{"id":2576,"date":"2019-04-18T09:14:53","date_gmt":"2019-04-18T09:14:53","guid":{"rendered":"https:\/\/calpg.online\/register-3\/"},"modified":"2019-07-14T07:25:22","modified_gmt":"2019-07-14T07:25:22","slug":"register","status":"publish","type":"page","link":"https:\/\/calpg.online\/register\/","title":{"rendered":"Register"},"content":{"rendered":"\n<div class=\"um um-register um-2570\">\n\t<div class=\"um-form\" data-mode=\"register\">\n\t\t<form method=\"post\" action=\"\">\n\t\t\t<div class=\"um-row _um_row_1 \" style=\"margin: 0 0 30px 0;\"><div class=\"um-col-1\"><div  id=\"um_field_2570_user_login\" class=\"um-field um-field-text  um-field-user_login um-field-text um-field-type_text\" data-key=\"user_login\"><div class=\"um-field-label\"><label for=\"user_login-2570\">Username<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"user_login-2570\" id=\"user_login-2570\" value=\"\" placeholder=\"\" data-validate=\"unique_username\" data-key=\"user_login\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_2570_first_name\" class=\"um-field um-field-text  um-field-first_name um-field-text um-field-type_text\" data-key=\"first_name\"><div class=\"um-field-label\"><label for=\"first_name-2570\">First Name<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"first_name-2570\" id=\"first_name-2570\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"first_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_2570_last_name\" class=\"um-field um-field-text  um-field-last_name um-field-text um-field-type_text\" data-key=\"last_name\"><div class=\"um-field-label\"><label for=\"last_name-2570\">Last Name<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"last_name-2570\" id=\"last_name-2570\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"last_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_2570_user_email\" class=\"um-field um-field-text  um-field-user_email um-field-text um-field-type_text\" data-key=\"user_email\"><div class=\"um-field-label\"><label for=\"user_email-2570\">E-mail Address<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"user_email-2570\" id=\"user_email-2570\" value=\"\" placeholder=\"\" data-validate=\"unique_email\" data-key=\"user_email\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_2570_phone_number\" class=\"um-field um-field-tel  um-field-phone_number um-field-tel um-field-type_tel\" data-key=\"phone_number\"><div class=\"um-field-label\"><div class=\"um-field-label-icon\"><i class=\"um-faicon-phone\" aria-label=\"Daytime Contact Phone Number\"><\/i><\/div><label for=\"phone_number-2570\">Daytime Contact Phone Number<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"tel\" name=\"phone_number-2570\" id=\"phone_number-2570\" value=\"\" placeholder=\"\" data-validate=\"phone_number\" data-key=\"phone_number\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_2570_user_password\" class=\"um-field um-field-password  um-field-user_password um-field-password um-field-type_password\" data-key=\"user_password\"><div class=\"um-field-label\"><label for=\"user_password-2570\">Password<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input class=\"um-form-field valid \" type=\"password\" name=\"user_password-2570\" id=\"user_password-2570\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"user_password\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_2570_confirm_user_password\" class=\"um-field um-field-password  um-field-user_password um-field-password um-field-type_password\" data-key=\"confirm_user_password\"><div class=\"um-field-label\"><label for=\"confirm_user_password-2570\">Confirm Password<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input class=\"um-form-field valid \" type=\"password\" name=\"confirm_user_password-2570\" id=\"confirm_user_password-2570\" value=\"\" placeholder=\"Confirm Password\" data-validate=\"\" data-key=\"confirm_user_password\"  aria-invalid=\"false\" \/><\/div><\/div><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_2572_5\">Which licensing agency would you like listed on your CE certificates?