{"id":9851,"date":"2026-01-28T12:54:26","date_gmt":"2026-01-28T10:54:26","guid":{"rendered":"https:\/\/www.huishorison.org.za\/?page_id=9851"},"modified":"2026-01-28T12:56:14","modified_gmt":"2026-01-28T10:56:14","slug":"registration-form-cpd-professional-training","status":"publish","type":"page","link":"https:\/\/www.huishorison.org.za\/en\/registration-form-cpd-professional-training\/","title":{"rendered":"Registration Form &#8211; CPD Professional Training"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-9847\"><form id=\"wpforms-form-9847\" class=\"wpforms-validate wpforms-form\" data-formid=\"9847\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/en\/wp-json\/wp\/v2\/pages\/9851\" data-token=\"b6630ffc5e6f9e57e7b2f6ff10b5aac0\"><div class=\"wpforms-head-container\"><div class=\"wpforms-description\">Huis Horison CPD Accredited Training<\/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-9847-field_1-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_1\">Name and Surname <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-9847-field_1\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][1][first]\" required><label for=\"wpforms-9847-field_1\" class=\"wpforms-field-sublabel after \">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-9847-field_1-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][1][last]\" required><label for=\"wpforms-9847-field_1-last\" class=\"wpforms-field-sublabel after \">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-9847-field_4-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_4\">Your title <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-9847-field_4\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][4]\" required><\/div><div id=\"wpforms-9847-field_3-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_3\">Email address <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-9847-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" required><\/div><div id=\"wpforms-9847-field_2-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_2\">ID \/ Passport number <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-9847-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" required><\/div><div id=\"wpforms-9847-field_6-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_6\">Mobile number <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-9847-field_6\" class=\"wpforms-field-medium wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][6]\" required><\/div><div id=\"wpforms-9847-field_5-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_5\">Contact number (Home) <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-9847-field_5\" class=\"wpforms-field-medium wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][5]\" required><\/div><div id=\"wpforms-9847-field_7-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_7\">SACSSP #<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-9847-field_7\" class=\"wpforms-field-medium\" name=\"wpforms[fields][7]\" ><\/div><div id=\"wpforms-9847-field_8-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_8\">HPCSA #<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-9847-field_8\" class=\"wpforms-field-medium\" name=\"wpforms[fields][8]\" ><\/div><div id=\"wpforms-9847-field_9-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_9\">SANC #<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-9847-field_9\" class=\"wpforms-field-medium\" name=\"wpforms[fields][9]\" ><\/div><div id=\"wpforms-9847-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_11\">Organisation name <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-9847-field_11\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][11]\" required><\/div><div id=\"wpforms-9847-field_12-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_12\">Contact person<\/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-9847-field_12\" class=\"wpforms-field-name-first\" name=\"wpforms[fields][12][first]\" ><label for=\"wpforms-9847-field_12\" class=\"wpforms-field-sublabel after \">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-9847-field_12-last\" class=\"wpforms-field-name-last\" name=\"wpforms[fields][12][last]\" ><label for=\"wpforms-9847-field_12-last\" class=\"wpforms-field-sublabel after \">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-9847-field_14-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_14\">Contact number (Work)<\/label><input type=\"tel\" id=\"wpforms-9847-field_14\" class=\"wpforms-field-medium wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][14]\" ><\/div><div id=\"wpforms-9847-field_15-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_15\">Address <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-9847-field_15\" class=\"wpforms-field-address-address1 wpforms-field-required\" name=\"wpforms[fields][15][address1]\" required><label for=\"wpforms-9847-field_15\" 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-9847-field_15-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][15][address2]\" ><label for=\"wpforms-9847-field_15-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-9847-field_15-city\" class=\"wpforms-field-address-city wpforms-field-required\" name=\"wpforms[fields][15][city]\" required><label for=\"wpforms-9847-field_15-city\" class=\"wpforms-field-sublabel after \">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-9847-field_15-state\" class=\"wpforms-field-address-state wpforms-field-required\" name=\"wpforms[fields][15][state]\" required><label for=\"wpforms-9847-field_15-state\" class=\"wpforms-field-sublabel after \">State \/ Province \/ Region<\/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-9847-field_15-postal\" class=\"wpforms-field-address-postal