{"id":4910,"date":"2023-06-16T20:08:51","date_gmt":"2023-06-16T10:08:51","guid":{"rendered":"https:\/\/www.bnaibrith.org.au\/victoria\/?page_id=4910"},"modified":"2024-09-12T21:49:12","modified_gmt":"2024-09-12T11:49:12","slug":"akiba","status":"publish","type":"page","link":"https:\/\/www.bnaibrith.org.au\/victoria\/akiba\/","title":{"rendered":"Akiba Membership Renewal"},"content":{"rendered":"<section class=\"wpb-content-wrapper\"><p>[vc_section el_class=&#8221;container akiba-form-wrapper&#8221;][vc_row gap=&#8221;15&#8243; equal_height=&#8221;yes&#8221; rtl_reverse=&#8221;yes&#8221; content_placement=&#8221;middle&#8221; el_class=&#8221;bb-contact-form single-contact&#8221;][vc_column width=&#8221;1\/6&#8243;][\/vc_column][vc_column width=&#8221;2\/3&#8243;][vc_custom_heading text=&#8221;Akiba Membership Renewal Form&#8221; use_theme_fonts=&#8221;yes&#8221; el_class=&#8221;bb-general-content-heading&#8221;][vc_column_text]Dear Members,<\/p>\n<p style=\"text-align: left;\">Thank you for helping make our membership renewal process easier by completing this online form and making your payment via credit card. If you have any difficulties completing the form, please contact the office on 9523 0888 and they will be able to assist you.<\/p>\n<p style=\"text-align: left;\">We hope that you will consider making a donation so that we can continue to support wonderful causes on your behalf.<\/p>\n<p style=\"text-align: left;\">If you are a couple, you are be able to complete a single form and payment for both of you.<\/p>\n<p style=\"text-align: left;\">Your prompt attention and payment would be greatly appreciated.<\/p>\n<p style=\"text-align: left;\">Thank you for your membership and we look forward to another wonderful year.<\/p>\n<p>[\/vc_column_text]<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_13' id='gform_13'  action='\/victoria\/wp-json\/wp\/v2\/pages\/4910#gf_13' data-formid='13' novalidate>\n        <div id='gf_progressbar_wrapper_13' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>4<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_orange' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_orange percentbar_25' style='width:25%;'><span>25%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_13_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_13' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><fieldset id=\"field_13_1\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield_price gfield_price_13_1 gfield_product_13_1 field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"31aea450\" data-field-span=\"12\"><legend id='gfield_label_13_1' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>2023\/24 Unit Akiba Membership<\/span><\/legend><div class='gfield_description' id='gfield_description_13_1'>2023\/24 Unit Akiba Membership<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_1'>\n\t\t\t<div class='gchoice gchoice_13_1_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='1 Membership - $130|130'  id='choice_13_1_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_1\" aria-labelledby=\"label_13_1_0 gfield_label_13_1\"   \/>\n\t\t\t\t\t<label for='choice_13_1_0' id='label_13_1_0' class='gform-field-label gform-field-label--type-inline'>1 Membership - $130<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_1_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1' type='radio' value='2 Memberships - $260|260'  id='choice_13_1_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_13_1_1' id='label_13_1_1' class='gform-field-label gform-field-label--type-inline'>2 Memberships - $260<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_18\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"33434d7e\" data-field-span=\"12\"><legend id='gfield_label_13_18' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Would you like to make an additional donation?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_18'>\n\t\t\t<div class='gchoice gchoice_13_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Yes'  id='choice_13_18_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_13_18_0 gfield_label_13_18\"   \/>\n\t\t\t\t\t<label for='choice_13_18_0' id='label_13_18_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='No'  id='choice_13_18_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_13_18_1' id='label_13_18_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_11\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield_price gfield_price_13_11 gfield_product_13_11 gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"03b4852e\" data-field-span=\"12\"><legend id='gfield_label_13_11' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Additional donation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_11'>If you would like to make an additional donation to B'nai B'rith, please select the amount you wish to donate<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_11'>\n\t\t\t<div class='gchoice