{"id":597,"date":"2020-06-27T08:24:16","date_gmt":"2020-06-27T08:24:16","guid":{"rendered":"https:\/\/nifaas.org.ng\/?page_id=597"},"modified":"2020-10-17T15:26:18","modified_gmt":"2020-10-17T15:26:18","slug":"new-membership-registration-and-dues","status":"publish","type":"page","link":"https:\/\/nifaas.org.ng\/site\/new-membership-registration-and-dues\/","title":{"rendered":"Membership-Registration"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><h1 id='pf-form527'>NIFAAS New Membership Registration &amp; Dues<\/h1><form version=\"4.0.5\" enctype=\"multipart\/form-data\" action=\"https:\/\/nifaas.org.ng\/site\/wp-admin\/admin-ajax.php\" method=\"post\" class=\"paystack-form j-forms\" novalidate>\n\t\t\t\t\t\t\t<div class=\"j-row\"><input type=\"hidden\" name=\"action\" value=\"pff_paystack_submit_action\">\n\t\t\t\t<input type=\"hidden\" name=\"pf-id\" value=\"527\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"pf-user_id\" value=\"0\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"pf-recur\" value=\"no\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"pf-currency\" id=\"pf-currency\" value=\"NGN\" \/><input type=\"hidden\" id=\"pf-nonce\" name=\"pf-nonce\" value=\"13f4761643\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/site\/wp-json\/wp\/v2\/pages\/597\" \/><div class=\"span12 unit\">\n\t\t\t<label class=\"label\">Full Name <span>*<\/span><\/label>\n\t\t\t<div class=\"input\">\n\t\t\t\t<input type=\"text\" name=\"pf-fname\" placeholder=\"First &amp; Last Name\" value=\"\" required>\n\t\t\t<\/div>\n\t\t<\/div><div class=\"span12 unit\">\n\t\t\t<label class=\"label\">Email <span>*<\/span><\/label>\n\t\t\t<div class=\"input\">\n\t\t\t\t<input type=\"email\" name=\"pf-pemail\" placeholder=\"Enter Email Address\" id=\"pf-email\" value=\"\"  required>\n\t\t\t<\/div>\n\t\t<\/div><div class=\"span12 unit\">\n\t\t\t<label class=\"label\">Amount (NGN) <span>*<\/span><\/label>\n\t\t\t<div class=\"input\"><div class=\"select\">\n\t\t\t\t\t\t\t<input type=\"hidden\"  id=\"pf-vname\" name=\"pf-vname\" \/>\n\t\t\t\t\t\t\t<input type=\"hidden\"  id=\"pf-amount\" \/>\n\t\t\t\t\t\t\t<select class=\"form-control\" id=\"pf-vamount\" name=\"pf-amount\"><option value=\"25000\" data-name=\"Individual\">Individual - NGN 25,000<\/option><option value=\"150000\" data-name=\"Coporate\">Coporate - NGN 150,000<\/option><\/select> <i><\/i> <\/div><small>Transaction Charge: <b class=\"pf-txncharge\"><\/b>, Total:<b  class=\"pf-txntotal\"><\/b><\/small><div style=\"color:red;\"><small id=\"pf-min-val-warn\"><\/small><\/div><\/div><\/div>Please Enter your Title and Names the way it should appear on your membership certificate\r\n<div class=\"span12 unit\"><label for=\"select-6acfb305c0182\" class=\"label\">Title <span>*<\/span><\/label><div class=\"input\"><select id=\"select-6acfb305c0182\" class=\"form-control\" name=\"Title\" required><option value=\"Prof\">Prof<\/option><option value=\"Dr\">Dr<\/option><option value=\"Engr\">Engr<\/option><option value=\"Mr\">Mr<\/option><option value=\"Mrs\">Mrs<\/option><option value=\"Ms\">Ms<\/option><\/select><i><\/i><\/div><\/div>\r\n<div class=\"span12 unit\">\n\t\t\t<label for=\"text-6acfb305c01c1\" class=\"label\">Enter Surname <span>*<\/span><\/label>\n\t\t\t<div class=\"input\">\n\t\t\t\t<input