{"id":1907,"date":"2019-10-22T13:37:45","date_gmt":"2019-10-22T13:37:45","guid":{"rendered":"http:\/\/kankakeevalleyhistoricalsociety.org\/?page_id=1907"},"modified":"2025-02-28T17:28:04","modified_gmt":"2025-02-28T17:28:04","slug":"kvhs-family-membership-form","status":"publish","type":"page","link":"https:\/\/kankakeevalleyhistoricalsociety.org\/?page_id=1907","title":{"rendered":"KVHS Family Membership form"},"content":{"rendered":"<p>Joining the Kankakee Valley Historical Society is now easier than ever. Membership dues may now be paid through PayPal or mailed in to the address on the form. Use either your PayPal account or credit card. You will receive payment acknowledgment when payment is received. We appreciate your support!<\/p>\n<p style=\"text-align: center;\"><div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-1902\"><form id=\"wpforms-form-1902\" class=\"wpforms-validate wpforms-form\" data-formid=\"1902\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F1907\" data-token=\"0d6b0402d696a2ce368951dd3e9321d7\"><div class=\"wpforms-head-container\"><div class=\"wpforms-title\">KVHS Family Membership application<\/div><\/div><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-1902-field_1-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_1\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1902-field_1\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][1][first]\" required><label for=\"wpforms-1902-field_1\" class=\"wpforms-field-sublabel after \">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1902-field_1-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][1][last]\" required><label for=\"wpforms-1902-field_1-last\" class=\"wpforms-field-sublabel after \">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-1902-field_2-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_2\">Age<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-1902-field_2\" class=\"wpforms-field-medium\" name=\"wpforms[fields][2]\" ><\/div><div id=\"wpforms-1902-field_3-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_3\">Phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-1902-field_3\" class=\"wpforms-field-medium wpforms-field-required wpforms-masked-input\" data-inputmask=\"&#039;mask&#039;: &#039;(999) 999-9999&#039;\" data-rule-us-phone-field=\"true\" data-inputmask-inputmode=\"tel\" name=\"wpforms[fields][3]\" required><\/div><div id=\"wpforms-1902-field_4-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_4\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-1902-field_4\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][4]\" required><\/div><div id=\"wpforms-1902-field_5-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_5\">Address <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-1902-field_5\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][5][address1]\" required><label for=\"wpforms-1902-field_5\" class=\"wpforms-field-sublabel after \">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-1902-field_5-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][5][address2]\" ><label for=\"wpforms-1902-field_5-address2\" class=\"wpforms-field-sublabel after \">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-1902-field_5-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][5][city]\" required><label for=\"wpforms-1902-field_5-city\" class=\"wpforms-field-sublabel after \">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-1902-field_5-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][5][state]\" required><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-1902-field_5-state\" class=\"wpforms-field-sublabel after \">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-1902-field_5-postal\" class=\"wpforms-field-address-postal wpforms-field-required wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][5][postal]\" required><label for=\"wpforms-1902-field_5-postal\" class=\"wpforms-field-sublabel after \">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-1902-field_12-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_12\">Family Members<\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1902-field_12\" class=\"wpforms-field-name-first\" name=\"wpforms[fields][12][first]\" ><label for=\"wpforms-1902-field_12\" class=\"wpforms-field-sublabel after \">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1902-field_12-last\" class=\"wpforms-field-name-last\" name=\"wpforms[fields][12][last]\" ><label for=\"wpforms-1902-field_12-last\" class=\"wpforms-field-sublabel after \">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-1902-field_18-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_18\">Relationship<\/label><input type=\"text\" id=\"wpforms-1902-field_18\" class=\"wpforms-field-medium\" name=\"wpforms[fields][18]\" ><\/div><div id=\"wpforms-1902-field_20-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_20\">Age <\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-1902-field_20\" class=\"wpforms-field-medium\" name=\"wpforms[fields][20]\" ><\/div><div