{"id":771,"date":"2020-04-25T13:09:04","date_gmt":"2020-04-25T13:09:04","guid":{"rendered":"http:\/\/www.societatoscoumbrachirurgia.org\/?page_id=771"},"modified":"2020-04-25T13:09:04","modified_gmt":"2020-04-25T13:09:04","slug":"richiesta-registrazione","status":"publish","type":"page","link":"https:\/\/societatoscoumbrachirurgia.org\/index.php\/richiesta-registrazione\/","title":{"rendered":"Richiesta registrazione"},"content":{"rendered":"\n<div class=\"um um-register um-769\">\n\t<div class=\"um-form\" data-mode=\"register\">\n\t\t<form method=\"post\" action=\"\">\n\t\t\t<div class=\"um-row _um_row_1 \" style=\"padding: 0px 0px 0px 0px;margin: 30px 0px 50px 0px;border-width: 0px 0px 0px 0px;border-style: solid;border-radius: 0px;\"><div class=\"um-col-1\"><div  id=\"um_field_769_first_name\" class=\"um-field um-field-text  um-field-first_name um-field-text um-field-type_text\" data-key=\"first_name\"><div class=\"um-field-label\"><label for=\"first_name-769\">Nome<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"first_name-769\" id=\"first_name-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"first_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_last_name\" class=\"um-field um-field-text  um-field-last_name um-field-text um-field-type_text\" data-key=\"last_name\"><div class=\"um-field-label\"><label for=\"last_name-769\">Cognome<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"last_name-769\" id=\"last_name-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"last_name\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_codice_fiscale\" class=\"um-field um-field-text  um-field-codice_fiscale um-field-text um-field-type_text\" data-key=\"codice_fiscale\"><div class=\"um-field-label\"><label for=\"codice_fiscale-769\">Codice Fiscale<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"codice_fiscale-769\" id=\"codice_fiscale-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"codice_fiscale\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_user_email\" class=\"um-field um-field-text  um-field-user_email um-field-text um-field-type_text\" data-key=\"user_email\"><div class=\"um-field-label\"><label for=\"user_email-769\">Indirizzo email<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"user_email-769\" id=\"user_email-769\" value=\"\" placeholder=\"\" data-validate=\"unique_email\" data-key=\"user_email\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_phone_number\" class=\"um-field um-field-tel  um-field-phone_number um-field-tel um-field-type_tel\" data-key=\"phone_number\"><div class=\"um-field-label\"><div class=\"um-field-label-icon\"><i class=\"um-faicon-phone\" aria-label=\"Numero di Telefono\"><\/i><\/div><label for=\"phone_number-769\">Numero di Telefono<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"tel\" name=\"phone_number-769\" id=\"phone_number-769\" value=\"\" placeholder=\"\" data-validate=\"phone_number\" data-key=\"phone_number\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_birth_date\" class=\"um-field um-field-date  um-field-birth_date um-field-date um-field-type_date\" data-key=\"birth_date\"><div class=\"um-field-label\"><div class=\"um-field-label-icon\"><i class=\"um-faicon-calendar\" aria-label=\"Data di Nascita\"><\/i><\/div><label for=\"birth_date-769\">Data di Nascita<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input   class=\"um-form-field valid um-datepicker \" type=\"text\" name=\"birth_date-769\" id=\"birth_date-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"birth_date\" data-range=\"years\" data-years=\"115\" data-years_x=\"past\" data-disabled_weekdays=\"\" data-date_min=\"1911,5,02\" data-date_max=\"2026,5,02\" data-format=\"d mmm yyyy\" data-value=\"\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_city_of_birth\" class=\"um-field um-field-text  um-field-city_of_birth um-field-text um-field-type_text\" data-key=\"city_of_birth\"><div class=\"um-field-label\"><label for=\"city_of_birth-769\">Citt\u00e0 di nascita<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"city_of_birth-769\" id=\"city_of_birth-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"city_of_birth\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_gender\" class=\"um-field um-field-radio  um-field-gender um-field-radio um-field-type_radio\" data-key=\"gender\"  aria-invalid=\"false\" ><div class=\"um-field-label\"><label for=\"gender-769\">Sesso<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><label class=\"um-field-radio  um-field-half \"><input  type=\"radio\" name=\"gender[]\" value=\"Maschio\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Maschio<\/span><\/label><label class=\"um-field-radio  um-field-half  right \"><input  type=\"radio\" name=\"gender[]\" value=\"Femmina\"  \/><span class=\"um-field-radio-state\"><i