type=\"text\" id=\"text-6acfb305c01c1\" name=\"Enter Surname\" placeholder=\"Enter Surname\" required \/><\/div><\/div>\r\n<div class=\"span12 unit\">\n\t\t\t<label for=\"text-6acfb305c01df\" class=\"label\">Enter Othernames <span>*<\/span><\/label>\n\t\t\t<div class=\"input\">\n\t\t\t\t<input type=\"text\" id=\"text-6acfb305c01df\" name=\"Enter Othernames\" placeholder=\"Enter Othernames\" required \/><\/div><\/div>\r\n<div class=\"span12 unit\"><label class=\"label\">Gender<\/label><div class=\"inline-group\"><label for=\"radio-6acfb305c01f2\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c01f2\" name=\"Gender\" value=\"Male\" checked ><i><\/i>Male<\/label><label for=\"radio-6acfb305c01f8\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c01f8\" name=\"Gender\" value=\"Female\"  ><i><\/i>Female<\/label><\/div><\/div>\r\n<div class=\"span12 unit\">\n\t\t\t<label for=\"text-6acfb305c0213\" class=\"label\">Enter Phone Number <span>*<\/span><\/label>\n\t\t\t<div class=\"input\">\n\t\t\t\t<input type=\"text\" id=\"text-6acfb305c0213\" name=\"Enter Phone Number\" placeholder=\"Enter Phone Number\" required \/><\/div><\/div>\r\n<div class=\"span12 unit\">\n\t\t\t<label for=\"text-6acfb305c022c\" class=\"label\">Enter Alternate Phone Number<\/label>\n\t\t\t<div class=\"input\">\n\t\t\t\t<input type=\"text\" id=\"text-6acfb305c022c\" name=\"Enter Alternate Phone Number\" placeholder=\"Enter Alternate Phone Number\"  \/><\/div><\/div>\r\n<div class=\"span12 unit\">\n\t\t\t<label for=\"text-6acfb305c0243\" class=\"label\">Enter Organization <span>*<\/span><\/label>\n\t\t\t<div class=\"input\">\n\t\t\t\t<input type=\"text\" id=\"text-6acfb305c0243\" name=\"Enter Organization\" placeholder=\"Enter Organization\" required \/><\/div><\/div>\r\n<div class=\"span12 unit\"><label for=\"textarea-6acfb305c025f\" class=\"label\">Enter Organization\/ Postal Address <span>*<\/span><\/label><div class=\"input\"><textarea id=\"textarea-6acfb305c025f\" name=\"Enter Organization\/ Postal Address\" rows=\"3\" placeholder=\"Enter Organization\/ Postal Address\" required><\/textarea><\/div><\/div>\r\n<div class=\"span12 unit\">\n\t\t\t<label for=\"text-6acfb305c0277\" class=\"label\">Enter Job Title<\/label>\n\t\t\t<div class=\"input\">\n\t\t\t\t<input type=\"text\" id=\"text-6acfb305c0277\" name=\"Enter Job Title\" placeholder=\"Enter Job Title\"  \/><\/div><\/div>\r\n<div class=\"span12 unit\"><label class=\"label\">Job Status<\/label><div class=\"inline-group\"><label for=\"radio-6acfb305c0287\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c0287\" name=\"Job Status\" value=\"Employee\" checked ><i><\/i>Employee<\/label><label for=\"radio-6acfb305c028c\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c028c\" name=\"Job Status\" value=\"Self-employed\"  ><i><\/i>Self-employed<\/label><\/div><\/div>\r\n<div class=\"span12 unit\"><label class=\"label\">Sector<\/label><div class=\"inline-group\"><label for=\"radio-6acfb305c029b\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c029b\" name=\"Sector\" value=\"Public\" checked ><i><\/i>Public<\/label><label for=\"radio-6acfb305c02a0\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c02a0\" name=\"Sector\" value=\"Private\"  ><i><\/i>Private<\/label><\/div><\/div>\r\n<div class=\"span12 