gchoice_13_11_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='$20|20'  id='choice_13_11_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_11\" aria-labelledby=\"label_13_11_0 gfield_label_13_11\"   \/>\n\t\t\t\t\t<label for='choice_13_11_0' id='label_13_11_0' class='gform-field-label gform-field-label--type-inline'>$20<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_11_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='$40|40'  id='choice_13_11_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_13_11_1' id='label_13_11_1' class='gform-field-label gform-field-label--type-inline'>$40<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_11_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='$50|50'  id='choice_13_11_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_13_11_2' id='label_13_11_2' class='gform-field-label gform-field-label--type-inline'>$50<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_11_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='$100|100'  id='choice_13_11_3' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_13_11_3' id='label_13_11_3' class='gform-field-label gform-field-label--type-inline'>$100<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_13_27' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_2' class='gform_page' data-js='page-field-id-27' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_2' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><fieldset id=\"field_13_7\" class=\"gfield gfield--type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2a2cb23e\" data-field-span=\"12\"><legend id='gfield_label_13_7' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Member #1<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_13_7'>\n                            \n                            <span id='input_13_7_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_13_7_3' id='input_13_7_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_7.3' id='input_13_7_3' value=''   aria-required='true'    autocomplete=\"given-name\" aria-labelledby=\"input_13_7_3_label gfield_label_13_7\"\/>\n                                                <\/span>\n                            \n                            <span id='input_13_7_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_13_7_6' id='input_13_7_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_7.6' id='input_13_7_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_13_24\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e1584821\" data-field-span=\"12\"><label id='gfield_label_13_24' class='gfield_label gform-field-label' for='input_13_24'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_24' id='input_13_24' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                        <\/div><\/div><div id=\"field_13_20\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"c8795bc0\" data-field-span=\"12\"><label id='gfield_label_13_20' class='gfield_label gform-field-label' for='input_13_20'><span class='gform-field-label__text'>Date of Birth<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_13_20'>To improve the integrity of the data in our database, please share your birthday with us.<\/div><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_13_20'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_20'\n\t\t\t\t\tvalue=''\n\t\t\t\t\taria-describedby=\"gfield_description_13_20\" \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_13_20' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_13_20' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_13_20' aria-label='Date of Birth: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><fieldset id=\"field_13_23\" class=\"gfield gfield--type-name gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"5ee7890e\" data-field-span=\"12\"><legend id='gfield_label_13_23' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Member #2<\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_13_23'>\n                            \n                            <span id='input_13_23_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_13_23_3' id='input_13_23_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_23.3' id='input_13_23_3' value=''   aria-required='false'    autocomplete=\"given-name\" aria-labelledby=\"input_13_23_3_label gfield_label_13_23\"\/>\n                                                <\/span>\n                            \n                            <span id='input_13_23_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_13_23_6' id='input_13_23_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_23.6' id='input_13_23_6' value=''   aria-required='false'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_13_9\" class=\"gfield gfield--type-email gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"19ddaff4\" data-field-span=\"12\"><label id='gfield_label_13_9' class='gfield_label gform-field-label' for='input_13_9'><span class='gform-field-label__text'>Email<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_9' id='input_13_9' type='email' value='' class='large'     aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                        <\/div><\/div><div id=\"field_13_25\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2a408fb3\" data-field-span=\"12\"><label id='gfield_label_13_25' class='gfield_label gform-field-label' for='input_13_25'><span class='gform-field-label__text'>Date of Birth<\/span><\/label><div class='gfield_description' id='gfield_description_13_25'>To improve the integrity of the data in our database, please share your birthday with us.