{"id":151,"date":"2021-10-15T14:57:25","date_gmt":"2021-10-15T14:57:25","guid":{"rendered":"https:\/\/nigeltuiste.org.za\/?page_id=151"},"modified":"2024-11-15T11:04:36","modified_gmt":"2024-11-15T11:04:36","slug":"doen-aansoek","status":"publish","type":"page","link":"https:\/\/nigeltuiste.org.za\/en\/doen-aansoek\/","title":{"rendered":"Apply"},"content":{"rendered":"<section class=\"section\" id=\"section_1488253506\">\n\t\t<div class=\"section-bg fill\" >\n\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"1700\" height=\"1130\" src=\"https:\/\/nigeltuiste.org.za\/wp-content\/uploads\/2021\/10\/clouds-1282314_1920-e1634215744199.jpg\" class=\"bg attachment- size-\" alt=\"\" \/>\t\t\t\t\t\t<div class=\"section-bg-overlay absolute fill\"><\/div>\n\t\t\t\n\n\t\t<\/div>\n\n\t\t\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\n  <div id=\"page-header-1767692194\" class=\"page-header-wrapper\">\n  <div class=\"page-title dark featured-title\">\n\n        <div class=\"page-title-bg\">\n      <div class=\"title-bg fill bg-fill\"\n        data-parallax-container=\".page-title\"\n        data-parallax-background\n data-parallax=\"-\">\n      <\/div>\n      <div class=\"title-overlay fill\"><\/div>\n    <\/div>\n    \n    <div class=\"page-title-inner container align-center flex-row medium-flex-wrap\" >\n              <div class=\"title-wrapper flex-col text-left medium-text-center\">\n          <h1 class=\"entry-title mb-0\">\n            Apply          <\/h1>\n        <\/div>\n                    <div class=\"title-content flex-col flex-right text-right medium-text-center\">\n        <div class=\"title-breadcrumbs pb-half pt-half\"><\/div>      <\/div>\n    <\/div>\n\n     \n<style>\n#page-header-1767692194 .page-title-inner {\n  min-height: 70px;\n}\n#page-header-1767692194 {\n  margin-bottom: 0px;\n}\n#page-header-1767692194 .title-overlay {\n  background-color: rgba(190, 113, 113, 0);\n}\n#page-header-1767692194 .featured-title {\n  background-color: rgba(0, 0, 0, 0.616);\n}\n<\/style>\n  <\/div>\n    <\/div>\n  \n\t\t<\/div>\n\n\t\t\n<style>\n#section_1488253506 {\n  padding-top: 30px;\n  padding-bottom: 30px;\n  background-color: #05365f;\n}\n#section_1488253506 .section-bg-overlay {\n  background-color: rgba(5, 54, 95, 0.291);\n}\n<\/style>\n\t<\/section>\n\t\n\t<div id=\"gap-644669401\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-644669401 {\n  padding-top: 30px;\n}\n<\/style>\n\t<\/div>\n\t\n\n\t<section class=\"section\" id=\"section_567997102\">\n\t\t<div class=\"section-bg fill\" >\n\t\t\t\t\t\t\t\t\t\n\t\t\t\n\n\t\t<\/div>\n\n\t\t\n\n\t\t<div class=\"section-content relative\">\n\t\t\t\n<div class=\"row\"  id=\"row-1001507273\">\n\n\t<div id=\"col-999750708\" class=\"col medium-9 small-12 large-9\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n<div data-uniq='69da06a1d74eb' class='uniq-69da06a1d74eb formcraft-css form-live align-left'><style type='text\/css' scoped='scoped'>#main .formcraft-css a{\n\tvisibility:hidden;\n\t\n}\n\n#footer .formcraft-css a{\n\tvisibility:hidden;\n\t\n}\n\n\n\n#body .formcraft-css a{\n\tvisibility:hidden;\n\t\n}\n\n\n#header .formcraft-css a{\n\tvisibility:hidden;\n\t\n}<\/style><script> window.formcraftLogic = window.formcraftLogic || {}; window.formcraftLogic[2] = [[[[\"field8\",\"contains\",\"BASIC\"]],[[\"hide_fields\",\"field6\"]],\"and\"]]; <\/script><div class=\"fc-pagination-cover fc-pagination-1\">\n\t\t\t\t<div class=\"fc-pagination width-100\">\n\t\t\t\t\t<!-- ngRepeat: page in Builder.FormElements track by $index --><div class=\"pagination-trigger\" data-index=\"0\">\n\t\t\t\t\t\t<span class=\"page-number\"><span >1<\/span><\/span>\n\t\t\t\t\t\t<span class=\"page-name\">Step 1<\/span>\n\t\t\t\t\t\t\n\t\t\t\t\t<\/div><!