<\/div><div  id=\"um_field_2570_agency_name\" class=\"um-field um-field-text  um-field-agency_name um-field-text um-field-type_text\" data-key=\"agency_name\"><div class=\"um-field-label\"><label for=\"agency_name-2570\">Name of Licensing Agency (i.e. BBS, CAMFT, or N\/A)<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"agency_name-2570\" id=\"agency_name-2570\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"agency_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_2570_licence_number1\" class=\"um-field um-field-text  um-field-licence_number1 um-field-text um-field-type_text\" data-key=\"licence_number1\"><div class=\"um-field-label\"><label for=\"licence_number1-2570\">License Number (i.e MFT 55566, LCSW 55566, or N\/A)<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"licence_number1-2570\" id=\"licence_number1-2570\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"licence_number1\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_2570_not_applicable\" class=\"um-field um-field-checkbox  um-is-conditional um-field-not_applicable um-field-checkbox um-field-type_checkbox\" data-key=\"not_applicable\" data-cond-0-action=\"hide\" data-cond-0-field=\"licence_number1\" data-cond-0-operator=\"not empty\" data-cond-0-value=\"\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"not_applicable-2570\">Not Applicable<\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-checkbox  um-field-half \"><input   type=\"checkbox\" name=\"not_applicable[]\" value=\"No license\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">No license<\/span><\/label><div class=\"um-clear\"><\/div><\/div><\/div><div  id=\"um_field_2570_private_accountnew\" class=\"um-field um-field-checkbox  um-field-private_accountnew um-field-checkbox um-field-type_checkbox\" data-key=\"private_accountnew\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"private_accountnew-2570\">Keep my activity private from other users?<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-checkbox active um-field-half \"><input   type=\"checkbox\" name=\"private_accountnew[]\" value=\"YES\" checked \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline\"><\/i><\/span><span class=\"um-field-checkbox-option\">YES<\/span><\/label><label class=\"um-field-checkbox  um-field-half  right \"><input   type=\"checkbox\" name=\"private_accountnew[]\" value=\"NO\"  \/><span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span><span class=\"um-field-checkbox-option\">NO<\/span><\/label><div class=\"um-clear\"><\/div><div class=\"um-clear\"><\/div><\/div><\/div><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_2570_10\"><span style=\"font-size: 10pt;\">By submitting the form, you will be subscribed to CCPG newsletter.<\/span><br><br>\r\n<a class=\"um-toggle-gdpr um-privacy-policy\" href=\"https:\/\/calpg.online\/privacy-policy\/\" target=\"_blank\" rel=\"noopener\">Show privacy policy<\/a><\/div><\/div><\/div>\t\t<input type=\"hidden\" name=\"form_id\" id=\"form_id_2570\" value=\"2570\" \/>\n\t\n\t<p class=\"um_request_name\">\n\t\t<label for=\"um_request_2570\">Only fill in if you are not human<\/label>\n\t\t<input type=\"hidden\" name=\"um_request\" id=\"um_request_2570\" class=\"input\" value=\"\" size=\"25\" autocomplete=\"off\" \/>\n\t<\/p>\n\n\t<input type=\"hidden\" id=\"_wpnonce\" name=\"_wpnonce\" value=\"cd43a2a163\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/2576\" \/>\n<div class=\"g-recaptcha\" id=\"um-2570\" data-mode=\"register\"><\/div>\n\n\n\t<div class=\"um-col-alt\">\n\n\t\t\n\t\t\t<div class=\"um-center\">\n\t\t\t\t<input type=\"submit\" value=\"Submit\" class=\"um-button\" id=\"um-submit-btn\" \/>\n\t\t\t<\/div>\n\n\t\t\n\t\t<div class=\"um-clear\"><\/div>\n\n\t<\/div>\n\n\t\t\t<\/form>\n\t<\/div>\n<\/div>\n<style>\n\t\t\t.um-2570.um {\n\t\t\tmax-width: 450px;\n\t\t}\n\t\t<\/style>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_uag_custom_page_level_css":"","footnotes":""},"uagb_featured_image_src":{"full":false,"thumbnail":false,"medium":false,"medium_large":false,"large":false,"1536x1536":false,"2048x2048":false,"custom-size":false,"adjust-size":false,"course-thumb":false},"uagb_author_info":{"display_name":"lui Soriano","author_link":"https:\/\/calpg.online\/author\/lui-soriano\/"},"uagb_comment_info":0,"uagb_excerpt":null,"_links":{"self":[{"href":"https:\/\/calpg.online\/wp-json\/wp\/v2\/pages\/2576"}],"collection":[{"href":"https:\/\/calpg.online\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/calpg.online\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/calpg.online\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/calpg.online\/wp-json\/wp\/v2\/comments?post=2576"}],"version-history":[{"count":1,"href":"https:\/\/calpg.online\/wp-json\/wp\/v2\/pages\/2576\/revisions"}],"predecessor-version":[{"id":2634,"href":"https:\/\/calpg.online\/wp-json\/wp\/v2\/pages\/2576\/revisions\/2634"}],"wp:attachment":[{"href":"https:\/\/calpg.online\/wp-json\/wp\/v2\/media?parent=2576"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}