unit\"><label class=\"label\">Geographic area of operation<\/label><div class=\"inline-group\"><label for=\"radio-6acfb305c02c2\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c02c2\" name=\"Geographic area of operation\" value=\"South West\" checked ><i><\/i>South West<\/label><label for=\"radio-6acfb305c02c7\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c02c7\" name=\"Geographic area of operation\" value=\"South East\"  ><i><\/i>South East<\/label><label for=\"radio-6acfb305c02ca\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c02ca\" name=\"Geographic area of operation\" value=\"South South\"  ><i><\/i>South South<\/label><label for=\"radio-6acfb305c02ce\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c02ce\" name=\"Geographic area of operation\" value=\"North Central\"  ><i><\/i>North Central<\/label><label for=\"radio-6acfb305c02d2\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c02d2\" name=\"Geographic area of operation\" value=\"North West\"  ><i><\/i>North West<\/label><label for=\"radio-6acfb305c02d5\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c02d5\" name=\"Geographic area of operation\" value=\"North East\"  ><i><\/i>North East<\/label><\/div><\/div>\r\n<div class=\"span12 unit\">\n\t\t\t<label for=\"text-6acfb305c02f2\" class=\"label\">Enter Area of Expertise in Agric Ext. and Advisory Services <span>*<\/span><\/label>\n\t\t\t<div class=\"input\">\n\t\t\t\t<input type=\"text\" id=\"text-6acfb305c02f2\" name=\"Enter Area of Expertise in Agric Ext. and Advisory Services\" placeholder=\"Enter Area of Expertise in Agric Ext. and Advisory Services\" required \/><\/div><\/div>\r\n<div class=\"span12 unit\"><label class=\"label\">Types of Membership Requested <span>*<\/span><\/label><div class=\"inline-group\"><label for=\"radio-6acfb305c0303\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c0303\" name=\"Types of Membership Requested\" value=\"Individual\" checked required><i><\/i>Individual<\/label><label for=\"radio-6acfb305c0308\" class=\"radio\"><input type=\"radio\" id=\"radio-6acfb305c0308\" name=\"Types of Membership Requested\" value=\"Corporate\"  required><i><\/i>Corporate<\/label><\/div><\/div>\r\n<div class=\"span12 unit\"><label for=\"select-6acfb305c031c\" class=\"label\">Highest Educational Qualification<\/label><div class=\"input\"><select id=\"select-6acfb305c031c\" class=\"form-control\" name=\"Highest Educational Qualification\" ><option value=\"Select\">Select<\/option><option value=\"OND\">OND<\/option><option value=\"HND\">HND<\/option><option value=\"PGD\">PGD<\/option><option value=\"BSC\/BEngr\/BEd\/Btech\">BSC\/BEngr\/BEd\/Btech<\/option><option value=\"MSC\/MEd\/etc\">MSC\/MEd\/etc<\/option><option value=\"MPhil\">MPhil<\/option><option value=\"PhD\">PhD<\/option><\/select><i><\/i><\/div><\/div>\r\n<div class=\"span12 unit\"><label for=\"select-6acfb305c0350\" class=\"label\">State <span>*<\/span><\/label><div class=\"input\"><select id=\"select-6acfb305c0350\" class=\"form-control\" name=\"State\" required><option value=\"Select\">Select<\/option><option value=\"Abia\">Abia<\/option><option value=\"Adamawa\">Adamawa<\/option><option value=\"Akwa Ibom\">Akwa Ibom<\/option><option value=\"Anambra\">Anambra<\/option><option value=\"Bauchi\">Bauchi<\/option><option