-- end ngRepeat: page in Builder.FormElements track by $index -->\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t<style scoped=\"scoped\" >\n\t\t\t@media (max-width : 480px) {\n\t\t\t\t.fc_modal-dialog-2 .fc-pagination-cover .fc-pagination\n\t\t\t\t{\n\t\t\t\t\tbackground-color: none !important;\n\t\t\t\t}\n\t\t\t}\n\t\t\t\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .submit-cover .submit-button,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .fileupload-cover .button-file,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover .button,\n\t\t\t.formcraft-datepicker .ui-datepicker-header,\n\t\t\t.formcraft-datepicker .ui-datepicker-title\n\t\t\t{\n\t\t\t\tbackground: #05365f;\n\t\t\t\tcolor: #ffffff;\n\t\t\t}\n\t\t\t.formcraft-datepicker td .ui-state-active,\n\t\t\t.formcraft-datepicker td .ui-state-hover,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .slider-cover .ui-slider-range\n\t\t\t{\n\t\t\t\tbackground: #05365f;\n\t\t\t}\n\t\t\t#ui-datepicker-div.formcraft-datepicker .ui-datepicker-header,\n\t\t\t.formcraft-css .fc-form .field-cover>div.full hr\n\t\t\t{\n\t\t\t\tborder-color: #042f53;\n\t\t\t}\n\t\t\t#ui-datepicker-div.formcraft-datepicker .ui-datepicker-prev:hover,\n\t\t\t#ui-datepicker-div.formcraft-datepicker .ui-datepicker-next:hover,\n\t\t\t#ui-datepicker-div.formcraft-datepicker select.ui-datepicker-month:hover,\n\t\t\t#ui-datepicker-div.formcraft-datepicker select.ui-datepicker-year:hover\n\t\t\t{\n\t\t\t\tbackground-color: #042f53;\n\t\t\t}\n\t\t\t.formcraft-css .fc-pagination>div.active .page-number,\n\t\t\t.formcraft-css .form-cover-builder .fc-pagination>div:first-child .page-number\n\t\t\t{\n\t\t\t\tbackground-color: #4488ee;\n\t\t\t\tcolor: #ffffff;\n\t\t\t}\n\t\t\t#ui-datepicker-div.formcraft-datepicker table.ui-datepicker-calendar th,\n\t\t\t#ui-datepicker-div.formcraft-datepicker table.ui-datepicker-calendar td.ui-datepicker-today a,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .star-cover label,\n\t\t\thtml .formcraft-css .fc-form.label-floating .form-element .field-cover.has-focus>span,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .customText-cover a,\n\t\t\t.formcraft-css .prev-next>div span:hover\n\t\t\t{\n\t\t\t\tcolor: #05365f;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .customText-cover a:hover\n\t\t\t{\n\t\t\t\tcolor: #042f53;\n\t\t\t}\n\t\t\thtml .formcraft-css .fc-form.fc-form-2.label-floating .form-element .field-cover > span\n\t\t\t{\n\t\t\t\tcolor: #3f3f3f;\n\t\t\t}\n\t\t\thtml .formcraft-css .fc-form .final-success .final-success-check {\n\t\t\t\tborder: 2px solid #3f3f3f;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"text\"],\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"email\"],\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"password\"],\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"tel\"],\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover textarea,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover select,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover .time-fields-cover,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover .awesomplete ul\n\t\t\t{\n\t\t\t\tcolor: #3a3a3a;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"text\"],\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"password\"],\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"email\"],\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"radio\"],\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"checkbox\"],\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"tel\"],\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover select,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover textarea\n\t\t\t{\n\t\t\t\tbackground-color: #ffffff;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"radio\"]:checked,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .field-cover input[type=\"checkbox\"]:checked {\n\t\t\t\tborder-color: #042f53;\n\t\t\t\tbackground: #05365f;\t\t\t\t\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .star-cover label .star\n\t\t\t{\n\t\t\t\ttext-shadow: 0px 1px 0px #042f53;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .slider-cover .ui-slider-range\n\t\t\t{\n\t\t\t\tbox-shadow: 0px 1px 1px #042f53 inset;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .fileupload-cover .button-file\n\t\t\t{\n\t\t\t\tborder-color: #042f53;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .form-element-html input[type=\"password\"]:focus,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .form-element-html input[type=\"email\"]:focus,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .form-element-html input[type=\"tel\"]:focus,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .form-element-html