<\/div><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_13_25'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_25'\n\t\t\t\t\tvalue=''\n\t\t\t\t\taria-describedby=\"gfield_description_13_25\" \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_13_25' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_13_25' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_13_25' aria-label='Date of Birth: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_13_28' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_13_28' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_3' class='gform_page' data-js='page-field-id-28' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_3' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><fieldset id=\"field_13_14\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"f411d92c\" data-field-span=\"12\"><legend id='gfield_label_13_14' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Home Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip ginput_container_address gform-grid-row' id='input_13_14' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_13_14_1_container' >\n                                        <label for='input_13_14_1' id='input_13_14_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_14.1' id='input_13_14_1' value=''    aria-required='true'   autocomplete=\"address-line1\" aria-labelledby=\"input_13_14_1_label gfield_label_13_14\"\/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_13_14_2_container' >\n                                        <label for='input_13_14_2' id='input_13_14_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_14.2' id='input_13_14_2' value=''    autocomplete=\"address-line2\" aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_13_14_3_container' >\n                                    <label for='input_13_14_3' id='input_13_14_3_label' class='gform-field-label gform-field-label--type-sub '>Suburb<\/label>\n                                    <input type='text' name='input_14.3' id='input_13_14_3' value=''    aria-required='true'   autocomplete=\"address-level2\" \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_14.4' id='input_13_14_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_13_14_5_container' >\n                                    <label for='input_13_14_5' id='input_13_14_5_label' class='gform-field-label gform-field-label--type-sub '>Post Code<\/label>\n                                    <input type='text' name='input_14.5' id='input_13_14_5' value=''    aria-required='true'   autocomplete=\"postal-code\" \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_14.6' id='input_13_14_6' value='AU' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_13_8\" class=\"gfield gfield--type-address field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"141adef5\" data-field-span=\"12\"><legend id='gfield_label_13_8' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Postal Address<\/span><\/legend>    <div id='input_13_8_copy_values_option_container' class='copy_values_option_container' >\n                                        <input type='checkbox' id='input_13_8_copy_values_activated' class='copy_values_activated' value='1' data-source_field_id='14' data-source-field-label='Home Address' data-destination-field-label='Postal Address' name='input_8_copy_values_activated'  \/>\n                                        <label for='input_13_8_copy_values_activated' id='input_13_8_copy_values_option_label' class='copy_values_option_label inline gform-field-label gform-field-label--type-inline'>Same as home address<\/label>\n                                    <\/div>\n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_13_8' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_13_8_1_container' >\n                                        <label for='input_13_8_1' id='input_13_8_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_8.1' id='input_13_8_1' value=''    aria-required='false'   autocomplete=\"address-line1\" aria-labelledby=\"input_13_8_1_label gfield_label_13_8\"\/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_13_8_3_container' >\n                                    <label for='input_13_8_3' id='input_13_8_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_8.3' id='input_13_8_3' value=''    