{"id":4444,"date":"2016-10-24T14:01:10","date_gmt":"2016-10-24T21:01:10","guid":{"rendered":"https:\/\/www.assistanceleague.org\/visalia\/?page_id=4444"},"modified":"2023-05-01T13:15:23","modified_gmt":"2023-05-01T20:15:23","slug":"online-membership-application","status":"publish","type":"page","link":"https:\/\/archive.assistanceleague.org\/visalia\/online-membership-application\/","title":{"rendered":"Online Membership Application"},"content":{"rendered":"<div class=\"wpb-content-wrapper\" id=\"wpb-content-root\"><p>[vc_row][vc_column width=&#8221;3\/4&#8243;]<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 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_5' ><form method='post' enctype='multipart\/form-data'  id='gform_5'  action='\/visalia\/wp-json\/wp\/v2\/pages\/4444' data-formid='5' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_5_3\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><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_5_3'>\n                            \n                            <span id='input_5_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_3.3' id='input_5_3_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_3_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_5_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_3.6' id='input_5_3_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_3_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_5_26\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_26'><span class='gform-field-label__text'>Birthdate<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_5_26' type='text' value='' class='medium'  aria-describedby=\"gfield_description_5_26\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_5_26'>(mm\/dd\/yyyy)<\/div><\/li><li id=\"field_5_5\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_5_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_5_5_1_container' >\n                                        <input type='text' name='input_5.1' id='input_5_5_1' value=''    aria-required='true'    \/>\n                                        <label for='input_5_5_1' id='input_5_5_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_5_5_3_container' >\n                                    <input type='text' name='input_5.3' id='input_5_5_3' value=''    aria-required='true'    \/>\n                                    <label for='input_5_5_3' id='input_5_5_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_5_5_4_container' >\n                                        <input type='text' name='input_5.4' id='input_5_5_4' value=''      aria-required='true'    \/>\n                                        <label for='input_5_5_4' id='input_5_5_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_5_5_5_container' >\n                                    <input type='text' name='input_5.5' id='input_5_5_5' value=''    aria-required='true'    \/>\n                                    <label for='input_5_5_5' id='input_5_5_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_5.6' id='input_5_5_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_5_6\" class=\"gfield gfield--type-phone gfield--phone-format-standard gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_6'><span class='gform-field-label__text'>Phone:                                      Cell Phone:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_5_6' type='tel' value='' class='medium'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_5_7\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_7'><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_7' id='input_5_7' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_5_8\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_8'><span class='gform-field-label__text'>Spouse&#039;s Name:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_5_8' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_9\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Emergency contact information<\/h2><\/li><li id=\"field_5_10\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><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_5_10'>\n                            \n                            <span id='input_5_10_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_10.3' id='input_5_10_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_10_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_5_10_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_10.6' id='input_5_10_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_5_10_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_5_11\" class=\"gfield gfield--type-phone gfield--phone-format-standard gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_11'><span class='gform-field-label__text'>Home Phone:                             Work Phone:                           Cell Phone:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_5_11' type='tel' value='' class='medium'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_5_12\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_12'><span class='gform-field-label__text'>Relationship:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_5_12' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_5_13\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Dues and Membership Classification<\/h2><div class='gsection_description' id='gfield_description_5_13'>Please mark the appropriate membership classification.   Dues are due and payable April 15 and are delinquent May 31. \nIf you plan to change your membership classification, please submit your request in writing to Vice President Membership.  You may email your request to vpmembership@alvisalia.org or mail to P.O. Box 4108, Visalia, Ca.  93278-1408<\/div><\/li><li id=\"field_5_14\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Membership Classifications<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_5_14'><li class='gchoice gchoice_5_14_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.1' type='checkbox'  value='Voting Member $75.00'  id='choice_5_14_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_1' id='label_5_14_1' class='gform-field-label gform-field-label--type-inline'>Voting Member $75.00<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_14_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.2' type='checkbox'  value='Nonvoting Member  $85.00'  id='choice_5_14_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_2' id='label_5_14_2' class='gform-field-label gform-field-label--type-inline'>Nonvoting Member  $85.00<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_14_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.3' type='checkbox'  value='Community Associate (nonvoting) $250.00'  id='choice_5_14_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_14_3' id='label_5_14_3' class='gform-field-label gform-field-label--type-inline'>Community Associate (nonvoting) $250.00<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_5_15\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Photo and Name\/Donor Release<\/h2><div class='gsection_description' id='gfield_description_5_15'>Please check your response below.  Assistance League Visalia has my permission to include my name as a member of and\/or donor to Assistance League in its printed materials such as chapter newsletters, event invitations or programs, press releases, etc.  Assistance League of Visalia also has my permission to use any photographs of me taken in connections with Assistance League activities in its printed materials or on the website.  <\/div><\/li><li id=\"field_5_16\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_5_16'><li class='gchoice gchoice_5_16_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.1' type='checkbox'  value='YES'  id='choice_5_16_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_16_1' id='label_5_16_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_16_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_16.2' type='checkbox'  value='NO'  id='choice_5_16_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_16_2' id='label_5_16_2' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_5_17\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Insurance<\/h2><div class='gsection_description' id='gfield_description_5_17'>I understand that I am required to provide my own health and accident insurance.  Assistance League of Visalia is not responsible for any medical or legal expenses that may result from any injury or illness that I may sustain while participating in Assistance League activities.  \nI also agree that I shall maintain adequate personal automobile insurance while using my own vehicle for Assistance League of Visalia business and shall not hold Assistance League liable for any claims that may result from accidents occurring while I am using my own vehicle for Assistance League business.  <\/div><\/li><li id=\"field_5_18\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>I understand the insurance requirements.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_5_18'><li class='gchoice gchoice_5_18_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.1' type='checkbox'  value='YES'  id='choice_5_18_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_18_1' id='label_5_18_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_5_27\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Background Information<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_5_27'><li class='gchoice gchoice_5_27_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.1' type='checkbox'  value='YES'  id='choice_5_27_1'   aria-describedby=\"gfield_description_5_27\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_5_27_1' id='label_5_27_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_5_27_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.2' type='checkbox'  value='NO'  id='choice_5_27_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_27_2' id='label_5_27_2' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_5_27'>BACKGROUND INFORMATION \n Have you ever been convicted of a criminal offense (felony or serious misdemeanor)? If yes, state nature of the crime(s), when and where convicted and disposition of the case.  \n(Convictions for marijuana-related offenses that are more than two years old need not be listed.) \n Note: No person will be denied membership solely on the grounds of conviction of a criminal offense. The nature of the offense, date of the offense, the surrounding circumstances and the relevance of the offense to the activities of the chapter may, however, be considered.)\n<\/div><\/li><li id=\"field_5_21\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_21'><span class='gform-field-label__text'>Signature<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_5_21' type='text' value='' class='medium'  aria-describedby=\"gfield_description_5_21\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_5_21'>Please submit this form and then mail your check for your dues payment to Assistance League of Visalia, P.O. Box 4108, Visalia, CA  93278-4108<\/div><\/li><li id=\"field_5_22\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_22'><span class='gform-field-label__text'>Date<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_5_22'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_22'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \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_5_22' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_5_22' 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_5_22' aria-label='Date: 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><\/li><li id=\"field_5_24\" class=\"gfield gfield--type-product gfield--input-type-select gfield_price gfield_price_5_24 gfield_product_5_24 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_24'><span class='gform-field-label__text'>Dues payment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_24' id='input_5_24' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Voting Member|75' >Voting Member<\/option><option value='Non-voting Member|85' >Non-voting Member<\/option><option value='Community Associate|250' >Community Associate<\/option><\/select><\/div><\/li><li id=\"field_5_23\" class=\"gfield gfield--type-captcha field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_23'><span class='gform-field-label__text'>CAPTCHA<\/span><\/label><div id='input_5_23' class='ginput_container ginput_recaptcha' data-sitekey='6LdWlwwTAAAAAOAl420A8UG42gPO0UU_evZ45_r7'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/li><li id=\"field_5_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Payment Selection<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_5_25'>\n\t\t\t<li class='gchoice gchoice_5_25_0'>\n\t\t\t\t<input name='input_25' type='radio' value='Pay by check and mail to P.O. Box 4108, Visalia, CA 93278-4108'  id='choice_5_25_0'    \/>\n\t\t\t\t<label for='choice_5_25_0' id='label_5_25_0' class='gform-field-label gform-field-label--type-inline'>Pay by check and mail to P.O. 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offset=&#8221;vc_hidden-xs&#8221;][vc_column_text]<\/p>\n<h4 style=\"text-align: center\">Help Families!<\/h4>\n<p>[\/vc_column_text][vc_single_image image=&#8221;4433&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_single_image image=&#8221;3937&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_single_image image=&#8221;3292&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_single_image image=&#8221;3944&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_single_image image=&#8221;3220&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_column_text]<\/p>\n<h4 style=\"text-align: center\">Socialize!<\/h4>\n<p>[\/vc_column_text][vc_single_image image=&#8221;3282&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_column_text]<\/p>\n<h4 style=\"text-align: center\">Gain Friends!<\/h4>\n<p>[\/vc_column_text][vc_single_image image=&#8221;4011&#8243; img_size=&#8221;medium&#8221; 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[\/vc_column_text][vc_single_image image=&#8221;4433&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_single_image image=&#8221;3937&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_single_image image=&#8221;3292&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_single_image image=&#8221;3944&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_single_image image=&#8221;3220&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_column_text] Socialize! [\/vc_column_text][vc_single_image image=&#8221;3282&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_column_text] Gain Friends! [\/vc_column_text][vc_single_image image=&#8221;4011&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_single_image image=&#8221;3973&#8243; img_size=&#8221;medium&#8221; alignment=&#8221;center&#8221;][vc_column_text] Raise Funds! 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