input[type=\"text\"]:focus,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .form-element-html textarea:focus,\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .form-element-html select:focus\n\t\t\t{\n\t\t\t\tborder-color: #05365f;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-2 .form-element .form-element-html .field-cover .is-read-only:focus {\n\t\t\t\tborder-color: #ccc;\n\t\t\t}\n\t\t\t.formcraft-css .fc-form.fc-form-2\t\t\t{\n\t\t\t\tfont-family: inherit;\n\t\t\t}\n\t\t\t@media (max-width : 480px) {\n\t\t\t\thtml .dedicated-page,\n\t\t\t\thtml .dedicated-page .formcraft-css .fc-pagination > div.active\n\t\t\t\t{\n\t\t\t\t\tbackground: none;\n\t\t\t\t}\n\t\t\t}\n\t\t<\/style>\n\t\t<div class=\"form-cover\">\n\t\t\t<form data-auto-scroll=\"\" data-no-message-redirect=\"\" data-thousand=\"\" data-decimal=\".\" data-delay=\"\" data-id=\"2\" class=\"fc-form fc-form-2 align- fc-temp-class save-form- dont-submit-hidden- disable-enter- label-block field-border-visible frame-hidden remove-asterisk-true icons-hide-true field-alignment-left   ng-submitted\" style=\"width: 800px; color: #3f3f3f; font-size: 95%; background: none\">\n\t\t\t\t<!-- ngRepeat: page in Builder.FormElements track by $index --><div class=\"form-page form-page-0\" data-index=\"0\">\n\t\t\t\t\t\n\t\t\t\t\t<div class=\"form-page-content      ng-not-empty\">\n\t\t\t\t\t\t<div data-identifier=\"field15\" data-index=\"0\" style=\"width: 100%\" class=\"form-element form-element-field15 options-false form-element-0 default-false form-element-type-customText is-required-false odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h3 align=\"center\" ><span id=\"selectionBoundary_1731666827110_7797580225191616\" class=\"rangySelectionBoundary\"><\/span><span id=\"selectionBoundary_1731666860802_02451969251560626\" class=\"rangySelectionBoundary\"><\/span>AANSOEKVORM \/ APPLICATION FORM<br>SOORT AKKOMMODASIE BENODIG \/ TYPE OF ACCO<span id=\"selectionBoundary_1731666830420_2753395003335498\" class=\"rangySelectionBoundary\"><\/span>MMODATION NEEDED<span id=\"selectionBoundary_1731666860802_034532924699750334\" class=\"rangySelectionBoundary\"><\/span><span id=\"selectionBoundary_1731666851165_39792652598029665\" class=\"rangySelectionBoundary\"><\/span><\/h3><div align=\"center\" ><span id=\"selectionBoundary_1731666832884_4915095226576257\" class=\"rangySelectionBoundary\"><\/span>(<span id=\"selectionBoundary_1731666840313_3548400009671048\" class=\"rangySelectionBoundary\"><\/span>Merk asseblief die nodige akkommodasie wat u verlang) \/<br>(Please mark the needed accommodation)<span id=\"selectionBoundary_1731666827110_7344610999108322\" class=\"rangySelectionBoundary\"><\/span><\/div><\/div><input type=\"hidden\" name=\"field15\" data-field-id=\"field15\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field16\" data-index=\"1\" style=\"width: 50%\" class=\"even form-element form-element-field16 options-false form-element-1 default-false form-element-type-checkbox is-required-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >VERSORGINGSEENHEID \/ CARE UNIT<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width: 100%\" ><img alt=\"\"><input data-field-id=\"field16\" type=\"checkbox\" data-is-required=\"false\" name=\"field16[]\" value=\"Semi-verswak \/ Semi-frail care\" class=\"validation-lenient\"><span><span >Semi-verswak \/ Semi-frail care<\/span><\/span><\/label><label style=\"width: 100%\" ><img alt=\"\"><input data-field-id=\"field16\" type=\"checkbox\" data-is-required=\"false\" name=\"field16[]\" value=\"Verswakte afdeling \/ Frail Care\" class=\"validation-lenient\"><span><span >Verswakte afdeling \/ Frail Care<\/span><\/span><\/label><label style=\"width: 100%\" ><img alt=\"\"><input data-field-id=\"field16\" type=\"checkbox\" data-is-required=\"false\" name=\"field16[]\" value=\"Alzheimer\" class=\"validation-lenient\"><span><span >Alzheimer<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field17\" data-index=\"2\" style=\"width: 50%\" class=\"form-element form-element-field17 options-false form-element-2 default-false form-element-type-checkbox is-required-false odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >SELFSORG HUURWOONSTELLE \/ SELF CARE RENTAL COTTAGES<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width: 