{"id":2291,"date":"2019-01-28T12:43:18","date_gmt":"2019-01-28T12:43:18","guid":{"rendered":"http:\/\/kca.edu.ph\/?page_id=2291"},"modified":"2022-06-28T09:28:50","modified_gmt":"2022-06-28T09:28:50","slug":"enrollment-form","status":"publish","type":"page","link":"https:\/\/kca.edu.ph\/?page_id=2291","title":{"rendered":"Enrollment Form"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-background-position:left top;--awb-border-sizes-top:0px;--awb-border-sizes-bottom:0px;--awb-border-sizes-left:0px;--awb-border-sizes-right:0px;--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:20px;--awb-padding-bottom:20px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_3_4 3_4 fusion-three-fourth fusion-column-first\" style=\"--awb-bg-size:cover;width:74%; margin-right: 4%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_5_container\" data-token=\"51ef707629d7a674744cbdeebf6af8ff\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_enrollmentform\" data-token=\"51ef707629d7a674744cbdeebf6af8ff\">\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Enrollment Form<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"5\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_5\" id=\"frm_hide_fields_5\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"enrollmentform\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_5\" name=\"frm_submit_entry_5\" value=\"29938bb74e\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F2291\" \/><div id=\"frm_field_28_container\" class=\"frm_form_field  frm_html_container form-field\">\n<h3>Student Details<\/h3>\n<\/div>\n<div id=\"frm_field_12_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_first\">\r\n    <label for=\"field_1q3ur\" id=\"field_1q3ur_label\" class=\"frm_primary_label\">Student's Last Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_1q3ur\" name=\"item_meta[12]\" value=\"\"  data-reqmsg=\"Student&#039;s Last Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_42_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n    <label for=\"field_4jt3e\" id=\"field_4jt3e_label\" class=\"frm_primary_label\">Student's First Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_4jt3e\" name=\"item_meta[42]\" value=\"\"  data-reqmsg=\"Student&#039;s First Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_44_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\r\n    <label for=\"field_qhwl7\" id=\"field_qhwl7_label\" class=\"frm_primary_label\">Student's Middle Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_qhwl7\" name=\"item_meta[44]\" value=\"\"  data-reqmsg=\"Student&#039;s Middle Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_15_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first horizontal_radio\">\r\n    <div  id=\"field_91ayb_label\" class=\"frm_primary_label\">Gender \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_91ayb_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_15-0\">\t\t\t<label  for=\"field_91ayb-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[15]\" id=\"field_91ayb-0\" value=\"Male\"\n\t\t data-reqmsg=\"Gender  cannot be blank.\" data-invmsg=\"Gender  is invalid\"   \/> Male<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_15-1\">\t\t\t<label  for=\"field_91ayb-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[15]\" id=\"field_91ayb-1\" value=\"Female\"\n\t\t data-reqmsg=\"Gender  cannot be blank.\" data-invmsg=\"Gender  is invalid\"   \/> Female<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_45_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_kqlko\" id=\"field_kqlko_label\" class=\"frm_primary_label\">Place of Birth\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_kqlko\" name=\"item_meta[45]\" value=\"\"  data-reqmsg=\"Place of Birth cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_17_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_gojme\" id=\"field_gojme_label\" class=\"frm_primary_label\">Address \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[17]\" id=\"field_gojme\" rows=\"5\"  data-reqmsg=\"Address  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address  is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_19_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_72gm0\" id=\"field_72gm0_label\" class=\"frm_primary_label\">Phone Number \r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_72gm0\" name=\"item_meta[19]\" value=\"\"  data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_13_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_pwu10\" id=\"field_pwu10_label\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_pwu10\" name=\"item_meta[13]\" value=\"\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_10_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_n7jnh\" id=\"field_n7jnh_label\" class=\"frm_primary_label\">Grade Level\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[10]\" id=\"field_n7jnh\"  data-invmsg=\"Grade Level is invalid\" aria-invalid=\"false\"  >\n\t\t<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><option  value=\"Grade 7\">Grade 7<\/option><option  value=\"Grade 8\">Grade 8<\/option><option  value=\"Grade 9\">Grade 9<\/option><option  value=\"Grade 10\">Grade 10<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_14_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_ub1d2\" id=\"field_ub1d2_label\" class=\"frm_primary_label\">Age \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_ub1d2\" name=\"item_meta[14]\" value=\"\"  data-reqmsg=\"Age  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_16_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_x572p\" id=\"field_x572p_label\" class=\"frm_primary_label\">Birthday \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_x572p\" name=\"item_meta[16]\" value=\"\"  maxlength=\"10\" data-reqmsg=\"Birthday  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_46_container\" class=\"frm_form_field  frm_html_container form-field\">\n<h3>EMERGENCY CONTACT PERSONAL DETAILS<\/h3>\n<\/div>\n<div id=\"frm_field_22_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm12 frm_first\">\r\n    <label