{"id":220,"date":"2018-08-15T01:36:47","date_gmt":"2018-08-15T01:36:47","guid":{"rendered":"https:\/\/amerabra.org\/studentmembership\/?page_id=220"},"modified":"2018-08-16T16:51:56","modified_gmt":"2018-08-16T16:51:56","slug":"membership-student","status":"publish","type":"page","link":"https:\/\/awal.amerabra.org\/studentmembership\/membership-student\/","title":{"rendered":"Membership"},"content":{"rendered":"<div class=\"body\">\n<div class=\"container\">\n<div class=\"row-fluid\">\n<div id=\"cbEditableWrapper1\" class=\"cbEditableWrapper\">\n<form id=\"adminform\" class=\"form-horizontal\" action=\"https:\/\/amerabra.org\/index.php\/registration\/edit\/1\/entry\" enctype=\"multipart\/form-data\" method=\"post\" name=\"adminForm\">New application for student<\/p>\n<div class=\"control-group form-inline\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<footer class=\"footer\" role=\"contentinfo\">\n<div class=\"container\"><div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f224-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><\/div>\n<form action=\"\/studentmembership\/wp-json\/wp\/v2\/pages\/220#wpcf7-f224-o1\" method=\"post\" class=\"wpcf7-form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"224\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.1.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f224-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<\/div>\n<p><span class=\"wpcf7-form-control-wrap cf7-counter\"><input type=\"hidden\" name=\"cf7-counter\" value=\"S-MY-225-2023-2023\" size=\"40\" class=\"wpcf7-form-control wpcf7dtx-dynamictext wpcf7-dynamichidden\" aria-invalid=\"false\" \/><\/span><br \/>\nTitle<br \/>\n<span class=\"wpcf7-form-control-wrap title\"><select name=\"title\" class=\"wpcf7-form-control wpcf7-select\" id=\"2\" aria-invalid=\"false\"><option value=\"\">---<\/option><option value=\"Mr\">Mr<\/option><option value=\"Mrs\">Mrs<\/option><option value=\"Ms\">Ms<\/option><option value=\"Dr\">Dr<\/option><\/select><\/span><\/p>\n<p>Title2<br \/>\n<span class=\"wpcf7-form-control-wrap title2\"><select name=\"title2\" class=\"wpcf7-form-control wpcf7-select\" id=\"3\" aria-invalid=\"false\"><option value=\"\">---<\/option><option value=\"Asst Prof\">Asst Prof<\/option><option value=\"Assoc Prof\">Assoc Prof<\/option><option value=\"Prof\">Prof<\/option><option value=\"Emer. Prof\">Emer. Prof<\/option><\/select><\/span><\/p>\n<p>Given Name* <span class=\"wpcf7-form-control-wrap nameuser\"><input type=\"text\" name=\"nameuser\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"4\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Surname* <span class=\"wpcf7-form-control-wrap surname\"><input type=\"text\" name=\"surname\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"5\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>MyKad Number \/ Passport for non-Malaysian* <span class=\"wpcf7-form-control-wrap mykad\"><input type=\"text\" name=\"mykad\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"6\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Citizenship* <span class=\"wpcf7-form-control-wrap citizenship\"><input type=\"text\" name=\"citizenship\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"7\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Date Of Birth* <span class=\"wpcf7-form-control-wrap dob\"><input type=\"text\" name=\"dob\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"8\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Place Of Birth* (state \/ country )<br \/>\n<span class=\"wpcf7-form-control-wrap birth\"><input type=\"text\" name=\"birth\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"9\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Job Title* (If student, please upload your Student Card below <span class=\"wpcf7-form-control-wrap job\"><input type=\"text\" name=\"job\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"10\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Institution or Organisation*<br \/>\n<span class=\"wpcf7-form-control-wrap organisation\"><input type=\"text\" name=\"organisation\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"11\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Postal Address*<br \/>\n<span class=\"wpcf7-form-control-wrap address1\"><input type=\"text\" name=\"address1\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"12\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap address2\"><input type=\"text\" name=\"address2\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" id=\"13\" aria-invalid=\"false\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap address3\"><input type=\"text\" name=\"address3\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" id=\"14\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Home address*<br \/>\n<span class=\"wpcf7-form-control-wrap home1\"><input type=\"text\" name=\"home1\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"15\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap home2\"><input type=\"text\" name=\"home2\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" id=\"16\" aria-invalid=\"false\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap home3\"><input type=\"text\" name=\"home3\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" id=\"17\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Mobile number*<br \/>\n<span class=\"wpcf7-form-control-wrap mobile\"><input type=\"tel\" name=\"mobile\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-required wpcf7-validates-as-tel\" id=\"18\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Email*<br \/>\n<span class=\"wpcf7-form-control-wrap your-email\"><input type=\"email\" name=\"your-email\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" id=\"19\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Alternative email<br \/>\n<span class=\"wpcf7-form-control-wrap email2\"><input type=\"email\" name=\"email2\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-email\" id=\"20\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Research Interest Topic*<br \/>\n<span class=\"wpcf7-form-control-wrap topic\"><span class=\"wpcf7-form-control wpcf7-checkbox\" id=\"21\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"topic[]\" value=\"Children &amp; Youth Environment\" \/><span class=\"wpcf7-list-item-label\">Children &amp; Youth Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Commercial \/ Retail \/ Services Environment\" \/><span class=\"wpcf7-list-item-label\">Commercial \/ Retail \/ Services Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Communications and Social Media Environment\" \/><span class=\"wpcf7-list-item-label\">Communications and Social Media Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Community Environment \/ Social Psychology\" \/><span class=\"wpcf7-list-item-label\">Community Environment \/ Social Psychology<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Construction Environment\" \/><span class=\"wpcf7-list-item-label\">Construction Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Disabled \/ Inclusive Environment\" \/><span class=\"wpcf7-list-item-label\">Disabled \/ Inclusive Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Educational \/ Learning Environment\" \/><span class=\"wpcf7-list-item-label\">Educational \/ Learning Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Elderly Environment\" \/><span class=\"wpcf7-list-item-label\">Elderly Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"General Psychology\" \/><span class=\"wpcf7-list-item-label\">General Psychology<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Healing \/ Healthcare Environment\" \/><span class=\"wpcf7-list-item-label\">Healing \/ Healthcare Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Hospitality\/Tourism Environment\" \/><span class=\"wpcf7-list-item-label\">Hospitality\/Tourism Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Landscaping Environment\" \/><span class=\"wpcf7-list-item-label\">Landscaping Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Legal Matters\" \/><span class=\"wpcf7-list-item-label\">Legal Matters<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Leisure \/ Recreational \/ Sports Environment\" \/><span class=\"wpcf7-list-item-label\">Leisure \/ Recreational \/ Sports Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Local Cultural \/ Heritage Environment (Food included)\" \/><span class=\"wpcf7-list-item-label\">Local Cultural \/ Heritage Environment (Food included)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Natural Environment\" \/><span class=\"wpcf7-list-item-label\">Natural Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Residential Environment\" \/><span class=\"wpcf7-list-item-label\">Residential Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Rural Environment \/ Rural Psychology\" \/><span class=\"wpcf7-list-item-label\">Rural Environment \/ Rural Psychology<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Technology-related Environment\" \/><span class=\"wpcf7-list-item-label\">Technology-related Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Transportation \/ Travelling Environment\" \/><span class=\"wpcf7-list-item-label\">Transportation \/ Travelling Environment<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Urban Environment \/ Urban Psychology\" \/><span class=\"wpcf7-list-item-label\">Urban Environment \/ Urban Psychology<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"topic[]\" value=\"Workplace Environment\" \/><span class=\"wpcf7-list-item-label\">Workplace Environment<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"topic[]\" value=\"Others\" \/><span class=\"wpcf7-list-item-label\">Others<\/span><\/span><\/span><\/span><\/p>\n<p>Do you wish to purchase or renew the Grammarly annual licence<br \/>\n<span class=\"wpcf7-form-control-wrap grammarly\"><select name=\"grammarly\" class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" id=\"22\" aria-required=\"true\" aria-invalid=\"false\"><option value=\"\">---<\/option><option value=\"Yes\">Yes<\/option><option value=\"No\">No<\/option><\/select><\/span><\/p>\n<p>Photo* :<\/p>\n<p><span class=\"wpcf7-form-control-wrap photo\"><input type=\"file\" name=\"photo\" size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" id=\"23\" accept=\".pdf,.jpg,.jpeg\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>CV* :<\/p>\n<p><span class=\"wpcf7-form-control-wrap cv\"><input type=\"file\" name=\"cv\" size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" id=\"24\" accept=\".pdf,.jpg,.jpeg\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Proof of payment* :<\/p>\n<p><span class=\"wpcf7-form-control-wrap payment\"><input type=\"file\" name=\"payment\" size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" id=\"25\" accept=\".pdf,.jpg,.jpeg\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Student Card* :<\/p>\n<p><span class=\"wpcf7-form-control-wrap studentcard\"><input type=\"file\" name=\"studentcard\" size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" id=\"26\" accept=\".pdf,.jpg,.jpeg\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Many thanks for your interest. Your application shall be processed soonest by AMER Secretariat. Please submit your application here.<\/p>\n<p><input type=\"submit\" value=\"SUBMIT\" class=\"wpcf7-form-control wpcf7-submit\" \/><\/p>\n<div class=\"wpcf7-response-output wpcf7-display-none\"><\/div><\/form><\/div><\/div>\n<\/footer>\n","protected":false},"excerpt":{"rendered":"<p>New application for student<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/awal.amerabra.org\/studentmembership\/wp-json\/wp\/v2\/pages\/220"}],"collection":[{"href":"https:\/\/awal.amerabra.org\/studentmembership\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/awal.amerabra.org\/studentmembership\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/awal.amerabra.org\/studentmembership\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/awal.amerabra.org\/studentmembership\/wp-json\/wp\/v2\/comments?post=220"}],"version-history":[{"count":5,"href":"https:\/\/awal.amerabra.org\/studentmembership\/wp-json\/wp\/v2\/pages\/220\/revisions"}],"predecessor-version":[{"id":296,"href":"https:\/\/awal.amerabra.org\/studentmembership\/wp-json\/wp\/v2\/pages\/220\/revisions\/296"}],"wp:attachment":[{"href":"https:\/\/awal.amerabra.org\/studentmembership\/wp-json\/wp\/v2\/media?parent=220"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}