100%\" ><img alt=\"\"><input data-field-id=\"field17\" type=\"checkbox\" data-is-required=\"false\" name=\"field17[]\" value=\"1x Slaap \/ 1 x Sleep\" class=\"validation-lenient\"><span><span >1x Slaap \/ 1 x Sleep<\/span><\/span><\/label><label style=\"width: 100%\" ><img alt=\"\"><input data-field-id=\"field17\" type=\"checkbox\" data-is-required=\"false\" name=\"field17[]\" value=\"2 x Slaap \/ 2 x Sleep\" class=\"validation-lenient\"><span><span >2 x Slaap \/ 2 x Sleep<\/span><\/span><\/label><label style=\"width: 100%\" ><img alt=\"\"><input data-field-id=\"field17\" type=\"checkbox\" data-is-required=\"false\" name=\"field17[]\" value=\"Enkel\/ Bachelor\" class=\"validation-lenient\"><span><span >Enkel\/ Bachelor<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field18\" data-index=\"3\" style=\"width: 100%\" class=\"even form-element form-element-field18 options-false form-element-3 default-false form-element-type-customText is-required-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h3 align=\"left\" ><span id=\"selectionBoundary_1731667065901_974596831231412\" class=\"rangySelectionBoundary\"><\/span>Te Koop \/ Buying<span id=\"selectionBoundary_1731667065900_6325165387317446\" class=\"rangySelectionBoundary\"><\/span><\/h3><\/div><input type=\"hidden\" name=\"field18\" data-field-id=\"field18\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field19\" data-index=\"4\" style=\"width: 100%\" class=\"form-element form-element-field19 options-false form-element-4 default-false form-element-type-checkbox is-required-false odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >GOUE JARE AFTREEOORD\/ GOUE JARE RETIREMENT COTTAGES<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width: 100%\" ><img alt=\"\"><input data-field-id=\"field19\" type=\"checkbox\" data-is-required=\"false\" name=\"field19[]\" value=\"1 Slaapkamer \/ 1 Bedroom\" class=\"validation-lenient\"><span><span >1 Slaapkamer \/ 1 Bedroom<\/span><\/span><\/label><label style=\"width: 100%\" ><img alt=\"\"><input data-field-id=\"field19\" type=\"checkbox\" data-is-required=\"false\" name=\"field19[]\" value=\"1\u00bd Slaapkamer \/ 1 \u00bd Bedroom\" class=\"validation-lenient\"><span><span >1\u00bd Slaapkamer \/ 1 \u00bd Bedroom<\/span><\/span><\/label><label style=\"width: 100%\" ><img alt=\"\"><input data-field-id=\"field19\" type=\"checkbox\" data-is-required=\"false\" name=\"field19[]\" value=\"2 Slaapkamer \/ 2 Bedroom\" class=\"validation-lenient\"><span><span >2 Slaapkamer \/ 2 Bedroom<\/span><\/span><\/label><label style=\"width: 100%\" ><img alt=\"\"><input data-field-id=\"field19\" type=\"checkbox\" data-is-required=\"false\" name=\"field19[]\" value=\"SILWER JARE\" class=\"validation-lenient\"><span><span >SILWER JARE<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field20\" data-index=\"5\" style=\"width: 100%\" class=\"even form-element form-element-field20 options-false form-element-5 default-false form-element-type-customText is-required-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h3 align=\"center\" ><span id=\"selectionBoundary_1731667203808_6955248601466323\" class=\"rangySelectionBoundary\"><\/span><span id=\"selectionBoundary_1731667211899_43689852323060274\" class=\"rangySelectionBoundary\"><\/span><span id=\"selectionBoundary_1731667219687_1688877736014458\" class=\"rangySelectionBoundary\"><\/span>AANSOEKER KONTAK BESONDERHEDE \/ APPLICANT CONTACT DETAILS<span id=\"selectionBoundary_1731667219686_03571443033943744\" class=\"rangySelectionBoundary\"><\/span><span id=\"selectionBoundary_1731667211899_976545123934652\" class=\"rangySelectionBoundary\"><\/span><br><span id=\"selectionBoundary_1731667203808_9662930672192548\" class=\"rangySelectionBoundary\"><\/span><\/h3><\/div><input type=\"hidden\" name=\"field20\" data-field-id=\"field20\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field1\" data-index=\"6\" style=\"width: 100%\" class=\"form-element form-element-field1 options-false form-element-6 default-false form-element-type-oneLineText is-required-true odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >VAN \/ SURNAME:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field1\" name=\"field1[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field21\" data-index=\"7\" style=\"width: 