field_qi918y\" value=\"\"   \/><\/div><\/div><div id=\"arf_field_7914_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio top_container frm_first_third\"  ><label  class=\"arf_main_label\">Food Restrictions:<span class=\"arfcheckrequiredfield\"><\/span><\/label><div class=\"setting_checkbox controls\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7914-0\"><label for=\"field_7914-0\"><input type=\"checkbox\" name=\"item_meta[7914][]\" id=\"field_7914-0\" value=\"Veg\"    style=\" \" data-change=\"\" \/>Veg<\/label>                                                                                                        <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7914-1\"><label for=\"field_7914-1\"><input type=\"checkbox\" name=\"item_meta[7914][]\" id=\"field_7914-1\" value=\"Non Veg\"    style=\" \" data-change=\"\" \/>Non Veg<\/label>                                                                                                        <\/div><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7915_container\" class=\"arfformfield control-group arfmainformfield  arf_horizontal_radio top_container frm_third\"  ><label  class=\"arf_main_label\">Allergies?<span class=\"arfcheckrequiredfield\"><\/span><\/label><div class=\"setting_checkbox controls\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7915-0\"><label for=\"field_7915-0\"><input type=\"checkbox\" name=\"item_meta[7915][]\" id=\"field_7915-0\" value=\"Yes\"    style=\" \" data-change=\"\" \/>Yes<\/label>                                                                                                        <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7915-1\"><label for=\"field_7915-1\"><input type=\"checkbox\" name=\"item_meta[7915][]\" id=\"field_7915-1\" value=\"No\"    style=\" \" data-change=\"\" \/>No<\/label>                                                                                                        <\/div><\/div><\/div><div class=\"arf_third_middle\"><\/div><div id=\"arf_field_7936_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_last_third\"  ><label for=\"field_sjjbe4\" class=\"arf_main_label\">Allergic Food If Any<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"controls\" >                             <input type=\"text\" id=\"field_sjjbe4\" name=\"item_meta[7936]\"   placeholder=\"\"       \/>                       <\/div><\/div><div id=\"arf_field_7916_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_first_half\"  ><label for=\"field_vtauyp\" class=\"arf_main_label\">Address Of Stay in US:<span class=\"arfcheckrequiredfield\"><\/span><\/label><div class=\"controls\" ><textarea name=\"item_meta[7916]\" id=\"field_vtauyp\" rows=\"3\"  placeholder=''                    ><\/textarea><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7917_container\" class=\"arfformfield control-group arfmainformfield  top_container \" ><div class=\"arf_htmlfield_control\"><h3 style=\"text-align: center;font-size: 22px;margin-top: 30px;margin-bottom: 50px;\">REGISTRATION PACKAGES<\/h3><\/div><\/div>\n<div id=\"arf_field_7920_container\" class=\"arfformfield control-group arfmainformfield  top_container \" ><div class=\"arf_htmlfield_control\"><img decoding=\"async\" src=\"http:\/\/wmcnj.org\/wp-content\/uploads\/2018\/05\/up1.jpg\" width=\"100%\"\/>\r\n<br \/>\r\n<span style=\"color:#FF0000;font-family:Times New Roman;font-size:12px;\"><br \/>**(for L2, M2, & N3 packages) If you would like to come aboard the cruise, please add $100 per person to the registration cost.<\/span><\/div><\/div>\n<div id=\"arf_field_7918_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_vertical_radio top_container \"  ><label  class=\"arf_main_label\">Packages<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_checkbox controls\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7918-0\"><label for=\"field_7918-0\"><input type=\"checkbox\" name=\"item_meta[7918][]\" id=\"field_7918-0\" value=\"2200\"   class=\" arf_required\" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=\" \" data-change=\"arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);\" \/>VIP Family (4) J1 ($2200)<\/label>                                                                                                                                        <script type=\"text\/javascript\">jQuery(document).ready(function () {                                        jQuery('#field_7918-0').on('ifChanged', function (event) {arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);                                        });                                    });<\/script>                                <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7918-1\"><label for=\"field_7918-1\"><input type=\"checkbox\" name=\"item_meta[7918][]\" id=\"field_7918-1\" value=\"1800\"   class=\" arf_required\"  style=\" \" data-change=\"arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);\" \/>VIP Couple (2) J2 ($1800)<\/label>                                                                                                                                        <script type=\"text\/javascript\">jQuery(document).ready(function () {                                        jQuery('#field_7918-1').on('ifChanged', function (event) {arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);                                        });                                    });<\/script>                                <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7918-2\"><label for=\"field_7918-2\"><input type=\"checkbox\" name=\"item_meta[7918][]\" id=\"field_7918-2\" value=\"1600\"   class=\" arf_required\"  style=\" \" data-change=\"arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);\" \/>VIP Single (1) J3 ($1600)<\/label>                                                                                                                                        <script type=\"text\/javascript\">jQuery(document).ready(function () {                                        jQuery('#field_7918-2').on('ifChanged', function (event) {arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);                                        });                                    });<\/script>                                <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7918-3\"><label for=\"field_7918-3\"><input type=\"checkbox\" name=\"item_meta[7918][]\" id=\"field_7918-3\" value=\"1400\"   class=\" arf_required\"  style=\" \" data-change=\"arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);\" \/>Family (4) L1 ($1400)<\/label>                                                                                                                                        <script type=\"text\/javascript\">jQuery(document).ready(function () {                                        jQuery('#field_7918-3').on('ifChanged', function (event) {arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);                                        });                                    });<\/script>                                <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7918-4\"><label for=\"field_7918-4\"><input type=\"checkbox\" name=\"item_meta[7918][]\" id=\"field_7918-4\" value=\"450\"   class=\" arf_required\"  style=\" \" data-change=\"arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);\" \/>Family (4) L2 ** ($450)<\/label>                                                                                                                                        <script type=\"text\/javascript\">jQuery(document).ready(function () {                                        jQuery('#field_7918-4').on('ifChanged', function (event) {arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);                                        });                                    });<\/script>                                <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7918-5\"><label for=\"field_7918-5\"><input type=\"checkbox\" name=\"item_meta[7918][]\" id=\"field_7918-5\" value=\"900\"   class=\" arf_required\"  style=\" \" data-change=\"arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);\" \/>Couple (2) M1 ($900)<\/label>                                                                                                                                        <script type=\"text\/javascript\">jQuery(document).ready(function () {                                        jQuery('#field_7918-5').on('ifChanged', function (event) {arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);                                        });                                    });<\/script>                                <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7918-6\"><label for=\"field_7918-6\"><input type=\"checkbox\" name=\"item_meta[7918][]\" id=\"field_7918-6\" value=\"350\"   class=\" arf_required\"  style=\" \" data-change=\"arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);\" \/>Couple (2) M2 ** ($350)<\/label>                                                                                                                                        <script type=\"text\/javascript\">jQuery(document).ready(function () {                                        jQuery('#field_7918-6').on('ifChanged', function (event) {arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);                                        });                                    });<\/script>                                <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7918-7\"><label for=\"field_7918-7\"><input type=\"checkbox\" name=\"item_meta[7918][]\" id=\"field_7918-7\" value=\"650\"   class=\" arf_required\"  style=\" \" data-change=\"arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);\" \/>Single (1) N1 ($650)<\/label>                                                                                                                                        <script type=\"text\/javascript\">jQuery(document).ready(function () {                                        jQuery('#field_7918-7').on('ifChanged', function (event) {arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);                                        });                                    });<\/script>                                <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7918-8\"><label for=\"field_7918-8\"><input type=\"checkbox\" name=\"item_meta[7918][]\" id=\"field_7918-8\" value=\"450.00\"   class=\" arf_required\"  