{"id":11,"date":"2021-03-24T11:30:31","date_gmt":"2021-03-24T11:30:31","guid":{"rendered":"http:\/\/localhost\/solomon\/?page_id=11"},"modified":"2021-04-05T03:14:41","modified_gmt":"2021-04-05T03:14:41","slug":"online-pre-registration","status":"publish","type":"page","link":"http:\/\/solomonintegratedschool.com\/?page_id=11","title":{"rendered":"Online Pre-Registration"},"content":{"rendered":"\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n<div id=\"erf_form_container_128\" class=\"erf-container erf-contact erf-label-top erf-layout-one-column erf-style-rounded-corner\">\n        \n    \n         \n                    <div class=\"erf-content-above\">\n                Contact us by filling out the form below.            <\/div>\n            <form method=\"post\" enctype=\"multipart\/form-data\" class=\"erf-form erf-front-form\" data-parsley-validate=\"\" novalidate=\"true\" data-erf-submission-id=\"0\" data-erf-form-id=\"128\">\n                <div class=\"erf-form-html\" id=\"erf_form_128\">\n                    <div class=\"rendered-form\">\n                        <div class=\"erf-header erf-element-width-12\"><h1  data-non-input='1' data-ref-label='Top_Header' data-ref-id='header-1elzbed6' class='' >Solomon Integrated School Ed Iloilo Registration Form<\/h1><\/div><div class=\"erf-text form-group field-text-309648515926 erf-element-width-12\"><label for=\"text-309648515926\" class=\"erf-text-label\">First Name<span class=\"erf-required\">*<\/span><\/label><input type='text' maxlength='50' required='required' class='form-control' name='text-309648515926' data-ref-label='First_Name' id='text-309648515926'  \/><\/div><div class=\"erf-text form-group field-field-SNDlys2Voo92n02 erf-element-width-12\"><label for=\"field-SNDlys2Voo92n02\" class=\"erf-text-label\">Middle Name<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Middle_Name' class='form-control' name='field-SNDlys2Voo92n02' required='required' id='field-SNDlys2Voo92n02'  \/><\/div><div class=\"erf-text form-group field-text-240894882818 erf-element-width-12\"><label for=\"text-240894882818\" class=\"erf-text-label\">Last Name<span class=\"erf-required\">*<\/span><\/label><input type='text' required='required' maxlength='50' class='form-control' name='text-240894882818' data-ref-label='Last_Name' id='text-240894882818'  \/><\/div><div class=\"erf-splitter erf-element-width-12\"><div data-non-input='1' custom-type='page-break' data-ref-label='Splitter1' class='' data-ref-id='splitter-tbz2wm5q' >Splitter1<\/div><\/div><div class=\"erf-header erf-element-width-12\"><h1  data-non-input='1' data-ref-label='Heading3' data-ref-id='header-lsibu6da' class='' >Complete Address<\/h1><\/div><div class=\"erf-text form-group field-field-3JS4z7nIhVbPSSH erf-element-width-12\"><label for=\"field-3JS4z7nIhVbPSSH\" class=\"erf-text-label\">Permanent Address<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Permanent_Address' class='form-control' name='field-3JS4z7nIhVbPSSH' required='required' id='field-3JS4z7nIhVbPSSH'  \/><\/div><div class=\"erf-text form-group field-field-yPDUONkjFcKM6fK erf-element-width-12\"><label for=\"field-yPDUONkjFcKM6fK\" class=\"erf-text-label\">Second Address<\/label><input type='text' data-ref-label='Second_Address' class='form-control' name='field-yPDUONkjFcKM6fK' id='field-yPDUONkjFcKM6fK'  \/><\/div><div class=\"erf-city form-group field-field-TNIH4uV5WXW5PUe erf-element-width-12\"><label for=\"field-TNIH4uV5WXW5PUe\" class=\"erf-city-label\">City<span class=\"erf-required\">*<\/span><\/label><input type='city' data-ref-label='City' class='form-control' name='field-TNIH4uV5WXW5PUe' required='required' id='field-TNIH4uV5WXW5PUe'  \/><\/div><div class=\"erf-text form-group field-field-xcJN0XBdurGoEXk erf-element-width-12\"><label for=\"field-xcJN0XBdurGoEXk\" class=\"erf-text-label\">State\/Province<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='State_Province' class='form-control' name='field-xcJN0XBdurGoEXk' required='required' id='field-xcJN0XBdurGoEXk'  \/><\/div><div class=\"erf-text form-group field-field-d37f9TCQQpq9oDf erf-element-width-12\"><label for=\"field-d37f9TCQQpq9oDf\" class=\"erf-text-label\">ZIP CODE<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='ZIP_CODE' class='form-control' name='field-d37f9TCQQpq9oDf' required='required' id='field-d37f9TCQQpq9oDf'  \/><\/div><div class=\"erf-splitter erf-element-width-12\"><div data-non-input='1' custom-type='page-break' data-ref-label='Splitter2' class='' data-ref-id='splitter-dlkistcn' >Splitter2<\/div><\/div><div class=\"erf-header erf-element-width-12\"><h1  data-non-input='1' data-ref-label='Heading4' data-ref-id='header-nxcjsfm4' class='' >Contact Details<\/h1><\/div><div class=\"erf-number form-group field-field-KC1hwkdB1NTCdEV erf-element-width-12\"><label for=\"field-KC1hwkdB1NTCdEV\" class=\"erf-number-label\">Landline No.