aria-required='false'   autocomplete=\"address-level2\" \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_13_8_4_container' >\n                                        <label for='input_13_8_4' id='input_13_8_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                        <input type='text' name='input_8.4' id='input_13_8_4' value='VIC'     placeholder='State' aria-required='false'   autocomplete=\"address-level1\" \/>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_13_8_5_container' >\n                                    <label for='input_13_8_5' id='input_13_8_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_8.5' id='input_13_8_5' value=''   placeholder='Post Code' aria-required='false'   autocomplete=\"postal-code\" \/>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_13_8_6_container' >\n                                        <label for='input_13_8_6' id='input_13_8_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                        <select name='input_8.6' id='input_13_8_6'   aria-required='false'   autocomplete=\"country-name\" ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='AX' >\u00c5land Islands<\/option><option value='AL' >Albania<\/option><option value='DZ' >Algeria<\/option><option value='AS' >American Samoa<\/option><option value='AD' >Andorra<\/option><option value='AO' >Angola<\/option><option value='AI' >Anguilla<\/option><option value='AQ' >Antarctica<\/option><option value='AG' >Antigua and Barbuda<\/option><option value='AR' >Argentina<\/option><option value='AM' >Armenia<\/option><option value='AW' >Aruba<\/option><option value='AU' selected='selected'>Australia<\/option><option value='AT' >Austria<\/option><option value='AZ' >Azerbaijan<\/option><option value='BS' >Bahamas<\/option><option value='BH' >Bahrain<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BY' >Belarus<\/option><option value='BE' >Belgium<\/option><option value='BZ' >Belize<\/option><option value='BJ' >Benin<\/option><option value='BM' >Bermuda<\/option><option value='BT' >Bhutan<\/option><option value='BO' >Bolivia<\/option><option value='BQ' >Bonaire, Sint Eustatius and Saba<\/option><option value='BA' >Bosnia and Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BV' >Bouvet Island<\/option><option value='BR' >Brazil<\/option><option value='IO' >British Indian Ocean Territory<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgaria<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='KH' >Cambodia<\/option><option value='CM' >Cameroon<\/option><option value='CA' >Canada<\/option><option value='CV' >Cape Verde<\/option><option value='KY' >Cayman Islands<\/option><option value='CF' >Central African Republic<\/option><option value='TD' >Chad<\/option><option value='CL' >Chile<\/option><option value='CN' >China<\/option><option value='CX' >Christmas Island<\/option><option value='CC' >Cocos Islands<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoros<\/option><option value='CG' >Congo<\/option><option value='CD' >Congo, Democratic Republic of the<\/option><option value='CK' >Cook Islands<\/option><option value='CR' >Costa Rica<\/option><option value='CI' >C\u00f4te d&#039;Ivoire<\/option><option value='HR' >Croatia<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='CY' >Cyprus<\/option><option value='CZ' >Czechia<\/option><option value='DK' >Denmark<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='DO' >Dominican Republic<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egypt<\/option><option value='SV' >El Salvador<\/option><option value='GQ' >Equatorial Guinea<\/option><option value='ER' >Eritrea<\/option><option value='EE' >Estonia<\/option><option value='SZ' >Eswatini<\/option><option value='ET' >Ethiopia<\/option><option value='FK' >Falkland Islands<\/option><option value='FO' >Faroe Islands<\/option><option value='FJ' >Fiji<\/option><option value='FI' >Finland<\/option><option value='FR' >France<\/option><option value='GF' >French Guiana<\/option><option value='PF' >French Polynesia<\/option><option value='TF' >French Southern Territories<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgia<\/option><option value='DE' >Germany<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GR' >Greece<\/option><option value='GL' >Greenland<\/option><option value='GD' >Grenada<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinea<\/option><option value='GW' >Guinea-Bissau<\/option><option value='GY' >Guyana<\/option><option value='HT' >Haiti<\/option><option value='HM' >Heard Island and McDonald Islands<\/option><option value='VA' >Holy See<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hungary<\/option><option value='IS' >Iceland<\/option><option value='IN' >India<\/option><option value='ID' >Indonesia<\/option><option value='IR' >Iran<\/option><option value='IQ' >Iraq<\/option><option value='IE' >Ireland<\/option><option value='IM' >Isle of Man<\/option><option