id=\"wpforms-1902-field_13-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_13\">Name<\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1902-field_13\" class=\"wpforms-field-name-first\" name=\"wpforms[fields][13][first]\" ><label for=\"wpforms-1902-field_13\" class=\"wpforms-field-sublabel after \">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1902-field_13-last\" class=\"wpforms-field-name-last\" name=\"wpforms[fields][13][last]\" ><label for=\"wpforms-1902-field_13-last\" class=\"wpforms-field-sublabel after \">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-1902-field_19-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_19\">Relationship<\/label><input type=\"text\" id=\"wpforms-1902-field_19\" class=\"wpforms-field-medium\" name=\"wpforms[fields][19]\" ><\/div><div id=\"wpforms-1902-field_21-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_21\">Age <\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-1902-field_21\" class=\"wpforms-field-medium\" name=\"wpforms[fields][21]\" ><\/div><div id=\"wpforms-1902-field_16-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"16\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_16\">Name<\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-1902-field_16\" class=\"wpforms-field-name-first\" name=\"wpforms[fields][16][first]\" ><label for=\"wpforms-1902-field_16\" class=\"wpforms-field-sublabel after \">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-1902-field_16-last\" class=\"wpforms-field-name-last\" name=\"wpforms[fields][16][last]\" ><label for=\"wpforms-1902-field_16-last\" class=\"wpforms-field-sublabel after \">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-1902-field_22-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"22\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_22\">Relationship<\/label><input type=\"text\" id=\"wpforms-1902-field_22\" class=\"wpforms-field-medium\" name=\"wpforms[fields][22]\" ><\/div><div id=\"wpforms-1902-field_23-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"23\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_23\">Age <\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-1902-field_23\" class=\"wpforms-field-medium\" name=\"wpforms[fields][23]\" ><\/div><div id=\"wpforms-1902-field_26-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"26\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_26\">Additional Family Members, relationship and age<\/label><textarea id=\"wpforms-1902-field_26\" class=\"wpforms-field-medium\" name=\"wpforms[fields][26]\" ><\/textarea><\/div><div id=\"wpforms-1902-field_29-container\" class=\"wpforms-field wpforms-field-payment-single\" data-field-id=\"29\"><label class=\"wpforms-field-label\" for=\"wpforms-1902-field_29\">KVHS Family Membership Dues<\/label><div class=\"wpforms-single-item-price\">Price: <span class=\"wpforms-price\">&#036; 40.00<\/span><\/div><input type=\"hidden\" id=\"wpforms-1902-field_29\" class=\"wpforms-field-medium wpforms-payment-price\" name=\"wpforms[fields][29]\" value=\"&#036; 40.00\"><\/div><\/div><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-1902-field-hp\" class=\"wpforms-field-label\">Name<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-1902-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-submit-container\"><input type=\"hidden\" name=\"wpforms[id]\" value=\"1902\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"1\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-1902\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Joining the Kankakee Valley Historical Society is now easier than ever. Membership dues may now be paid through PayPal or mailed in to the address on the form. Use either your PayPal account or credit card. You will receive payment acknowledgment when payment is received. We appreciate your support!<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":146,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"no-sidebar.php","meta":{"_mi_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-1907","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/kankakeevalleyhistoricalsociety.org\/index.php?rest_route=\/wp\/v2\/pages\/1907","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kankakeevalleyhistoricalsociety.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kankakeevalleyhistoricalsociety.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kankakeevalleyhistoricalsociety.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kankakeevalleyhistoricalsociety.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1907"}],"version-history":[{"count":5,"href":"https:\/\/kankakeevalleyhistoricalsociety.org\/index.php?rest_route=\/wp\/v2\/pages\/1907\/revisions"}],"predecessor-version":[{"id":3532,"href":"https:\/\/kankakeevalleyhistoricalsociety.org\/index.php?rest_route=\/wp\/v2\/pages\/1907\/revisions\/3532"}],"up":[{"embeddable":true,"href":"https:\/\/kankakeevalleyhistoricalsociety.org\/index.php?rest_route=\/wp\/v2\/pages\/146"}],"wp:attachment":[{"href":"https:\/\/kankakeevalleyhistoricalsociety.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1907"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}