{"id":201699,"date":"2016-05-16T13:48:02","date_gmt":"2016-05-16T18:48:02","guid":{"rendered":"http:\/\/siouxlandweb.com\/ios\/?page_id=201699"},"modified":"2024-03-19T08:17:09","modified_gmt":"2024-03-19T13:17:09","slug":"join-general-membership","status":"publish","type":"page","link":"https:\/\/iowaorthopaedic.org\/join-general-membership\/","title":{"rendered":"Join-General Membership"},"content":{"rendered":"<h1 style=\"text-align: center;\">APPLICATION FOR MEMBERSHIP<\/h1>\n<p>After submitting the form online we will contact you for payment.\u00a0<\/p>\n<div class=\"frm_forms  with_frm_style frm_style_divi\" id=\"frm_form_8_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_frmprocontact2\"  >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_hidden\">General Membership<\/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=\"8\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_8\" id=\"frm_hide_fields_8\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"frmprocontact2\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_8\" name=\"frm_submit_entry_8\" value=\"84f8c69faf\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/201699\" \/><div id=\"frm_field_71_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_wwtp302\" class=\"frm_primary_label\">Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_wwtp302\" name=\"item_meta[71]\" value=\"\"  data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_wwtp302\"\/>\r\n    <div id=\"frm_desc_field_wwtp302\" class=\"frm_description\">First<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_72_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container frm_half\">\r\n    <label for=\"field_oag1ms2\" class=\"frm_primary_label\">Last\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_oag1ms2\" name=\"item_meta[72]\" value=\"\"  data-reqmsg=\"Last cannot be blank.\" aria-required=\"true\" data-invmsg=\"Last is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_oag1ms2\"\/>\r\n    <div id=\"frm_desc_field_oag1ms2\" class=\"frm_description\">Last<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_81_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_67x2t\" class=\"frm_primary_label\">Practice Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_67x2t\" name=\"item_meta[81]\" value=\"\"  data-reqmsg=\"Practice Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Practice Name is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_75_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_full\">\r\n    <label for=\"field_3l3cwp2\" class=\"frm_primary_label\">Practice Address\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_3l3cwp2\" name=\"item_meta[75]\" value=\"\"  data-reqmsg=\"Practice Address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Practice Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_76_container\" class=\"frm_form_field form-field  frm_top_container frm_full\">\r\n    <label for=\"field_puitbx2\" class=\"frm_primary_label\">Practice Address Line 2\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_puitbx2\" name=\"item_meta[76]\" value=\"\"  data-invmsg=\"Practice Address Line 2 is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_77_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first_half\">\r\n    <label for=\"field_w8z3lb2\" class=\"frm_primary_label\">City\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_w8z3lb2\" name=\"item_meta[77]\" value=\"\"  data-reqmsg=\"City cannot be blank.\" aria-required=\"true\" data-invmsg=\"City is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_78_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_fourth\">\r\n    <label for=\"field_9c57wk2\" class=\"frm_primary_label\">State\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[78]\" id=\"field_9c57wk2\"  data-reqmsg=\"State cannot be blank.\" aria-required=\"true\" data-invmsg=\"State is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"AL\">AL<\/option><option  value=\"AK\">AK<\/option><option  value=\"AR\">AR<\/option><option  value=\"AZ\">AZ<\/option><option  value=\"CA\">CA<\/option><option  value=\"CO\">CO<\/option><option  value=\"CT\">CT<\/option><option  value=\"DE\">DE<\/option><option  value=\"DC\">DC<\/option><option  value=\"FL\">FL<\/option><option  value=\"GA\">GA<\/option><option  value=\"HI\">HI<\/option><option  value=\"ID\">ID<\/option><option  value=\"IL\">IL<\/option><option  value=\"IN\">IN<\/option><option  value=\"IA\">IA<\/option><option  value=\"KS\">KS<\/option><option  value=\"KY\">KY<\/option><option  value=\"LA\">LA<\/option><option  value=\"ME\">ME<\/option><option  value=\"MH\">MH<\/option><option  value=\"MD\">MD<\/option><option  value=\"MA\">MA<\/option><option  value=\"MI\">MI<\/option><option  value=\"MN\">MN<\/option><option  value=\"MS\">MS<\/option><option  value=\"MO\">MO<\/option><option  value=\"MT\">MT<\/option><option  value=\"NE\">NE<\/option><option  value=\"NV\">NV<\/option><option  value=\"NH\">NH<\/option><option  value=\"NJ\">NJ<\/option><option  value=\"NM\">NM<\/option><option  value=\"NY\">NY<\/option><option  value=\"NC\">NC<\/option><option  value=\"ND\">ND<\/option><option  value=\"OH\">OH<\/option><option  value=\"OK\">OK<\/option><option  value=\"OR\">OR<\/option><option  value=\"PA\">PA<\/option><option  value=\"RI\">RI<\/option><option  value=\"SC\">SC<\/option><option  value=\"SD\">SD<\/option><option  value=\"TN\">TN<\/option><option  value=\"TX\">TX<\/option><option  value=\"UT\">UT<\/option><option  value=\"VT\">VT<\/option><option  value=\"VA\">VA<\/option><option  value=\"WA\">WA<\/option><option  value=\"WV\">WV<\/option><option  value=\"WI\">WI<\/option><option  value=\"WY\">WY<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_79_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth\">\r\n    <label for=\"field_xk12lc2\" class=\"frm_primary_label\">Postal