{"id":1945,"date":"2026-05-04T12:23:35","date_gmt":"2026-05-04T12:23:35","guid":{"rendered":"https:\/\/jonathan.rcm-test-web.co.za\/Ethiopian-Association?page_id=1945"},"modified":"2026-05-28T07:02:33","modified_gmt":"2026-05-28T07:02:33","slug":"membership-application","status":"publish","type":"page","link":"https:\/\/jonathan.rcm-test-web.co.za\/Ethiopian-Association\/membership-application\/","title":{"rendered":"Membership Application"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1945\" class=\"elementor elementor-1945\" data-elementor-post-type=\"page\">\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-cef7528 e-con-full bg e-flex e-con e-parent\" data-id=\"cef7528\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;background_motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;background_motion_fx_scale_effect&quot;:&quot;yes&quot;,&quot;background_motion_fx_scale_direction&quot;:&quot;in-out&quot;,&quot;background_motion_fx_scale_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:2,&quot;sizes&quot;:[]},&quot;background_motion_fx_scale_range&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:20,&quot;end&quot;:80}},&quot;background_motion_fx_devices&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2e29d78 elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"2e29d78\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Member Application\n<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-fb7f3db e-con-full e-flex e-con e-parent\" data-id=\"fb7f3db\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-9aead74 e-flex e-con-boxed e-con e-child\" data-id=\"9aead74\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b1ef2ff eael-gravity-form-button-custom elementor-widget elementor-widget-eael-gravity-form\" data-id=\"b1ef2ff\" data-element_type=\"widget\" data-e-type=\"widget\" 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enctype='multipart\/form-data'  id='gform_3'  action='\/Ethiopian-Association\/wp-json\/wp\/v2\/pages\/1945' data-formid='3' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3_2\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_2'>Full Name<\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_3_2' type='text' value='' class='large'    placeholder='Full Name'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_3'>Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_3_3' type='text' value='' class='large'    placeholder='Last Name'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_4'>Address<\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_3_4' type='text' value='' class='large'    placeholder='Address'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_5'>Country<\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_3_5' type='text' value='' class='large'    placeholder='Country'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_11'>City<\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_3_11' type='text' value='' class='large'    placeholder='City'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_8\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below 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field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Status in South Africa<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_32'><div class='gchoice gchoice_3_32_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.1' type='checkbox'  value='Citizen And Citizenship'  id='choice_3_32_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_32_1' id='label_3_32_1' class='gform-field-label gform-field-label--type-inline'>Citizen And Citizenship<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_32_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.2' type='checkbox'  value='Permanent Resident Non-Citizen'  id='choice_3_32_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_32_2' id='label_3_32_2' class='gform-field-label gform-field-label--type-inline'>Permanent Resident Non-Citizen<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_32_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.3' type='checkbox'  value='Refuge States'  id='choice_3_32_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_32_3' id='label_3_32_3' class='gform-field-label gform-field-label--type-inline'>Refuge States<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_32_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.4' type='checkbox'  value='Asylum Seeker'  id='choice_3_32_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_32_4' id='label_3_32_4' class='gform-field-label gform-field-label--type-inline'>Asylum Seeker<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_12'>ID Number<\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_3_12' type='text' value='' class='large'    placeholder='ID Number'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_49\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_49'>Passport<\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_3_49' type='text' value='' class='large'    placeholder='Passport'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_50\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_50'>Refuge States<\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_3_50' type='text' value='' class='large'    placeholder='Refuge States'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_51'>Asylum Seeker Number<\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_3_51' type='text' value='' class='large'    placeholder='ID Number'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_3_14\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gf_list_2col gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Marriage Status<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_14'><div class='gchoice gchoice_3_14_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.1' type='checkbox'  value='Married'  id='choice_3_14_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_14_1' id='label_3_14_1' class='gform-field-label gform-field-label--type-inline'>Married<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_14_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_14.2' type='checkbox'  value='Not Married'  id='choice_3_14_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_14_2' id='label_3_14_2' class='gform-field-label gform-field-label--type-inline'>Not Married<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_15\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_15'>Mothers Name<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_3_15' type='text' value='' class='large'    placeholder='Mothers Name'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_16\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_16'>Fathers Name<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_3_16' type='text' value='' class='large'    placeholder='Fathers Name'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_17\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_17'>Date