{"id":128,"date":"2025-05-09T12:52:00","date_gmt":"2025-05-09T12:52:00","guid":{"rendered":"https:\/\/theclubelan.com\/blog\/?page_id=128"},"modified":"2025-05-09T12:52:02","modified_gmt":"2025-05-09T12:52:02","slug":"membership-application-form","status":"publish","type":"page","link":"https:\/\/theclubelan.com\/blog\/membership-application-form\/","title":{"rendered":"Membership Application Form"},"content":{"rendered":"<!-- HTML Forms v1.6.1 - https:\/\/wordpress.org\/plugins\/html-forms\/ -->\n<form method=\"post\"  class=\"hf-form hf-form-126 \" data-id=\"126\" data-title=\"Membership Application\" data-slug=\"membership-application\" data-message-success=\"Thank you! We will be in touch soon.\" data-message-invalid-email=\"Sorry, that email address looks invalid.\" data-message-required-field-missing=\"Please fill in the required fields.\" data-message-error=\"Oops. An error occurred.\" data-message-recaptcha-failed=\"reCAPTCHA verification failed. Please try again.\" data-message-recaptcha-low-score=\"Your submission appears to be spam. Please try again.\"><input type=\"hidden\" name=\"_hf_form_id\" value=\"126\" \/><div style=\"display: none;\"><input type=\"text\" name=\"_hf_h126\" value=\"\" \/><\/div><div class=\"hf-fields-wrap\"><div class=\"form_container\">\r\n            <div class=\"form-header\">\r\n              <div class=\"logo\">Club Elan Akure<\/div>\r\n              <h3>Membership Application Form<\/h3>\r\n            <\/div>\r\n            \r\n              <div class=\"form-section\">\r\n                <div class=\"form-group\">\r\n                  <label>Title<\/label><br>\r\n                  <select class=\"form-control\" name=\"title\" required=\"\" >\r\n                    <option value=\"Mr\">Mr<\/option>\r\n                    <option value=\"Ms\">Ms<\/option>\r\n                    <option value=\"Mrs\">Mrs<\/option>\r\n                    <option value=\"Dr\">Dr<\/option>\r\n                    <option value=\"Other\">Other<\/option>\r\n                  <\/select>\r\n                  \r\n                <\/div><br>\r\n                <div class=\"form-group\">\r\n                  <label>Surname<\/label>\r\n                  <input type=\"text\" class=\"form-control\" name=\"surname\" placeholder=\"Enter your surname\" required=\"\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>First Name<\/label>\r\n                  <input type=\"text\" class=\"form-control\" name=\"first_name\" placeholder=\"Enter your first name\" required=\"\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>Other Names<\/label>\r\n                  <input type=\"text\" class=\"form-control\" name=\"other_names\" placeholder=\"Enter your other names\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>Date of Birth<\/label>\r\n                  <input type=\"date\" class=\"form-control\" name=\"dob\" required=\"\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>Marital Status<\/label>\r\n                  <div class=\"radio-group\">\r\n                    <label><input type=\"radio\" name=\"marital_status\" value=\"Single\" required=\"\"> Single<\/label>\r\n                    <label><input type=\"radio\" name=\"marital_status\" value=\"Married\"> Married<\/label>\r\n                  <\/div>\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>Name of Spouse<\/label>\r\n                  <input type=\"text\" class=\"form-control\" name=\"spouse_name\" placeholder=\"Enter spouse's name (if applicable)\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>Name(s) of Children<\/label>\r\n                  <textarea class=\"form-control\" name=\"children_names\" placeholder=\"Enter names of children (if applicable)\"><\/textarea>\r\n                <\/div>\r\n              <\/div>\r\n              <div class=\"form-section\">\r\n                <h4  style=\"color:black\">Contact Details<\/h4>\r\n                <div class=\"form-group\">\r\n                  <label>Residential Address (House\/Plot Number)<\/label>\r\n                  <input type=\"text\" class=\"form-control\" name=\"address\" placeholder=\"Enter your residential address\" required=\"\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>LGA<\/label>\r\n                  <input type=\"text\" class=\"form-control\" name=\"lga\" placeholder=\"Enter your Local Government Area\" required=\"\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>City\/Town<\/label>\r\n                  <input type=\"text\" class=\"form-control\" name=\"city\" placeholder=\"Enter your city\/town\" required=\"\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>State<\/label>\r\n                  <input type=\"text\" class=\"form-control\" name=\"state\" placeholder=\"Enter your state\" required=\"\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>Country<\/label>\r\n                  <input type=\"text\" class=\"form-control\" name=\"country\" placeholder=\"Enter your country\" required=\"\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>Phone Number<\/label>\r\n                  <input type=\"tel\" class=\"form-control\" name=\"phone\" placeholder=\"Enter your phone number\" required=\"\">\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>Email Address<\/label>\r\n                  <input type=\"email\" class=\"form-control\" name=\"email\" placeholder=\"Enter your email address\" required=\"\">\r\n                <\/div>\r\n              <\/div>\r\n                <h4 style=\"color:black\">Educational Background with Dates<\/h4>\r\n              <div class=\"form-section\">\r\n                <div class=\"form-group\">\r\n                  <label>1.<\/label>\r\n                  <textarea class=\"form-control\" name=\"education_1\" placeholder=\"Enter your educational background (e.g., Degree, Institution, Dates)\"><\/textarea>\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>2.<\/label>\r\n                  <textarea class=\"form-control\" name=\"education_2\" placeholder=\"Enter additional educational background (if applicable)\"><\/textarea>\r\n                <\/div>\r\n                <div class=\"form-group\">\r\n                  <label>3.<\/label>\r\n                  <textarea class=\"form-control\" name=\"education_3\" placeholder=\"Enter additional educational background (if applicable)\"><\/textarea>\r\n                <\/div>\r\n              <\/div>\r\n              <div class=\"photo-section\">\r\n                <div class=\"photo-upload\">\r\n                  <div class=\"form-group\">\r\n                    <label>Upload Photo<\/label>\r\n                    <input type=\"file\" class=\"form-control\" name=\"photo\" id=\"photoInput\" accept=\"image\/*\" required=\"\">\r\n                    \r\n                  <\/div>\r\n                <\/div>\r\n              <\/div>\r\n              <div class=\"btn_box\">\r\n                <button class=\"btn1\" type=\"submit\">Submit Application<\/button>\r\n              <\/div>\r\n  \r\n            \r\n          <\/div><noscript>Please enable JavaScript for this form to work.<\/noscript><\/div><\/form><!-- \/ HTML Forms 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