100%\" class=\"even form-element form-element-field21 options-false form-element-7 default-false form-element-type-oneLineText is-required-true -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >VOLLE NAME \/ FULL NAMES:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field21\" name=\"field21[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field30\" data-index=\"8\" style=\"width: 50%\" class=\"form-element form-element-field30 options-false form-element-8 default-false form-element-type-oneLineText is-required-false odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >MNR \/ MR:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field30\" name=\"field30[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field23\" data-index=\"9\" style=\"width: 50%\" class=\"even form-element form-element-field23 options-false form-element-9 default-false form-element-type-oneLineText is-required-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >MNR \/ MR: ID NR<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field23\" name=\"field23[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field25\" data-index=\"10\" style=\"width: 50%\" class=\"form-element form-element-field25 options-false form-element-10 default-false form-element-type-oneLineText is-required-false odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >MEV \/ MRS:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field25\" name=\"field25[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field24\" data-index=\"11\" style=\"width: 50%\" class=\"even form-element form-element-field24 options-false form-element-11 default-false form-element-type-oneLineText is-required-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >MEV \/ MRS: ID NR<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field24\" name=\"field24[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field12\" data-index=\"12\" style=\"width: 100%\" class=\"form-element form-element-field12 options-false form-element-12 default-false form-element-type-textarea is-required-true odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"textarea-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >ADRES \/ ADDRESS:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><textarea data-field-id=\"field12\" placeholder=\"\" class=\"validation-lenient\" name=\"field12\" value=\"\" rows=\"5\" data-min-char=\"\" data-max-char=\"\" data-is-required=\"true\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-original-title=\"\" style=\"min-height: 105.35px\"><\/textarea><div class=\"count-\"><span class=\"current-count\">0<\/span> \/ <span class=\"max-count\"><\/span><\/div><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field26\" data-index=\"13\" style=\"width: 100%\" class=\"even form-element form-element-field26 options-false form-element-13 default-false form-element-type-customText is-required-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><h3 align=\"center\" ><span id=\"selectionBoundary_1731667458645_0076746679383628\" class=\"rangySelectionBoundary\"><\/span>KONTAKNOMMERS \/ CONTACT NUMBERS<br><\/h3><\/div><input type=\"hidden\" name=\"field26\" data-field-id=\"field26\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field13\" data-index=\"14\" style=\"width: 33.3%\" class=\"form-element form-element-field13 options-false form-element-14 default-false form-element-type-oneLineText is-required-true odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >HUIS\/HOME:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field13\" name=\"field13[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-call\">call<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field27\" data-index=\"15\" style=\"width: 33.3%\" class=\"even form-element form-element-field27 options-false form-element-15 default-false form-element-type-oneLineText is-required-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >WERK \/ WORK:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field27\" name=\"field27[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-call\">call<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field28\" data-index=\"16\" style=\"width: 33.3%\" class=\"form-element