style=\" \" data-change=\"arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);\" \/>Single (1) N2 ($450)<\/label>                                                                                                                                        <script type=\"text\/javascript\">jQuery(document).ready(function () {                                        jQuery('#field_7918-8').on('ifChanged', function (event) {arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);                                        });                                    });<\/script>                                <\/div><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7918-9\"><label for=\"field_7918-9\"><input type=\"checkbox\" name=\"item_meta[7918][]\" id=\"field_7918-9\" value=\"200\"   class=\" arf_required\"  style=\" \" data-change=\"arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);\" \/>Single (1) N3 ** ($200)<\/label>                                                                                                                                        <script type=\"text\/javascript\">jQuery(document).ready(function () {                                        jQuery('#field_7918-9').on('ifChanged', function (event) {arf_rule_apply('tgrb02', '7918', [7935,7935,7935]); arf_calculate_total('tgrb02', '7918', [7933,7932,7924]);                                        });                                    });<\/script>                                <\/div><\/div><\/div><div id=\"arf_field_7935_container\" class=\"arfformfield control-group arfmainformfield  top_container frm_first_third\"  style=\"display:none;\"><label for=\"field_q4yo5o\" class=\"arf_main_label\">Add cruise tickets ($100 per person). For L2, M2, N3 select additional passengers.<span class=\"arfcheckrequiredfield\"><\/span><\/label>    <div class=\"sltstandard_front controls\" >                                         <select name=\"item_meta[7935]\"  id=\"field_q4yo5o\"   data-size=\"15\"  onchange=\" arf_calculate_total('tgrb02', '7935', [7933,7932,7924]);\"  >                                                                        <option value=\"\" selected=\"selected\" data-content=\"Select number of passengers\"><\/option>                                                                        <option value=\"100\"  data-content=\"1\"><\/option>                                                                        <option value=\"200\"  data-content=\"2\"><\/option>                                                                        <option value=\"300\"  data-content=\"3\"><\/option>                                                                        <option value=\"400\"  data-content=\"4\"><\/option>                                        <\/select><\/div><\/div><div class=\"arf_half_middle\"><\/div><div id=\"arf_field_7925_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired top_container frm_third\"  ><label for=\"field_f82o96\" class=\"arf_main_label\">Mode Of Payment<span class=\"arfcheckrequiredfield\">*<\/span><\/label>    <div class=\"sltstandard_front controls\" >                                         <select name=\"item_meta[7925]\" data-validation-required-message=\"This field cannot be blank.\" id=\"field_f82o96\"  class=\"select_controll_7925 arf_required  arf_select_controll \"  data-size=\"15\"  onchange=\" arf_rule_apply('tgrb02', '7925', [7933,7932,7924,7923]);\"  >                                                                        <option value=\"\" selected=\"selected\" data-content=\"Please select\"><\/option>                                                                        <option value=\"paypal\"  data-content=\"Paypal \/ Credit Card\"><\/option>                                                                        <option value=\"cash\"  data-content=\"Check\/Cash\"><\/option>                                                                        <option value=\"wire\"  data-content=\"Wire\"><\/option>                                        <\/select><\/div><\/div><div class=\"arf_third_middle\"><\/div><div id=\"arf_field_7933_container\" class=\"arfformfield control-group arfmainformfield  top_container \" style=\"display:none;\"><div class=\"arf_htmlfield_control\"> <h2 style=\"font-family:Times New Roman;font-size:26px;\">Total Amount: \r\n\r\n<span style=\"color:#FF0000;font-family:Times New Roman;font-size:30px;\">$<div id=\"arf_running_total_7933\" class=\"arf_running_total\" data-arfcalc=\"\r\n0 + (0 *0.02)+ \r\n0 + (0 *0.02)+\r\n0 + (0 *0.02)+\r\n0 + (0 *0.02)+\r\n0 + (0 *0.02) +\r\n0 + (0 *0.02) +\r\n0 + (0 *0.02) +\r\n0 + (0 *0.02) +\r\n0 + (0 *0.02) + \r\n0 + (0 *0.02) +\r\n0 + (0 *0.02)\r\n\r\n\">&nbsp;<\/div><\/span><\/h2><h4> Includes 2% Service Charge...