wpforms-field-required\" name=\"wpforms[fields][15][postal]\" required><label for=\"wpforms-9847-field_15-postal\" class=\"wpforms-field-sublabel after \">Postal Code<\/label><\/div><\/div><\/div><div id=\"wpforms-9847-field_17-container\" class=\"wpforms-field wpforms-field-select wpforms-conditional-trigger wpforms-field-select-style-classic\" data-field-id=\"17\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_17\">Select course <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-9847-field_17\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][17]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>Select Course<\/option><option value=\"Fundamentals of Intellectual Disability &amp; Dementia\" >Fundamentals of Intellectual Disability &amp; Dementia<\/option><\/select><\/div><div id=\"wpforms-9847-field_16-container\" class=\"wpforms-field wpforms-field-select wpforms-conditional-field wpforms-conditional-show wpforms-field-select-style-classic\" data-field-id=\"16\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_16\">Select Course Date <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-9847-field_16\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][16]\" required=\"required\"><option value=\"6 February 2026\" >6 February 2026<\/option><option value=\"8 May 2026\" >8 May 2026<\/option><\/select><\/div><div id=\"wpforms-9847-field_18-container\" class=\"wpforms-field wpforms-field-payment-select wpforms-field-select-style-classic\" data-field-id=\"18\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_18\">Workbook language<\/label><select id=\"wpforms-9847-field_18\" class=\"wpforms-payment-price wpforms-field-medium\" name=\"wpforms[fields][18]\"><option value=\"1\" data-amount=\"10.00\" >English<\/option><option value=\"4\" data-amount=\"0.00\" >Afrikaans<\/option><\/select><\/div><div id=\"wpforms-9847-field_19-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"19\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_19\">Wheelchair access required?<\/label><select id=\"wpforms-9847-field_19\" class=\"wpforms-field-medium\" name=\"wpforms[fields][19]\"><option value=\"Yes\" >Yes<\/option><option value=\"No\" >No<\/option><\/select><\/div><div id=\"wpforms-9847-field_20-container\" class=\"wpforms-field wpforms-field-radio\" data-field-id=\"20\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_20\">Invoice Details<\/label><ul id=\"wpforms-9847-field_20\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-9847-field_20_1\" name=\"wpforms[fields][20]\" value=\"Same as organisation address\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-9847-field_20_1\">Same as organisation address<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-9847-field_20_2\" name=\"wpforms[fields][20]\" value=\"Different address\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-9847-field_20_2\">Different address<\/label><\/li><\/ul><\/div><div id=\"wpforms-9847-field_21-container\" class=\"wpforms-field wpforms-field-number\" data-field-id=\"21\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_21\">VAT Number<\/label><input type=\"number\" pattern=\"\\d*\" id=\"wpforms-9847-field_21\" class=\"wpforms-field-medium\" name=\"wpforms[fields][21]\" ><\/div><div id=\"wpforms-9847-field_22-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"22\"><div id=\"wpforms-9847-field_22\"><h2>Terms and Conditions<\/h2>\r\n<br>\r\n<p> Delegates who are unable to attend the course after registering, may nominate a substitute. <br> Organisers <b>must be informed in writing <\/b> no later than 4 days prior to the start of the course.<br> \r\n<b> No refunds <\/b> shall be given for no shows. <\/p>\r\n<\/div><\/div><div id=\"wpforms-9847-field_23-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"23\"><label class=\"wpforms-field-label\" for=\"wpforms-9847-field_23\">Confirmation <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-9847-field_23\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-9847-field_23_1\" name=\"wpforms[fields][23][]\" value=\"I confirm that the details submitted are correct and that I understand and accept the terms and conditions\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-9847-field_23_1\">I confirm that the details submitted are correct and that I understand and accept the terms and conditions<\/label><\/li><\/ul><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"9847\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"2\"><button type=\"submit\" name=\"wpforms[submit]\" class=\"wpforms-submit \" id=\"wpforms-submit-9847\" value=\"wpforms-submit\" aria-live=\"assertive\" data-alt-text=\"Sending\u2026\" data-submit-text=\"Submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; &nbsp; &nbsp;<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-9851","page","type-page","status-publish"],"_links":{"self":[{"href":"https:\/\/www.huishorison.org.za\/en\/wp-json\/wp\/v2\/pages\/9851","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.huishorison.org.za\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.huishorison.org.za\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.huishorison.org.za\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.huishorison.org.za\/en\/wp-json\/wp\/v2\/comments?post=9851"}],"version-history":[{"count":3,"href":"https:\/\/www.huishorison.org.za\/en\/wp-json\/wp\/v2\/pages\/9851\/revisions"}],"predecessor-version":[{"id":9854,"href":"https:\/\/www.huishorison.org.za\/en\/wp-json\/wp\/v2\/pages\/9851\/revisions\/9854"}],"wp:attachment":[{"href":"https:\/\/www.huishorison.org.za\/en\/wp-json\/wp\/v2\/media?parent=9851"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}