of Birth<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_17' id='input_3_17' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='Date of Birth' aria-describedby=\"input_3_17_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_3_17_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_3_17' class='gform_hidden' value='https:\/\/jonathan.rcm-test-web.co.za\/Ethiopian-Association\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_3_18\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_18'>Place of Birth<\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_3_18' type='text' value='' class='large'    placeholder='Place of Birth'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_19'>Gender<\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_3_19' type='text' value='' class='large'    placeholder='Gender'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_20\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_20'>Nationality<\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_3_20' type='text' value='' class='large'    placeholder='Nationality'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_21'>Occupation<\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_3_21' type='text' value='' class='large'    placeholder='Occupation'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_22'>Business Name<\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_3_22' type='text' value='' class='large'    placeholder='Business Name'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_23'>Business Address<\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_3_23' type='text' value='' class='large'    placeholder='Business Address'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_25\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_25'>Business Contact Number<\/label><div class='ginput_container ginput_container_phone'><input name='input_25' id='input_3_25' type='tel' value='' class='large'  placeholder='Business Contact Number'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_26\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_26'>Position<\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_3_26' type='text' value='' class='large'    placeholder='Position'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_27\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_27'>Yearly Membership Payment<\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_3_27' type='text' value='' class='large'    placeholder='Yearly Membership Payment'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_30'>Mother Tongue<\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_3_30' type='text' value='' class='large'    placeholder='Mother Tongue'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_31\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_31'>First Additiona Language<\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_3_31' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_33\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_33'>Other Information<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_33' id='input_3_33' class='textarea small'    placeholder='Other Information'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_3_34\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_34'>Province<\/label><div class='ginput_container ginput_container_select'><select name='input_34' id='input_3_34' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Province<\/option><option value='Gauteng' >Gauteng<\/option><option value='Limpopo' >Limpopo<\/option><option value='Mpumalanga' >Mpumalanga<\/option><option value='KwaZulu-Natal' >KwaZulu-Natal<\/option><option value='North West' >North West<\/option><option value='Free State' >Free State<\/option><option value='Eastern Cape' >Eastern Cape<\/option><option value='Northern Cape' >Northern Cape<\/option><option value='Western Cape' >Western Cape<\/option><\/select><\/div><\/div><fieldset id=\"field_3_35\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Gauteng<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_35'><div class='gchoice gchoice_3_35_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_35.1' type='checkbox'  value='City Of Tshwane'  id='choice_3_35_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_35_1' id='label_3_35_1' class='gform-field-label gform-field-label--type-inline'>City Of Tshwane<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_35_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_35.2' type='checkbox'  value='Ekurhuleni'  id='choice_3_35_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_35_2' id='label_3_35_2' class='gform-field-label gform-field-label--type-inline'>Ekurhuleni<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_35_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_35.3' type='checkbox'  value='City Of Johannesburg'  id='choice_3_35_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_35_3' id='label_3_35_3' class='gform-field-label gform-field-label--type-inline'>City Of Johannesburg<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_35_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_35.4' type='checkbox'  value='Sedibeng Midvaal'  id='choice_3_35_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_35_4' id='label_3_35_4' class='gform-field-label gform-field-label--type-inline'>Sedibeng Midvaal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_35_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_35.5' type='checkbox'  value='West Rand'  id='choice_3_35_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_35_5' id='label_3_35_5' class='gform-field-label gform-field-label--type-inline'>West Rand<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_35_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_35.6' type='checkbox'  value='Other'  id='choice_3_35_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_35_6' id='label_3_35_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_38\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Limpopo<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_38'><div class='gchoice gchoice_3_38_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.1' type='checkbox'  value='Capricorn'  id='choice_3_38_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_38_1' id='label_3_38_1' class='gform-field-label gform-field-label--type-inline'>Capricorn<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_38_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.2' type='checkbox'  value='Mopani'  id='choice_3_38_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_38_2' id='label_3_38_2' class='gform-field-label gform-field-label--type-inline'>Mopani<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_38_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.3' type='checkbox'  value='Sekhukhune'  id='choice_3_38_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_38_3' id='label_3_38_3' class='gform-field-label