form-element-field28 options-false form-element-16 default-false form-element-type-oneLineText is-required-true odd -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >SELFOON\/CELLPHONE:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field28\" name=\"field28[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-call\">call<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field29\" data-index=\"17\" style=\"width: 100%\" class=\"even form-element form-element-field29 form-element-17 default-false form-element-type-customText is-required-false options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><p ><b><span id=\"selectionBoundary_1731667674325_767506307619807\" class=\"rangySelectionBoundary\"><\/span>KONTAKBESONDERHEDE VAN KINDERS \/ FAMILIE WAT GEKONTAK KAN WORD INDIEN U NIE <span id=\"selectionBoundary_1731667686449_3507221200147449\" class=\"rangySelectionBoundary\"><\/span>BESKIKBAAR IS NIE \/&nbsp;<\/b><\/p><p ><b>CONTACT DETAILS OF CHILDREN \/ FAMILY IN CASE YOU CAN\u2019T BE REACHED<span id=\"selectionBoundary_1731667674325_8653196791860542\" class=\"rangySelectionBoundary\"><\/span><\/b><br><\/p><\/div><input type=\"hidden\" name=\"field29\" data-field-id=\"field29\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field22\" data-index=\"18\" style=\"width: 100%\" class=\"form-element form-element-field22 form-element-18 default-false form-element-type-oneLineText odd is-required-true options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >NAAM \/ NAME:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"No 1\" make-read-only=\"\" data-field-id=\"field22\" name=\"field22[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"No 1\" data-original-title=\"\" autocomplete=\"off\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field34\" data-index=\"19\" style=\"width: 50%\" class=\"form-element form-element-field34 default-false form-element-type-oneLineText even form-element-19 is-required-true options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >TEL NO \/ NR:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field34\" name=\"field34[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field35\" data-index=\"20\" style=\"width: 50%\" class=\"form-element form-element-field35 default-false form-element-type-oneLineText odd form-element-20 is-required-true options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >SELFOON \/ CELLPHONE:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field35\" name=\"field35[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"true\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field2\" data-index=\"21\" style=\"width: 100%\" class=\"form-element form-element-field2 default-false form-element-type-email is-required-true even form-element-21 options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"email-cover field-cover\"><span class=\"sub-label-true\"><span class=\"main-label\"><span >E-POS\/E-MAIL:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input placeholder=\"\" data-field-id=\"field2\" type=\"text\" data-val-type=\"email\" make-read-only=\"\" data-is-required=\"true\" name=\"field2\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-original-title=\"\"><i class=\"formcraft-icon\">email<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field33\" data-index=\"22\" style=\"width: 100%; position: relative; z-index: 101; left: 0px; top: 0px\" class=\"form-element form-element-field33 default-false form-element-type-oneLineText is-required-false odd form-element-22 options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >NAAM \/ NAME:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"No 2\" make-read-only=\"\" data-field-id=\"field33\" name=\"field33[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"No 2\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field31\" data-index=\"23\" style=\"width: 50%; position: relative; z-index: 101; left: 0px; top: 0px\" class=\"form-element form-element-field31 default-false form-element-type-oneLineText is-required-false even form-element-23 options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >TEL NO \/ NR:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field31\" name=\"field31[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field32\" data-index=\"24\" style=\"width: 