<\/label><input type='number' data-ref-label='Land_Line' class='form-control' name='field-KC1hwkdB1NTCdEV' id='field-KC1hwkdB1NTCdEV'  \/><\/div><div class=\"erf-number form-group field-field-r65DHhWkkHPgL79 erf-element-width-12\"><label for=\"field-r65DHhWkkHPgL79\" class=\"erf-number-label\">Phone No.<span class=\"erf-required\">*<\/span><\/label><input type='number' data-ref-label='Phone No.' class='form-control' name='field-r65DHhWkkHPgL79' required='required' id='field-r65DHhWkkHPgL79'  \/><\/div><div class=\"erf-text form-group field-field-Ss18GLjSxpoc1nb erf-element-width-12\"><label for=\"field-Ss18GLjSxpoc1nb\" class=\"erf-text-label\">Citizenship<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Citizen_Ship' class='form-control' name='field-Ss18GLjSxpoc1nb' required='required' id='field-Ss18GLjSxpoc1nb'  \/><\/div><div class=\"erf-text form-group field-field-Do46BXRojg8E72H erf-element-width-12\"><label for=\"field-Do46BXRojg8E72H\" class=\"erf-text-label\">Date of Birth<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Birthday' data-date-format='mm\/dd\/yy' class='form-control erf-date-field' name='field-Do46BXRojg8E72H' required='required' id='field-Do46BXRojg8E72H'  \/><\/div><div class=\"erf-number form-group field-field-Qbu4JQGcUQltmUD erf-element-width-12\"><label for=\"field-Qbu4JQGcUQltmUD\" class=\"erf-number-label\">Age<span class=\"erf-required\">*<\/span><\/label><input type='number' data-ref-label='age' class='form-control' name='field-Qbu4JQGcUQltmUD' required='required' id='field-Qbu4JQGcUQltmUD'  \/><\/div><div class=\"erf-select form-group field-field-MxBA7cioP1o4rd5 erf-element-width-12\"><label for=\"field-MxBA7cioP1o4rd5\" class=\"erf-select-label\">Grade Level<span class=\"erf-required\">*<\/span><\/label><select data-ref-label='grade_level' class='form-control' name='field-MxBA7cioP1o4rd5' required='required' id='field-MxBA7cioP1o4rd5'  ><option value=\"Nursery \/ Kinder 1\">Nursery \/ Kinder 1<\/option><option value=\"Kinder 2\">Kinder 2<\/option><option value=\"Grade 1\">Grade 1<\/option><option value=\"Grade 2\">Grade 2<\/option><option value=\"Grade 3\">Grade 3<\/option><option value=\"Grade 4\">Grade 4<\/option><option value=\"Grade 5\">Grade 5<\/option><option value=\"Grade 6\">Grade 6<\/option><\/select><\/div><div class=\"erf-radio-group form-group field-field-zCOwCKOlmyQi1xc erf-element-width-12\"><label for=\"field-zCOwCKOlmyQi1xc\" class=\"erf-radio-group-label\">Gender<span class=\"erf-required\">*<\/span><\/label><div class=\"radio-group\"><div class=\"radio\"><input id=\"field-zCOwCKOlmyQi1xc-0\" name='field-zCOwCKOlmyQi1xc' data-ref-label='Gender' required='required' class='form-control'  type=\"radio\" value=\"Male\" \/><label for=\"field-zCOwCKOlmyQi1xc-0\">Male<\/label><\/div><div class=\"radio\"><input id=\"field-zCOwCKOlmyQi1xc-1\" name='field-zCOwCKOlmyQi1xc' data-ref-label='Gender' required='required' class='form-control'  type=\"radio\" value=\"Female\" \/><label for=\"field-zCOwCKOlmyQi1xc-1\">Female<\/label><\/div><\/div><\/div><div class=\"erf-text form-group field-field-JFk7KIY289nD6px erf-element-width-12\"><label for=\"field-JFk7KIY289nD6px\" class=\"erf-text-label\">Mother's Maiden Name<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='mother' class='form-control' name='field-JFk7KIY289nD6px' required='required' id='field-JFk7KIY289nD6px'  \/><\/div><div class=\"erf-text form-group field-field-pmXlAc1YTH8ZCXr erf-element-width-12\"><label for=\"field-pmXlAc1YTH8ZCXr\" class=\"erf-text-label\">Occupation<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='m_occupation' class='form-control' name='field-pmXlAc1YTH8ZCXr' required='required' id='field-pmXlAc1YTH8ZCXr'  \/><\/div><div class=\"erf-text form-group field-field-sdyZSb4DWaqC7J5 erf-element-width-12\"><label for=\"field-sdyZSb4DWaqC7J5\" class=\"erf-text-label\">Company Name<\/label><input type='text' data-ref-label='M_Company' class='form-control' name='field-sdyZSb4DWaqC7J5' id='field-sdyZSb4DWaqC7J5'  \/><\/div><div class=\"erf-text form-group field-field-s5EcXsC8KfIrtcX erf-element-width-12\"><label for=\"field-s5EcXsC8KfIrtcX\" class=\"erf-text-label\">Company Address<\/label><input type='text' data-ref-label='Comp_address' class='form-control' name='field-s5EcXsC8KfIrtcX' id='field-s5EcXsC8KfIrtcX'  \/><\/div><div class=\"erf-text form-group field-field-boUq8nyODojfCzT erf-element-width-12\"><label for=\"field-boUq8nyODojfCzT\" class=\"erf-text-label\">Father's Maiden Name<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='F_Maiden' class='form-control' name='field-boUq8nyODojfCzT' required='required' id='field-boUq8nyODojfCzT'  \/><\/div><div class=\"erf-text form-group field-field-pu5tTZFeNpxVWqd erf-element-width-12\"><label for=\"field-pu5tTZFeNpxVWqd\" class=\"erf-text-label\">Occupation<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='F_Occupation' class='form-control' name='field-pu5tTZFeNpxVWqd' required='required' id='field-pu5tTZFeNpxVWqd'  \/><\/div><div class=\"erf-text form-group field-field-OkH1BvtubnoNmST erf-element-width-12\"><label for=\"field-OkH1BvtubnoNmST\" class=\"erf-text-label\">Company Name<\/label><input type='text' data-ref-label='F_Company' class='form-control' name='field-OkH1BvtubnoNmST' id='field-OkH1BvtubnoNmST'  \/><\/div><div class=\"erf-text form-group field-field-VEp6NolmGXj4jaq erf-element-width-12\"><label for=\"field-VEp6NolmGXj4jaq\" class=\"erf-text-label\">Company Address<\/label><input type='text' data-ref-label='F_Comp_address' class='form-control' name='field-VEp6NolmGXj4jaq' id='field-VEp6NolmGXj4jaq'  \/><\/div><div class=\"erf-number form-group field-field-kJdvosyjWoEna1U erf-element-width-12\"><label for=\"field-kJdvosyjWoEna1U\" class=\"erf-number-label\">Number of Siblings<\/label><input type='number' data-ref-label='Number_Siblings' class='form-control' name='field-kJdvosyjWoEna1U' id='field-kJdvosyjWoEna1U'  \/><\/div><div class=\"erf-text form-group field-field-KhWkjaNfFy0zzJW erf-element-width-12\"><label for=\"field-KhWkjaNfFy0zzJW\" class=\"erf-text-label\">Last School Attended<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Last_School' class='form-control' name='field-KhWkjaNfFy0zzJW' required='required' id='field-KhWkjaNfFy0zzJW'  \/><\/div><div class=\"erf-text form-group field-field-XLliCl73Y7PfI8V erf-element-width-12\"><label for=\"field-XLliCl73Y7PfI8V\" class=\"erf-text-label\">Address<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Last_Address' class='form-control' name='field-XLliCl73Y7PfI8V' required='required' id='field-XLliCl73Y7PfI8V'  \/><\/div><div class=\"erf-header erf-element-width-12\"><h1  data-non-input='1' data-ref-label='Heading1' data-ref-id='header-wzkiyrgs' class='' >Medical Information<\/h1><\/div><div class=\"erf-text form-group field-field-RWQ5AStdO71rGxJ erf-element-width-12\"><label for=\"field-RWQ5AStdO71rGxJ\" class=\"erf-text-label\">Doctor Name<\/label><input type='text' data-ref-label='Doc_Name' class='form-control' name='field-RWQ5AStdO71rGxJ' id='field-RWQ5AStdO71rGxJ'  \/><\/div><div class=\"erf-text form-group field-field-wY6CLMGP6rf4S9T erf-element-width-12\"><label for=\"field-wY6CLMGP6rf4S9T\" class=\"erf-text-label\">Contact No.<\/label><input type='text' data-ref-label='Doc_Num' class='form-control' name='field-wY6CLMGP6rf4S9T' id='field-wY6CLMGP6rf4S9T'  \/><\/div><div class=\"erf-text form-group field-field-EKGEx1Ybat6Xmou erf-element-width-12\"><label for=\"field-EKGEx1Ybat6Xmou\" class=\"erf-text-label\">Insurance Company<\/label><input type='text' data-ref-label='Insurance_Company' class='form-control' name='field-EKGEx1Ybat6Xmou' id='field-EKGEx1Ybat6Xmou'  \/><\/div><div class=\"erf-textarea form-group field-field-suGlfUMBs5N4SVC erf-element-width-12\"><label for=\"field-suGlfUMBs5N4SVC\" class=\"erf-textarea-label\">List of allergies, prescription medicines, or health Issues that we should be aware of.