gform-field-label--type-inline'>Sekhukhune<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_38_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.4' type='checkbox'  value='Vhembe'  id='choice_3_38_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_38_4' id='label_3_38_4' class='gform-field-label gform-field-label--type-inline'>Vhembe<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_38_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.5' type='checkbox'  value='Waterberg'  id='choice_3_38_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_38_5' id='label_3_38_5' class='gform-field-label gform-field-label--type-inline'>Waterberg<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_38_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.6' type='checkbox'  value='Other'  id='choice_3_38_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_38_6' id='label_3_38_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_39\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mpumalanga<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_39'><div class='gchoice gchoice_3_39_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.1' type='checkbox'  value='Bushbuckridge'  id='choice_3_39_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_39_1' id='label_3_39_1' class='gform-field-label gform-field-label--type-inline'>Bushbuckridge<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_39_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.2' type='checkbox'  value='Nkomazi'  id='choice_3_39_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_39_2' id='label_3_39_2' class='gform-field-label gform-field-label--type-inline'>Nkomazi<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_39_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.3' type='checkbox'  value='Thaba Chwev'  id='choice_3_39_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_39_3' id='label_3_39_3' class='gform-field-label gform-field-label--type-inline'>Thaba Chwev<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_39_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.4' type='checkbox'  value='Dipaleseng'  id='choice_3_39_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_39_4' id='label_3_39_4' class='gform-field-label gform-field-label--type-inline'>Dipaleseng<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_39_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.5' type='checkbox'  value='Other'  id='choice_3_39_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_39_5' id='label_3_39_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_40\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >KwaZulu-Natal<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_40'><div class='gchoice gchoice_3_40_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.1' type='checkbox'  value='Amajuba'  id='choice_3_40_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_40_1' id='label_3_40_1' class='gform-field-label gform-field-label--type-inline'>Amajuba<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_40_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.2' type='checkbox'  value='uMzinyathi'  id='choice_3_40_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_40_2' id='label_3_40_2' class='gform-field-label gform-field-label--type-inline'>uMzinyathi<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_40_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.3' type='checkbox'  value='uThukela'  id='choice_3_40_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_40_3' id='label_3_40_3' class='gform-field-label gform-field-label--type-inline'>uThukela<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_40_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.4' type='checkbox'  value='Big 5 Hlabisa Municipality'  id='choice_3_40_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_40_4' id='label_3_40_4' class='gform-field-label gform-field-label--type-inline'>Big 5 Hlabisa Municipality<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_40_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_40.5' type='checkbox'  value='Other'  id='choice_3_40_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_40_5' id='label_3_40_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_41\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >North West<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_41'><div class='gchoice gchoice_3_41_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.1' type='checkbox'  value='Ditsobotla'  id='choice_3_41_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_41_1' id='label_3_41_1' class='gform-field-label gform-field-label--type-inline'>Ditsobotla<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_41_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.2' type='checkbox'  value='Kgetlengrivier'  id='choice_3_41_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_41_2' id='label_3_41_2' class='gform-field-label gform-field-label--type-inline'>Kgetlengrivier<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_41_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.3' type='checkbox'  value='Moretele'  id='choice_3_41_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_41_3' id='label_3_41_3' class='gform-field-label gform-field-label--type-inline'>Moretele<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_41_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.4' type='checkbox'  value='Moses Kotane'  id='choice_3_41_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_41_4' id='label_3_41_4' class='gform-field-label gform-field-label--type-inline'>Moses Kotane<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_41_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.5' type='checkbox'  value='Other'  id='choice_3_41_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_41_5' id='label_3_41_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_42\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Free State<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_42'><div class='gchoice gchoice_3_42_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.1' type='checkbox'  value='Fezile Dabi District Municipality'  id='choice_3_42_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_42_1' id='label_3_42_1' class='gform-field-label gform-field-label--type-inline'>Fezile Dabi District Municipality<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_42_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.2' type='checkbox'  value='Lejweleputswa'  id='choice_3_42_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_42_2' id='label_3_42_2' class='gform-field-label gform-field-label--type-inline'>Lejweleputswa<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_42_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.3' type='checkbox'  value='Mangaung Metropolitan Municipality'  