50%; position: relative; z-index: 101; left: 0px; top: 0px\" class=\"form-element form-element-field32 default-false form-element-type-oneLineText is-required-false options-false odd form-element-24 -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"oneLineText-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><span >SELFOON \/ CELLPHONE:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input type=\"text\" placeholder=\"\" make-read-only=\"\" data-field-id=\"field32\" name=\"field32[]\" data-min-char=\"\" data-max-char=\"\" data-val-type=\"\" data-regexp=\"\" data-is-required=\"false\" data-allow-spaces=\"true\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-input-mask=\"\" data-mask-placeholder=\"\" data-original-title=\"\"><i class=\"formcraft-icon formcraft-icon-type-account_circle\">account_circle<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field36\" data-index=\"25\" style=\"width: 100%; position: relative; z-index: 101; left: 0px; top: 0px\" class=\"form-element form-element-field36 default-false form-element-type-email even form-element-25 is-required-false options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><label class=\"email-cover field-cover\"><span class=\"sub-label-true\"><span class=\"main-label\"><span >E-POS\/E-MAIL:<\/span><\/span><span class=\"sub-label\"><\/span><\/span><div><span class=\"error\"><\/span><input placeholder=\"\" data-field-id=\"field36\" type=\"text\" data-val-type=\"email\" make-read-only=\"\" data-is-required=\"false\" name=\"field36\" class=\"validation-lenient\" data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"focus\" data-html=\"true\" data-original-title=\"\"><i class=\"formcraft-icon\">email<\/i><\/div><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field37\" data-index=\"26\" style=\"width: 100%; position: relative; z-index: 101; left: 0px; top: -9.2625px\" class=\"form-element form-element-field37 default-false form-element-type-customText is-required-false odd form-element-26 options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><p ><b>Verklaring en Toestemming<\/b><\/p><p ><span id=\"selectionBoundary_1731667927502_2824299256919056\" class=\"rangySelectionBoundary\"><\/span>Deur hierdie aansoekvorm in te dien, bevestig ek dat die inligting wat verskaf is akkuraat, volledig en waar is na die beste van my kennis. Ek verstaan dat die elektroniese indiening van hierdie vorm my wettige instemming met die bepalings en voorwaardes soos uiteengesit in hierdie aansoek verteenwoordig en gelykstaande is aan die verskaffing van my handgeskrewe handtekening.<\/p><\/div><input type=\"hidden\" name=\"field37\" data-field-id=\"field37\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field38\" data-index=\"27\" style=\"width: 100%\" class=\"even form-element form-element-field38 form-element-27 default-false form-element-type-customText is-required-false options-false -handle\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"absolute-false customText-cover field-cover\" style=\"left: ; top: ;right: ;bottom: ;color: #666666 !important; background-color:\"><div class=\"full\" style=\"text-align: left\"><p ><b>Declaration and Consent<\/b><\/p><p ><span id=\"selectionBoundary_1731667963949_7529038881820233\" class=\"rangySelectionBoundary\"><\/span><span id=\"selectionBoundary_1731667967692_8067153418289843\" class=\"rangySelectionBoundary\"><\/span><span id=\"selectionBoundary_1731667971814_7346619184731917\" class=\"rangySelectionBoundary\"><\/span>By submitting this application form, I confirm that the information provided is accurate, complete, and truthful to the best of my knowledge. I understand that submitting this form electronically constitutes my legal agreement to the terms and conditions set forth in this application, and it is equivalent to providing my handwritten signature.