value='IL' >Israel<\/option><option value='IT' >Italy<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Japan<\/option><option value='JE' >Jersey<\/option><option value='JO' >Jordan<\/option><option value='KZ' >Kazakhstan<\/option><option value='KE' >Kenya<\/option><option value='KI' >Kiribati<\/option><option value='KP' >Korea, Democratic People&#039;s Republic of<\/option><option value='KR' >Korea, Republic of<\/option><option value='KW' >Kuwait<\/option><option value='KG' >Kyrgyzstan<\/option><option value='LA' >Lao People&#039;s Democratic Republic<\/option><option value='LV' >Latvia<\/option><option value='LB' >Lebanon<\/option><option value='LS' >Lesotho<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libya<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Lithuania<\/option><option value='LU' >Luxembourg<\/option><option value='MO' >Macao<\/option><option value='MG' >Madagascar<\/option><option value='MW' >Malawi<\/option><option value='MY' >Malaysia<\/option><option value='MV' >Maldives<\/option><option value='ML' >Mali<\/option><option value='MT' >Malta<\/option><option value='MH' >Marshall Islands<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritania<\/option><option value='MU' >Mauritius<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexico<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldova<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongolia<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MA' >Morocco<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibia<\/option><option value='NR' >Nauru<\/option><option value='NP' >Nepal<\/option><option value='NL' >Netherlands<\/option><option value='NC' >New Caledonia<\/option><option value='NZ' >New Zealand<\/option><option value='NI' >Nicaragua<\/option><option value='NE' >Niger<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='NF' >Norfolk Island<\/option><option value='MK' >North Macedonia<\/option><option value='MP' >Northern Mariana Islands<\/option><option value='NO' >Norway<\/option><option value='OM' >Oman<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PS' >Palestine, State of<\/option><option value='PA' >Panama<\/option><option value='PG' >Papua New Guinea<\/option><option value='PY' >Paraguay<\/option><option value='PE' >Peru<\/option><option value='PH' >Philippines<\/option><option value='PN' >Pitcairn<\/option><option value='PL' >Poland<\/option><option value='PT' >Portugal<\/option><option value='PR' >Puerto Rico<\/option><option value='QA' >Qatar<\/option><option value='RE' >R\u00e9union<\/option><option value='RO' >Romania<\/option><option value='RU' >Russian Federation<\/option><option value='RW' >Rwanda<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='SH' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='KN' >Saint Kitts and Nevis<\/option><option value='LC' >Saint Lucia<\/option><option value='MF' >Saint Martin<\/option><option value='PM' >Saint Pierre and Miquelon<\/option><option value='VC' >Saint Vincent and the Grenadines<\/option><option value='WS' >Samoa<\/option><option value='SM' >San Marino<\/option><option value='ST' >Sao Tome and Principe<\/option><option value='SA' >Saudi Arabia<\/option><option value='SN' >Senegal<\/option><option value='RS' >Serbia<\/option><option value='SC' >Seychelles<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapore<\/option><option value='SX' >Sint Maarten<\/option><option value='SK' >Slovakia<\/option><option value='SI' >Slovenia<\/option><option value='SB' >Solomon Islands<\/option><option value='SO' >Somalia<\/option><option value='ZA' >South Africa<\/option><option value='GS' >South Georgia and the South Sandwich Islands<\/option><option value='SS' >South Sudan<\/option><option value='ES' >Spain<\/option><option value='LK' >Sri Lanka<\/option><option value='SD' >Sudan<\/option><option value='SR' >Suriname<\/option><option value='SJ' >Svalbard and Jan Mayen<\/option><option value='SE' >Sweden<\/option><option value='CH' >Switzerland<\/option><option value='SY' >Syria Arab Republic<\/option><option value='TW' >Taiwan<\/option><option value='TJ' >Tajikistan<\/option><option value='TZ' >Tanzania, the United Republic of<\/option><option value='TH' >Thailand<\/option><option value='TL' >Timor-Leste<\/option><option value='TG' >Togo<\/option><option value='TK' >Tokelau<\/option><option value='TO' >Tonga<\/option><option value='TT' >Trinidad and Tobago<\/option><option value='TN' >Tunisia<\/option><option value='TR' >T\u00fcrkiye<\/option><option value='TM' >Turkmenistan<\/option><option value='TC' >Turks and Caicos Islands<\/option><option value='TV' >Tuvalu<\/option><option value='UG' >Uganda<\/option><option value='UA' >Ukraine<\/option><option value='AE' >United Arab Emirates<\/option><option value='GB' >United Kingdom<\/option><option value='US' >United States<\/option><option value='UY' >Uruguay<\/option><option value='UM' >US Minor Outlying Islands<\/option><option value='UZ' >Uzbekistan<\/option><option value='VU' >Vanuatu<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Viet Nam<\/option><option value='VG' >Virgin Islands, British<\/option><option value='VI' >Virgin Islands, U.S.