class=\"um-icon-android-radio-button-off\"><\/i><\/span><span class=\"um-field-radio-option\">Femmina<\/span><\/label><div class=\"um-clear\"><\/div><div class=\"um-clear\"><\/div><\/div><\/div><div  id=\"um_field_769_residential_address\" class=\"um-field um-field-text  um-field-residential_address um-field-text um-field-type_text\" data-key=\"residential_address\"><div class=\"um-field-label\"><label for=\"residential_address-769\">Indirizzo di residenza<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"residential_address-769\" id=\"residential_address-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"residential_address\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_residential_city\" class=\"um-field um-field-text  um-field-residential_city um-field-text um-field-type_text\" data-key=\"residential_city\"><div class=\"um-field-label\"><label for=\"residential_city-769\">Citt\u00e0 di residenza<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"residential_city-769\" id=\"residential_city-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"residential_city\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_cap\" class=\"um-field um-field-text  um-field-cap um-field-text um-field-type_text\" data-key=\"cap\"><div class=\"um-field-label\"><label for=\"cap-769\">Cap<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"cap-769\" id=\"cap-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"cap\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_region\" class=\"um-field um-field-text  um-field-region um-field-text um-field-type_text\" data-key=\"region\"><div class=\"um-field-label\"><label for=\"region-769\">Regione<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"region-769\" id=\"region-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"region\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_occupation\" class=\"um-field um-field-text  um-field-occupation um-field-text um-field-type_text\" data-key=\"occupation\"><div class=\"um-field-label\"><label for=\"occupation-769\">Professione<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"occupation-769\" id=\"occupation-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"occupation\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_discipline\" class=\"um-field um-field-text  um-field-discipline um-field-text um-field-type_text\" data-key=\"discipline\"><div class=\"um-field-label\"><label for=\"discipline-769\">Disciplina<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"discipline-769\" id=\"discipline-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"discipline\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_hospital\" class=\"um-field um-field-text  um-field-hospital um-field-text um-field-type_text\" data-key=\"hospital\"><div class=\"um-field-label\"><label for=\"hospital-769\">Ospedale<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"hospital-769\" id=\"hospital-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"hospital\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_member_active\" class=\"um-field um-field-select  um-field-member_active um-field-select um-field-type_select\" data-key=\"member_active\"><div class=\"um-field-label\"><label for=\"member_active-769\">Socio anno attuale<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area  \"><select data-default=\"\"     name=\"member_active\" id=\"member_active\" data-validate=\"\" data-key=\"member_active\" class=\"um-form-field valid um-s1 \" style=\"width: 100%\" data-placeholder=\"\"   aria-invalid=\"false\" ><option value=\"\"><\/option><option value=\"Si\" >Si<\/option><option value=\"No\" >No<\/option><\/select><\/div><\/div><div  class=\"um-field um-field-spacing  um-field-spacing um-field-type_spacing\" data-key=\"um_spacing_769_19\" style=\"height:20px;\"><\/div><\/div><div class=\"um-col-1\"><div  class=\"um-field um-field-block  um-field-block um-field-type_block\" data-key=\"um_block_769_21\"><strong>Credenaziali per l'accesso<\/strong><\/div><div  id=\"um_field_769_user_login\" class=\"um-field um-field-text  um-field-user_login um-field-text um-field-type_text\" data-key=\"user_login\"><div class=\"um-field-label\"><label for=\"user_login-769\">Username<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input  autocomplete=\"off\" class=\"um-form-field valid \" type=\"text\" name=\"user_login-769\" id=\"user_login-769\" value=\"\" placeholder=\"\" data-validate=\"unique_username\" data-key=\"user_login\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_user_password\" class=\"um-field um-field-password  um-field-user_password um-field-password um-field-type_password\" data-key=\"user_password\"><div class=\"um-field-label\"><label for=\"user_password-769\">Password<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input class=\"um-form-field