<\/label><textarea data-ref-label='Lists' class='form-control' name='field-suGlfUMBs5N4SVC' id='field-suGlfUMBs5N4SVC' ><\/textarea><\/div><div class=\"erf-text form-group field-field-JaPj6nFdAoMWIo4 erf-element-width-12\"><label for=\"field-JaPj6nFdAoMWIo4\" class=\"erf-text-label\">Person to Notify<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='person_to_notify' class='form-control' name='field-JaPj6nFdAoMWIo4' required='required' id='field-JaPj6nFdAoMWIo4'  \/><\/div><div class=\"erf-text form-group field-field-yhrLAQtxDgJ8MeO erf-element-width-12\"><label for=\"field-yhrLAQtxDgJ8MeO\" class=\"erf-text-label\">Relation<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='relation' class='form-control' name='field-yhrLAQtxDgJ8MeO' required='required' id='field-yhrLAQtxDgJ8MeO'  \/><\/div><div class=\"erf-text form-group field-field-8SXpYe7yWQNcVeX erf-element-width-12\"><label for=\"field-8SXpYe7yWQNcVeX\" class=\"erf-text-label\">Contact No.<span class=\"erf-required\">*<\/span><\/label><input type='text' data-ref-label='Contact_No' class='form-control' name='field-8SXpYe7yWQNcVeX' required='required' id='field-8SXpYe7yWQNcVeX'  \/><\/div><div class=\"erf-header erf-element-width-12\"><h1  data-non-input='1' data-ref-label='Heading5' data-ref-id='header-m5rnv8e8' class='' >Receipt <\/h1><\/div><div class=\"erf-file form-group field-field-kk626UxF1DigiZs erf-element-width-12\"><label for=\"field-kk626UxF1DigiZs\" class=\"erf-file-label\">Photo of Receipt<span class=\"erf-required\">*<\/span><\/label><input type='file' data-ref-label='File_Upload1' class='form-control' name='field-kk626UxF1DigiZs' required='required' id='field-kk626UxF1DigiZs'  \/><\/div><div class=\"erf-button form-group field-button-13507654867 erf-element-width-12\"><button type='submit'class='btn btn-default'name='button-13507654867'data-ref-label='Send'id='button-13507654867'>Send<\/button><\/div>                    <\/div> \n                <\/div>    \n\n                <div class=\"erf-external-form-elements\">\n                    \n                    \n                    \n\n                    \n                                        <div class=\"erf-errors\" style=\"display:none\">\n                        <span class=\"erf-errors-head erf-error-row\">Error occured. Please confirm your data and submit again:<\/span>\n                        <div class=\"erf-errors-body\">\n                                                    <\/div> \n                    <\/div>\n\n                <\/div>\n                <!-- Contains multipage Next,Previous buttons -->\n                <div class=\"erf-form-nav clearfix\"><\/div> \n\n                <!-- Single page form button -->\n                <div class=\"erf-submit-button clearfix\"><\/div>\n\n\n                <input type=\"hidden\" name=\"erform_id\" value=\"128\" \/>\n                <input type=\"hidden\" id=\"erform_submission_nonce\" name=\"erform_submission_nonce\" value=\"6b895a856e\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F11\" \/>                <input type=\"hidden\" name=\"action\" value=\"erf_submit_form\" \/>\n\n            <\/form>\n            \n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":43,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-11","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"http:\/\/solomonintegratedschool.com\/index.php?rest_route=\/wp\/v2\/pages\/11","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/solomonintegratedschool.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/solomonintegratedschool.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/solomonintegratedschool.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/solomonintegratedschool.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=11"}],"version-history":[{"count":7,"href":"http:\/\/solomonintegratedschool.com\/index.php?rest_route=\/wp\/v2\/pages\/11\/revisions"}],"predecessor-version":[{"id":132,"href":"http:\/\/solomonintegratedschool.com\/index.php?rest_route=\/wp\/v2\/pages\/11\/revisions\/132"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/solomonintegratedschool.com\/index.php?rest_route=\/wp\/v2\/media\/43"}],"wp:attachment":[{"href":"http:\/\/solomonintegratedschool.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=11"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}