value=\"Bayelsa\">Bayelsa<\/option><option value=\"Benue\">Benue<\/option><option value=\"Borno\">Borno<\/option><option value=\"Cross River\">Cross River<\/option><option value=\"Delta\">Delta<\/option><option value=\"Ebonyi\">Ebonyi<\/option><option value=\"Edo\">Edo<\/option><option value=\"Ekiti\">Ekiti<\/option><option value=\"Enugu\">Enugu<\/option><option value=\"FCT\">FCT<\/option><option value=\"Gombe\">Gombe<\/option><option value=\"Imo\">Imo<\/option><option value=\"Jigawa\">Jigawa<\/option><option value=\"Kaduna\">Kaduna<\/option><option value=\"Kano\">Kano<\/option><option value=\"Katsina\">Katsina<\/option><option value=\"Kebbi\">Kebbi<\/option><option value=\"Kogi\">Kogi<\/option><option value=\"Kwara\">Kwara<\/option><option value=\"Lagos\">Lagos<\/option><option value=\"Nasarawa\">Nasarawa<\/option><option value=\"Niger\">Niger<\/option><option value=\"Ogun\">Ogun<\/option><option value=\"Ondo\">Ondo<\/option><option value=\"Osun\">Osun<\/option><option value=\"Oyo\">Oyo<\/option><option value=\"Plateau\">Plateau<\/option><option value=\"Rivers\">Rivers<\/option><option value=\"Sokoto\">Sokoto<\/option><option value=\"Taraba\">Taraba<\/option><option value=\"Yobe\">Yobe<\/option><option value=\"Zamfara\">Zamfara<\/option><\/select><i><\/i><\/div><\/div>\r\n<div class=\"span12 unit\"><label for=\"select-6acfb305c0392\" class=\"label\">Country <span>*<\/span><\/label><div class=\"input\"><select id=\"select-6acfb305c0392\" class=\"form-control\" name=\"Country\" required><option value=\"Nigeria\">Nigeria<\/option><option value=\"Others\">Others<\/option><\/select><i><\/i><\/div><\/div><div class=\"span12 unit\">\n\t\t\t<small><span style=\"color: red;\">*<\/span> are compulsory<\/small>\n\t\t\t<br \/>\n\t\t\t<img decoding=\"async\" src=\"https:\/\/nifaas.org.ng\/site\/wp-content\/plugins\/payment-forms-for-paystack\/\/assets\/images\/logos@2x.png\" alt=\"cardlogos\" class=\"paystack-cardlogos size-full wp-image-1096\" \/>\n\t\t\t<button type=\"reset\" class=\"secondary-btn\">Reset<\/button><button type=\"submit\" class=\"primary-btn\">Pay<\/button><\/div><\/div><\/form><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","pmpro_default_level":0,"footnotes":""},"class_list":["post-597","page","type-page","status-publish","hentry","pmpro-has-access"],"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"super_admin","author_link":"https:\/\/nifaas.org.ng\/site\/author\/super_admin\/"},"rttpg_comment":0,"rttpg_category":null,"rttpg_excerpt":null,"_links":{"self":[{"href":"https:\/\/nifaas.org.ng\/site\/wp-json\/wp\/v2\/pages\/597","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nifaas.org.ng\/site\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nifaas.org.ng\/site\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nifaas.org.ng\/site\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/nifaas.org.ng\/site\/wp-json\/wp\/v2\/comments?post=597"}],"version-history":[{"count":2,"href":"https:\/\/nifaas.org.ng\/site\/wp-json\/wp\/v2\/pages\/597\/revisions"}],"predecessor-version":[{"id":602,"href":"https:\/\/nifaas.org.ng\/site\/wp-json\/wp\/v2\/pages\/597\/revisions\/602"}],"wp:attachment":[{"href":"https:\/\/nifaas.org.ng\/site\/wp-json\/wp\/v2\/media?parent=597"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}