valid \" type=\"password\" name=\"user_password-769\" id=\"user_password-769\" value=\"\" placeholder=\"\" data-validate=\"\" data-key=\"user_password\"  aria-invalid=\"false\" \/>\n\n\t\t\t\t\t\t\t<\/div><\/div><div  id=\"um_field_769_confirm_user_password\" class=\"um-field um-field-password  um-field-user_password um-field-password um-field-type_password\" data-key=\"confirm_user_password\"><div class=\"um-field-label\"><label for=\"confirm_user_password-769\">Confirm Password<span class=\"um-req\" title=\"Required\">*<\/span><\/label><div class=\"um-clear\"><\/div><\/div><div class=\"um-field-area\"><input class=\"um-form-field valid \" type=\"password\" name=\"confirm_user_password-769\" id=\"confirm_user_password-769\" value=\"\" placeholder=\"Confirm Password\" data-validate=\"\" data-key=\"confirm_user_password\"  aria-invalid=\"false\" \/><\/div><\/div><\/div><\/div>\n<!-- This file should primarily consist of HTML with a little bit of PHP. -->\n<div class=\"um-field um-field-type_terms_conditions\" data-key=\"use_terms_conditions_agreement\" style=\"display:block;padding:0;\">\n\t<div class=\"um-field-area\">\n\t\t<div class=\"um-gdpr-content\" style=\"display:none;\">\n\t\t\t<pre><span style=\"font-size: 8.0pt;\">Ai sensi dell'articolo 13 del D.lgs. 30.06.2003 N.196, Le forniamo le seguenti informazioni:\n1. I dati da Lei forniti verranno utilizzati dalla Societa\u0300 Tosco Umbra di Chirurgia per l\u2019iscrizione all\u2019associazione\n<\/span><span style=\"font-size: 8.0pt;\">   e per le finalita\u0300 strettamente connesse alle attivita\u0300 di competenza.\n2. Il trattamento sara\u0300 effettuato con le seguenti modalita\u0300: manuale o informatizzato.\n3. I dati obbligatori sono contrassegnati da asterisco; l'eventuale rifiuto a fornire tali dati potrebbe comportare \n   la mancata o parziale esecuzione dell\u2019iscrizione.\n4. I dati potranno essere comunicati o diffusi presso gli organismi centrali e le sedi <\/span>\n\n<span style=\"font-size: 8.0pt;\">Autorizzo il trattamento dei miei dati personali nei termini consentiti dal D.Lgs. n.196\/03 <\/span><\/pre>\n\t\t<\/div>\n\n\t\t\n\t\t<a href=\"javascript:void(0);\" class=\"um-toggle-gdpr\" data-toggle-state=\"hidden\"\n\t\t   data-toggle-show=\"Visualizza informativa sulla privacy\"\n\t\t   data-toggle-hide=\"Nascondi la nostra politica sulla privacy\">\n\t\t\tVisualizza informativa sulla privacy\t\t<\/a>\n\t<\/div>\n\t<div class=\"um-field-area\">\n\n\t\t\n\t\t<label class=\"um-field-checkbox\">\n\t\t\t<input type=\"checkbox\" name=\"use_gdpr_agreement\" value=\"1\">\n\t\t\t<span class=\"um-field-checkbox-state\"><i class=\"um-icon-android-checkbox-outline-blank\"><\/i><\/span>\n\t\t\t<span class=\"um-field-checkbox-option\">Accetta la nostra politica sulla privacy<\/span>\n\t\t<\/label>\n\t\t<div class=\"um-clear\"><\/div>\n\n\t\t\n\t\t<div class=\"um-clear\"><\/div>\n\t<\/div>\n<\/div>\n\t\t<input type=\"hidden\" name=\"form_id\" id=\"form_id_769\" value=\"769\" \/>\n\t\n\t<p class=\"um_request_name\">\n\t\t<label for=\"um_request_769\">Only fill in if you are not human<\/label>\n\t\t<input type=\"hidden\" name=\"um_request\" id=\"um_request_769\" class=\"input\" value=\"\" size=\"25\" autocomplete=\"off\" \/>\n\t<\/p>\n\n\t<input type=\"hidden\" id=\"_wpnonce\" name=\"_wpnonce\" value=\"fa47fd0cc1\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/771\" \/>\n\t<div class=\"um-col-alt\">\n\n\t\t\n\t\t\t<div class=\"um-center\">\n\t\t\t\t<input type=\"submit\" value=\"Invia la richiesta\" class=\"um-button\" id=\"um-submit-btn\" \/>\n\t\t\t<\/div>\n\n\t\t\n\t\t<div class=\"um-clear\"><\/div>\n\n\t<\/div>\n\n\t\t\t<\/form>\n\t<\/div>\n<\/div>\n<style>\n\t\t\t.um-769.um {\n\t\t\tmax-width: 50px;\n\t\t}\n\t\t<\/style>\n\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":{"footnotes":""},"class_list":["post-771","page","type-page","status-publish","hentry","entry"],"_links":{"self":[{"href":"https:\/\/societatoscoumbrachirurgia.org\/index.php\/wp-json\/wp\/v2\/pages\/771"}],"collection":[{"href":"https:\/\/societatoscoumbrachirurgia.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/societatoscoumbrachirurgia.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/societatoscoumbrachirurgia.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/societatoscoumbrachirurgia.org\/index.php\/wp-json\/wp\/v2\/comments?post=771"}],"version-history":[{"count":1,"href":"https:\/\/societatoscoumbrachirurgia.org\/index.php\/wp-json\/wp\/v2\/pages\/771\/revisions"}],"predecessor-version":[{"id":772,"href":"https:\/\/societatoscoumbrachirurgia.org\/index.php\/wp-json\/wp\/v2\/pages\/771\/revisions\/772"}],"wp:attachment":[{"href":"https:\/\/societatoscoumbrachirurgia.org\/index.php\/wp-json\/wp\/v2\/media?parent=771"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}