<\/option><option value='WF' >Wallis and Futuna<\/option><option value='EH' >Western Sahara<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbabwe<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_13_26' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='button' id='gform_next_button_13_26' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_13_4' class='gform_page' data-js='page-field-id-26' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_13_4' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><fieldset id=\"field_13_30\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield--width-full gfield_price gfield_price_13_30 gfield_product_13_30 gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"97398666\" data-field-span=\"12\"><legend id='gfield_label_13_30' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Assistance in covering processing fees<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_30'>The cost of processing is around $2.50 per membership purchased. Please select the amount you are able to help contribute towards that fee.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_13_30'>\n\t\t\t<div class='gchoice gchoice_13_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='$0|0'  id='choice_13_30_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_13_30\" aria-labelledby=\"label_13_30_0 gfield_label_13_30\"   \/>\n\t\t\t\t\t<label for='choice_13_30_0' id='label_13_30_0' class='gform-field-label gform-field-label--type-inline'>$0<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='$2.50|2.5'  id='choice_13_30_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_13_30_1' id='label_13_30_1' class='gform-field-label gform-field-label--type-inline'>$2.50<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_30_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='$5.00|5'  id='choice_13_30_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_13_30_2' id='label_13_30_2' class='gform-field-label gform-field-label--type-inline'>$5.00 (for 2 memberships)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_3\" class=\"gfield gfield--type-total gfield_price gfield_price_13_ gfield_total gfield_total_13_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" aria-atomic=\"true\" aria-live=\"polite\" data-group-id=\"04984a61\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_13_3' class='gfield_label gform-field-label' for='input_13_3'><span class='gform-field-label__text'>Total<\/span><\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_3' id='input_13_3' value='$ 0.00' class='gform-text-input-reset ginput_total ginput_total_13'  \/>\n\t\t\t\t\t\t<\/div><\/div><div id=\"field_13_17\" class=\"gfield gfield--type-stripe_creditcard gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--type-stripe_creditcard-card\" data-group-id=\"b9aa1ed5\" data-field-span=\"12\"><label id='gfield_label_13_17' class='gfield_label gfield_label_before_complex gform-field-label' for='input_13_17_1'><span class='gform-field-label__text'>Credit Card<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container_creditcard ginput_stripe_creditcard gform-grid-row' id='input_13_17'><div class='ginput_full gform-grid-col' id='input_13_17_1_container' data-payment-element='false'><label for='input_13_17_1' id='input_13_17_1_label' class='gform-field-label gform-field-label--type-sub'>Card Details<\/label><div id='input_13_17_1' class='gform-theme-field-control StripeElement--card'><\/div><\/div><!-- .ginput_full --><div class='ginput_full gform-grid-col' id='input_13_17_5_container'>\r\n\t\t\t\t\t<label for='input_13_17_5' id='input_13_17_5_label' class='gform-field-label gform-field-label--type-sub'>Cardholder Name<\/label>\r\n\t\t\t\t\t<input type='text' name='input_17.5' id='input_13_17_5' value=''>\r\n\t\t\t\t<\/div><\/div><!-- .ginput_container -->\r\n\t\t\t<style type=\"text\/css\">\r\n\t\t\t\t:root {\r\n  \t\t\t\t\t--link-login-string: \"Link login\"\r\n\t\t\t\t}\r\n\t\t\t<\/style><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_13' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='submit' id='gform_submit_button_13' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> <input type='hidden' name='gform_ajax' value='form_id=13&amp;title=&amp;description=&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=ad1c8205bd7a873fec921df7045f66c6' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_13' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_13' id='gform_theme_13' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_13' id='gform_style_settings_13' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_13' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' 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