{"id":1965,"date":"2025-08-17T11:46:02","date_gmt":"2025-08-17T11:46:02","guid":{"rendered":"https:\/\/doiniktazabazar.com\/?page_id=1965"},"modified":"2025-08-17T11:47:59","modified_gmt":"2025-08-17T11:47:59","slug":"membership-form","status":"publish","type":"page","link":"https:\/\/doiniktazabazar.com\/bn\/membership-form\/","title":{"rendered":"Membership Form"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"1965\" class=\"elementor elementor-1965\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"wd-negative-gap elementor-element elementor-element-d245f21 e-flex e-con-boxed e-con e-parent\" data-id=\"d245f21\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-be94235 wd-cf7 elementor-widget elementor-widget-wd_contact_form_7\" data-id=\"be94235\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"wd_contact_form_7.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1964-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1964\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/bn\/wp-json\/wp\/v2\/pages\/1965#wpcf7-f1964-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/bn\/wp-json\/wp\/v2\/pages\/1965#wpcf7-f1964-o1\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1964\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1964-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p><br \/>\n<label>Full Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"full-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"full-name\" \/><\/span><br \/>\n<\/label>\n<\/p>\n<p><br \/>\n<label>Last Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span><br \/>\n<\/label>\n<\/p>\n<p><br \/>\n<label>Mobile Number *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"mobile\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"01XXXXXXXXX\" value=\"\" type=\"tel\" name=\"mobile\" \/><\/span><br \/>\n<\/label>\n<\/p>\n<p><br \/>\n<label>Email (Optional)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" aria-invalid=\"false\" placeholder=\"example@mail.com\" value=\"\" type=\"email\" name=\"email\" \/><\/span><br \/>\n<\/label>\n<\/p>\n<p><br \/>\n<label>Present Address<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Enter your address\" value=\"\" type=\"text\" name=\"address\" \/><\/span><br \/>\n<\/label>\n<\/p>\n<p><br \/>\n<label>Preferred Delivery Area *<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"delivery-area\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"delivery-area\"><option value=\"Moddho Para\">Moddho Para<\/option><option value=\"Haldar Para\">Haldar Para<\/option><option value=\"Paikpara\">Paikpara<\/option><option value=\"College Para\">College Para<\/option><option value=\"Puniauth\">Puniauth<\/option><option value=\"Others\">Others<\/option><\/select><\/span><br \/>\n<\/label>\n<\/p>\n<p><br \/>\n<strong>Membership Type *<\/strong>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-775\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radio-775\" value=\"Individual\" \/><span class=\"wpcf7-list-item-label\">Individual<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radio-775\" value=\"Family\" \/><span class=\"wpcf7-list-item-label\">Family<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radio-775\" value=\"Institutional\" \/><span class=\"wpcf7-list-item-label\">Institutional<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><br \/>\n<strong>Preferences<\/strong>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"preferences\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"preferences[]\" value=\"Weekly Promotions\" \/><span class=\"wpcf7-list-item-label\">Weekly Promotions<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"preferences[]\" value=\"Festival Discounts\" \/><span class=\"wpcf7-list-item-label\">Festival Discounts<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"preferences[]\" value=\"Delivery Notifications\" \/><span class=\"wpcf7-list-item-label\">Delivery Notifications<\/span><\/span><\/span><\/span>\n<\/p>\n<p><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-77\"><span class=\"wpcf7-form-control wpcf7-acceptance optional\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-77\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">I agree to the Terms & Conditions of Doinik Taza Bazar.<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><br \/>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Become a Member\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"trp-form-language\" value=\"bn\"\/><\/form>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Full Name Last Name Mobile Number * Email (Optional) Present Address Preferred Delivery Area * Moddho ParaHaldar ParaPaikparaCollege ParaPuniauthOthers Membership<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1965","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/doiniktazabazar.com\/bn\/wp-json\/wp\/v2\/pages\/1965","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doiniktazabazar.com\/bn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/doiniktazabazar.com\/bn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/doiniktazabazar.com\/bn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/doiniktazabazar.com\/bn\/wp-json\/wp\/v2\/comments?post=1965"}],"version-history":[{"count":0,"href":"https:\/\/doiniktazabazar.com\/bn\/wp-json\/wp\/v2\/pages\/1965\/revisions"}],"wp:attachment":[{"href":"https:\/\/doiniktazabazar.com\/bn\/wp-json\/wp\/v2\/media?parent=1965"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}