id='choice_3_42_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_42_3' id='label_3_42_3' class='gform-field-label gform-field-label--type-inline'>Mangaung Metropolitan Municipality<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_42_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.4' type='checkbox'  value='Thabo Mofutsanyana'  id='choice_3_42_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_42_4' id='label_3_42_4' class='gform-field-label gform-field-label--type-inline'>Thabo Mofutsanyana<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_42_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.5' type='checkbox'  value='Other'  id='choice_3_42_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_42_5' id='label_3_42_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_43\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Eastern Cape<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_43'><div class='gchoice gchoice_3_43_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.1' type='checkbox'  value='Emalahleni'  id='choice_3_43_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_1' id='label_3_43_1' class='gform-field-label gform-field-label--type-inline'>Emalahleni<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_43_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.2' type='checkbox'  value='Joe Gqabi District'  id='choice_3_43_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_2' id='label_3_43_2' class='gform-field-label gform-field-label--type-inline'>Joe Gqabi District<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_43_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.3' type='checkbox'  value='Alfred Nzo'  id='choice_3_43_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_3' id='label_3_43_3' class='gform-field-label gform-field-label--type-inline'>Alfred Nzo<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_43_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.4' type='checkbox'  value='Blue Crane Route'  id='choice_3_43_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_4' id='label_3_43_4' class='gform-field-label gform-field-label--type-inline'>Blue Crane Route<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_43_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.5' type='checkbox'  value='Other'  id='choice_3_43_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_43_5' id='label_3_43_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_44\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Northen Cape<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_44'><div class='gchoice gchoice_3_44_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.1' type='checkbox'  value='John Taolo Gaetsewe'  id='choice_3_44_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_1' id='label_3_44_1' class='gform-field-label gform-field-label--type-inline'>John Taolo Gaetsewe<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.2' type='checkbox'  value='Pixley Ka Seme'  id='choice_3_44_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_2' id='label_3_44_2' class='gform-field-label gform-field-label--type-inline'>Pixley Ka Seme<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.3' type='checkbox'  value='Frances Baard'  id='choice_3_44_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_3' id='label_3_44_3' class='gform-field-label gform-field-label--type-inline'>Frances Baard<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.4' type='checkbox'  value='Namakwa District'  id='choice_3_44_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_4' id='label_3_44_4' class='gform-field-label gform-field-label--type-inline'>Namakwa District<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_44_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_44.5' type='checkbox'  value='Other'  id='choice_3_44_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_44_5' id='label_3_44_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_3_45\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Western Cape<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_3_45'><div class='gchoice gchoice_3_45_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.1' type='checkbox'  value='Cape Winelands'  id='choice_3_45_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_45_1' id='label_3_45_1' class='gform-field-label gform-field-label--type-inline'>Cape Winelands<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_45_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.2' type='checkbox'  value='Overberg'  id='choice_3_45_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_45_2' id='label_3_45_2' class='gform-field-label gform-field-label--type-inline'>Overberg<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_45_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.3' type='checkbox'  value='City Of Cape Town'  id='choice_3_45_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_45_3' id='label_3_45_3' class='gform-field-label gform-field-label--type-inline'>City Of Cape Town<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_45_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.4' type='checkbox'  value='Central Karoo District'  id='choice_3_45_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_45_4' id='label_3_45_4' class='gform-field-label gform-field-label--type-inline'>Central Karoo District<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3_45_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_45.5' type='checkbox'  value='Other'  id='choice_3_45_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3_45_5' id='label_3_45_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3_36\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_36'>Other<\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_3_36' type='text' value='' class='large'    placeholder='Other'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3_48\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3_48'>Upload Image<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_48' id='input_3_48' type='file' class='large' aria-describedby=\"gfield_upload_rules_3_48\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_3_48'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_3_48'><\/div> <\/div><\/div><fieldset id=\"field_3_46\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<\/legend><div class='ginput_container ginput_container_consent'><input name='input_46.1' id='input_3_46_1' type='checkbox' value='1'    aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_3_46_1' >I understand that I want to be a member of the Ethiopian Association and have read and understand the constitution. I confirm with my signature that I agree to fulfill the duties and responsibilities expected of me as any member.<\/label><input type='hidden' name='input_46.2' value='I understand that I want to be a member of the Ethiopian Association and have read and understand the constitution. 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