<\/h4><\/div><\/div>\n<div id=\"arf_field_7932_container\" class=\"arfformfield control-group arfmainformfield  top_container \" style=\"display:none;\"><div class=\"arf_htmlfield_control\"> <h2 style=\"font-family:Times New Roman;font-size:26px;\">Total Amount: \r\n<span style=\"color:#FF0000;font-family:Times New Roman;font-size:30px;\">$ <div id=\"arf_running_total_7932\" class=\"arf_running_total\" data-arfcalc=\"0+0+0+0+0+0+0+0+0+0+0\">&nbsp;<\/div><\/div><\/div>\n<div id=\"arf_field_7924_container\" class=\"arfformfield control-group arfmainformfield  top_container \" style=\"display:none;\"><div class=\"arf_htmlfield_control\"> <h2 style=\"font-family:Times New Roman;font-size:26px;\">Total Amount: \r\n<span style=\"color:#FF0000;font-family:Times New Roman;font-size:30px;\">$ <div id=\"arf_running_total_7924\" class=\"arf_running_total\" data-arfcalc=\"0+0+0+0+0+0+0+0+0+0+0\">&nbsp;<\/div><\/div><\/div>\n<div id=\"arf_field_7923_container\" class=\"arfformfield control-group arfmainformfield  top_container \" style=\"display:none;\"><div class=\"arf_htmlfield_control\"><table style=\"width:100%\">\r\n<h3>The Bank Details for WMC Conference 2018 payment.<\/h3>\r\n  <caption>To avoid processing delays, please use the following routing instructions for incoming wire transfers:<\/caption>\r\n  \r\n  <tr>\r\n    <td>For Domestic Wires<\/td>\r\n    <td>Wire Routing Transit Number (RTN\/ABA) 121000248<\/td>\r\n  <\/tr>\r\n  <tr>\r\n    <td>For International<\/td>\r\n    <td>SWIFT\/BIC code WFBIUS6S<\/td>\r\n  <\/tr>\r\n  <tr>\r\n    <td>Bank name<\/td>\r\n    <td>Wells Fargo Bank, N.A.<\/td>\r\n  <\/tr>\r\n  <tr>\r\n    <td>Bank address<\/td>\r\n    <td>420 Montgomery St.<\/td>\r\n  <\/tr>\r\n  <tr>\r\n    <td>City &amp; State<\/td>\r\n    <td>San Francisco, CA 94104<\/td>\r\n  <\/tr>\r\n  <tr>\r\n    <td>Account Name<\/td>\r\n    <td>World Malayalee Council NJ province convention 2018<\/td>\r\n  <\/tr>\r\n  <tr>\r\n    <td>Account number<\/td>\r\n    <td>2457888630<\/td>\r\n  <\/tr>\r\n<\/table><br>Make Check Payable to: WMC convention 2018. Check Mailing Address: Shobha Jacob, PO Box 75, Little Falls, NJ 07424<\/div><\/div>\n<div id=\"heading_7929\" class=\"arf_heading_div\" ><h2 class=\"arf_sec_heading_field pos_top\"><\/h2><div><\/div><div id=\"arf_field_7930_container\" class=\"arfformfield control-group arfmainformfield  top_container \" ><div class=\"arf_htmlfield_control\"><h3>Terms and Conditions<\/h3><p style=\"text-align:left;padding-bottom:30px;\"> By registering for the Conference, intending to be legally bound, I understand that it is my sole responsibility to provide for the visa, safety, liability and medical insurance of\r\neveryone listed on this form and I hereby agree to release from liability and to fully indemnify and hold harmless The World Malayalee Council and the Biennial Conference\r\nCommittee (including, but no limited to, its officers, directors and members) and the World Malayalee Council America Region. This waiver and release is for any and all\r\nliability, including, but not limited to, personal injuries (including death), costs, expenses, property losses or damages occasioned by, or arising in connection with, any\r\nactivity related to any and all Conference Events. I voluntarily assume all risk and danger relating to the Conference, whether occurring prior to, during or after the event. I\r\nfully agree to comply by the local and Federal laws of the land. <\/p>\r\n<br>\r\nFor Check\/Cash\/Wire - The Registration is complete on receipt of payments.\r\nWire payment instructions are sent to your registration e-mail. <\/div><\/div>\n<div id=\"arf_field_7934_container\" class=\"arfformfield control-group arfmainformfield  top_container \" ><div class=\"arf_htmlfield_control\"><span style=\"color:#FF0000;font-family:Times New Roman;font-size:20px;\">Registration questions or issues email to : wmcconfregister@gmail.com\r\n<br \/>\r\nContacts: Pinto Kannampally 001 (973) 337-7238 | Thangam 001 (908) 477-9895<\/span><\/div><\/div>\n<div id=\"arf_field_7931_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_vertical_radio top_container \"  ><label  class=\"arf_main_label\">Conditions<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_checkbox controls\" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style\" id=\"frm_checkbox_7931-0\"><label for=\"field_7931-0\"><input type=\"checkbox\" name=\"item_meta[7931][]\" id=\"field_7931-0\" value=\"Yes\"   class=\" arf_required\" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"This field cannot be blank.\" style=\" \" data-change=\"\" \/>Accept Terms and Conditions<\/label>                                                                                                        <\/div><\/div><\/div><div><input type=\"hidden\" name=\"entry_key\" value=\"\" \/><\/div><div class='arf_clear'><\/div><\/div><div style=\"clear:both;height:1px;\">&#32;<\/div><\/div><div class=\"arfsubmitbutton top_container\" ><div class=\"arf_submit_div top_container\"><input type=\"hidden\" value=\"1\" name=\"is_submit_form_110\" id=\"is_submit_form_110\" \/><input type=\"hidden\" value=\"0\" data-val=\"0\" data-max=\"0\" name=\"submit_form_110\" id=\"submit_form_110\" \/><button class=\"arf_submit_btn btn btn-info arfstyle-button \" data-style=\"zoom-in\" ><span class=\"arfstyle-label\">Submit<\/span><span class=\"arfstyle-spinner\"><div class=\"arflogo\"><div class=\"b arfred\"><div><\/div><\/div><div class=\"b arfblue\"><div><\/div><\/div><div class=\"b arfyellow\"><div><\/div><\/div><div class=\"b arfgreen\"><div><\/div><\/div><\/div><\/span><\/button><\/div><\/div><div style=\"clear:both\"><\/div><div id=\"brand-div\" class=\"brand-div top_container\" style=\"margin-top:20px; 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