for=\"field_zzdoe\" id=\"field_zzdoe_label\" class=\"frm_primary_label\">Mother\/Legal Guardian's Full Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_zzdoe\" name=\"item_meta[22]\" value=\"\"  data-reqmsg=\"Mother\/Legal Guardian&#039;s Full Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_21_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label for=\"field_l705y\" id=\"field_l705y_label\" class=\"frm_primary_label\">Mother\/Guardian Occupation \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_l705y\" name=\"item_meta[21]\" value=\"\"  data-reqmsg=\"Mother\/Guardian Occupation  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_47_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_fjpxj\" id=\"field_fjpxj_label\" class=\"frm_primary_label\">Mother\/Guardian Address \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[47]\" id=\"field_fjpxj\" rows=\"5\"  data-reqmsg=\"Mother\/Guardian Address  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Mother\/Guardian Address  is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_48_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_mitam\" id=\"field_mitam_label\" class=\"frm_primary_label\">Mother\/Guardian Phone Number \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_mitam\" name=\"item_meta[48]\" value=\"\"  data-reqmsg=\"Mother\/Guardian Phone Number  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_49_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_42f1y\" id=\"field_42f1y_label\" class=\"frm_primary_label\">Mother\/Guardian Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_42f1y\" name=\"item_meta[49]\" value=\"\"  data-reqmsg=\"Mother\/Guardian Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_20_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm12 frm_first\">\r\n    <label for=\"field_qcj7c\" id=\"field_qcj7c_label\" class=\"frm_primary_label\">Father\/Legal Guardian's Full Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_qcj7c\" name=\"item_meta[20]\" value=\"\"  data-reqmsg=\"Father\/Legal Guardian&#039;s Full Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_50_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_58gov\" id=\"field_58gov_label\" class=\"frm_primary_label\">Father\/Guardian Occupation \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_58gov\" name=\"item_meta[50]\" value=\"\"  data-reqmsg=\"Father\/Guardian Occupation  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_51_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_miupp\" id=\"field_miupp_label\" class=\"frm_primary_label\">Father\/Guardian Address \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[51]\" id=\"field_miupp\" rows=\"5\"  data-reqmsg=\"Father\/Guardian Address  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Father\/Guardian Address  is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_52_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_e7slo\" id=\"field_e7slo_label\" class=\"frm_primary_label\">Father\/Guardian Phone Number \r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_e7slo\" name=\"item_meta[52]\" value=\"\"  data-reqmsg=\"Father\/Guardian Phone Number  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_53_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_61jks\" id=\"field_61jks_label\" class=\"frm_primary_label\">Father\/Guardian Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_61jks\" name=\"item_meta[53]\" value=\"\"  data-reqmsg=\"Father\/Guardian Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_32_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_623b5\" id=\"field_623b5_label\" class=\"frm_primary_label\">Message and Concerns\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[32]\" id=\"field_623b5\" rows=\"5\"  data-invmsg=\"Message and Concerns is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_41_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n\t<label for=\"g-recaptcha-response\" id=\"field_75trv_label\" class=\"frm_primary_label\">Captcha\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<div  id=\"field_75trv\" class=\"g-recaptcha\" data-sitekey=\"6LfJukErAAAAALipe66N_xVpfvLhN097EVvqVXAG\" data-size=\"normal\" data-theme=\"light\"><\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_37_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Submit<\/button>\r\n\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_54_container\">\n\t\t\t<label for=\"field_immje\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_immje\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[54]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"lQWIpOg\/7MtoZEEhqziOiikeK8brGn0R3qgSQ3jrYEcLdBs\/MZq\/iNR9mw1j2OQ1\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n<div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_4 1_4 fusion-one-fourth fusion-column-last\" style=\"--awb-bg-size:cover;width:22%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-1\"><p>Need more information about the enrollment?<\/p>\n<p>Email us at <span style=\"color: #0000ff;\">registrar@kca.edu.ph<\/span> or visit us at<\/p>\n<p>Kerusso Christian Academy,<br \/>\nChurch of God Bldg., Marilag Subdivision, Aguinaldo Highway, Dasmarinas City, Cavite<\/p>\n<\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-2291","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/kca.edu.ph\/index.php?rest_route=\/wp\/v2\/pages\/2291","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kca.edu.ph\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kca.edu.ph\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kca.edu.ph\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kca.edu.ph\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2291"}],"version-history":[{"count":28,"href":"https:\/\/kca.edu.ph\/index.php?rest_route=\/wp\/v2\/pages\/2291\/revisions"}],"predecessor-version":[{"id":4382,"href":"https:\/\/kca.edu.ph\/index.php?rest_route=\/wp\/v2\/pages\/2291\/revisions\/4382"}],"wp:attachment":[{"href":"https:\/\/kca.edu.ph\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2291"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}