<\/p><\/div><input type=\"hidden\" name=\"field38\" data-field-id=\"field38\"><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field39\" data-index=\"28\" style=\"width: 100%; position: relative; z-index: 101; left: 0px; top: 0px\" class=\"form-element form-element-field39 default-false form-element-type-checkbox odd -handle form-element-28 is-required-true options-false\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"images- checkbox-cover field-cover\"><span class=\"sub-label-false\"><span class=\"main-label\"><\/span><span class=\"sub-label\"><\/span><\/span><div data-placement=\"right\" data-toggle=\"tooltip\" tooltip=\"\" data-trigger=\"hover\" data-html=\"true\" data-original-title=\"\"><span class=\"error\"><\/span><label style=\"width:\" ><img alt=\"\"><input data-field-id=\"field39\" type=\"checkbox\" data-is-required=\"true\" name=\"field39[]\" value=\"Ek aanvaar \/ I accept\" class=\"validation-lenient\"><span><span >Ek aanvaar \/ I accept<\/span><\/span><\/label><\/div><\/div><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field10\" data-index=\"29\" style=\"width: 100%\" class=\"form-element form-element-field10 options-false default-false form-element-type-reCaptcha is-required-false -handle even form-element-29\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div data-site-key=\"6LdbYA8cAAAAAHd-Tb3TnCpBR_onHjrHixQPrHKl\" class=\"captcha-placeholder\">reCaptcha v3<\/div><input type=\"hidden\" class=\"recaptcha-token\" name=\"recaptcha-token\"><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div><div data-identifier=\"field3\" data-index=\"30\" style=\"width: 100%\" class=\"form-element form-element-field3 options-false default-false form-element-type-submit is-required-false -handle odd form-element-30\">\n\t\t\t\t\t\t\t<div class=\"form-element-html\"><div ><div class=\"align-right wide-true submit-cover field-cover\"><button type=\"submit\" class=\"button submit-button\"><span class=\"text\">Submit<\/span><span class=\"spin-cover\"><i style=\"color:\" class=\"loading-icon icon-cog animate-spin\"><\/i><\/span><\/button><\/div><div class=\"submit-response\"><\/div><label ><input type=\"text\" class=\"required_field\" name=\"website\" autocomplete=\"maple-syrup-pot\"><\/label><\/div><\/div>\n\t\t\t\t\t\t\t\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div><!-- end ngRepeat: page in Builder.FormElements track by $index -->\n\t\t\t<input type=\"hidden\" name=\"trp-form-language\" value=\"en\"\/><\/form>\n\t\t\t<div class=\"prev-next prev-next-1\" style=\"width: 800px; color: #3f3f3f; font-size: 95%; background: none\">\n\t\t\t\t<div>\n\t\t\t\t\t\n\t\t\t\t\t<span class=\"inactive page-prev\"><i class=\"formcraft-icon\">keyboard_arrow_left<\/i>Terug<\/span><\/div>\n\t\t\t\t<div>\n\t\t\t\t\t\n\t\t\t\t\t<span class=\"page-next\">Volgende<i class=\"formcraft-icon\">keyboard_arrow_right<\/i><\/span><\/div>\n\t\t\t<\/div>\n\t\t<\/div><\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n\n\t<div id=\"col-1104932040\" class=\"col medium-3 small-12 large-3\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n<p>Contact us if you require further information regarding the application procedure.<\/p>\n<p><a href=\"mailto:info@nigeltuiste.org.za\">info@nigeltuiste.org.za<\/a><br \/><a href=\"tel:011 814 5313\">011 814 5313<\/a><\/p>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n<\/div>\n\n\t<div id=\"gap-218043692\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-218043692 {\n  padding-top: 74px;\n}\n<\/style>\n\t<\/div>\n\t\n\t\t<\/div>\n\n\t\t\n<style>\n#section_567997102 {\n  padding-top: 30px;\n  padding-bottom: 30px;\n}\n<\/style>\n\t<\/section>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"page-blank.php","meta":{"footnotes":""},"class_list":["post-151","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/nigeltuiste.org.za\/en\/wp-json\/wp\/v2\/pages\/151","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nigeltuiste.org.za\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/nigeltuiste.org.za\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/nigeltuiste.org.za\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/nigeltuiste.org.za\/en\/wp-json\/wp\/v2\/comments?post=151"}],"version-history":[{"count":10,"href":"https:\/\/nigeltuiste.org.za\/en\/wp-json\/wp\/v2\/pages\/151\/revisions"}],"predecessor-version":[{"id":208,"href":"https:\/\/nigeltuiste.org.za\/en\/wp-json\/wp\/v2\/pages\/151\/revisions\/208"}],"wp:attachment":[{"href":"https:\/\/nigeltuiste.org.za\/en\/wp-json\/wp\/v2\/media?parent=151"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}