Code\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xk12lc2\" name=\"item_meta[79]\" value=\"\"  data-invmsg=\"Postal Code is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_82_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_ijbt8\" class=\"frm_primary_label\">Phone Number\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_ijbt8\" name=\"item_meta[82]\" value=\"\"  style=\"width:160px !important\" data-invmsg=\"Phone Number is invalid\" class=\"auto_width\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_83_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_uxbbh\" class=\"frm_primary_label\">Fax Number\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_uxbbh\" name=\"item_meta[83]\" value=\"\"  style=\"width:160px !important\" data-invmsg=\"Fax Number is invalid\" class=\"auto_width\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_73_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_third\">\r\n    <label for=\"field_xnkv8k2\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_xnkv8k2\" name=\"item_meta[73]\" value=\"\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Please enter a valid email address\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_84_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_clha3\" class=\"frm_primary_label\">Home Address\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <fieldset aria-labelledby=\"field_clha3_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tHome Address<\/legend>\n<div class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_84-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_clha3_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tHome Address\t<\/label>\n\t\t<input type=\"text\" id=\"field_clha3_line1\" value=\"\" name=\"item_meta[84][line1]\"  data-invmsg=\"Home Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_84-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_clha3_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tHome Address\t<\/label>\n\t\t<input type=\"text\" id=\"field_clha3_line2\" value=\"\" name=\"item_meta[84][line2]\"  data-invmsg=\"Home Address is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_84-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_clha3_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCity\t<\/label>\n\t\t<input type=\"text\" id=\"field_clha3_city\" value=\"\" name=\"item_meta[84][city]\"  data-invmsg=\"Home Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">City<\/div><\/div>\n<div id=\"frm_field_84-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_clha3_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tState\/Province\t<\/label>\n\t\t\t<select name=\"item_meta[84][state]\" id=\"field_clha3_state\"  data-invmsg=\"Home Address is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\">\n\t\t\t<option value=\"\">\n\t\t\t\t \t\t\t<\/option>\n\t\t\t<option  value=\"Alabama\">Alabama<\/option><option  value=\"Alaska\">Alaska<\/option><option  value=\"Arkansas\">Arkansas<\/option><option  value=\"Arizona\">Arizona<\/option><option  value=\"California\">California<\/option><option  value=\"Colorado\">Colorado<\/option><option  value=\"Connecticut\">Connecticut<\/option><option  value=\"Delaware\">Delaware<\/option><option  value=\"District of Columbia\">District of Columbia<\/option><option  value=\"Florida\">Florida<\/option><option  value=\"Georgia\">Georgia<\/option><option  value=\"Hawaii\">Hawaii<\/option><option  value=\"Idaho\">Idaho<\/option><option  value=\"Illinois\">Illinois<\/option><option  value=\"Indiana\">Indiana<\/option><option  value=\"Iowa\">Iowa<\/option><option  value=\"Kansas\">Kansas<\/option><option  value=\"Kentucky\">Kentucky<\/option><option  value=\"Louisiana\">Louisiana<\/option><option  value=\"Maine\">Maine<\/option><option  value=\"Maryland\">Maryland<\/option><option  value=\"Massachusetts\">Massachusetts<\/option><option  value=\"Michigan\">Michigan<\/option><option  value=\"Minnesota\">Minnesota<\/option><option  value=\"Mississippi\">Mississippi<\/option><option  value=\"Missouri\">Missouri<\/option><option  value=\"Montana\">Montana<\/option><option  value=\"Nebraska\">Nebraska<\/option><option  value=\"Nevada\">Nevada<\/option><option  value=\"New Hampshire\">New Hampshire<\/option><option  value=\"New Jersey\">New Jersey<\/option><option  value=\"New Mexico\">New Mexico<\/option><option  value=\"New York\">New York<\/option><option  value=\"North Carolina\">North Carolina<\/option><option  value=\"North Dakota\">North Dakota<\/option><option  value=\"Ohio\">Ohio<\/option><option  value=\"Oklahoma\">Oklahoma<\/option><option  value=\"Oregon\">Oregon<\/option><option  value=\"Pennsylvania\">Pennsylvania<\/option><option  value=\"Rhode Island\">Rhode Island<\/option><option  value=\"South Carolina\">South Carolina<\/option><option  value=\"South Dakota\">South Dakota<\/option><option  value=\"Tennessee\">Tennessee<\/option><option  value=\"Texas\">Texas<\/option><option  value=\"Utah\">Utah<\/option><option  value=\"Vermont\">Vermont<\/option><option  value=\"Virginia\">Virginia<\/option><option  value=\"Washington\">Washington<\/option><option  value=\"West Virginia\">West Virginia<\/option><option  value=\"Wisconsin\">Wisconsin<\/option><option  value=\"Wyoming\">Wyoming<\/option>\t\t<\/select>\n\t<div class=\"frm_description\">State\/Province<\/div><\/div>\n<div id=\"frm_field_84-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_clha3_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tZip\/Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_clha3_zip\" value=\"\" name=\"item_meta[84][zip]\"  data-invmsg=\"Home Address is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">Zip\/Postal<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_85_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_half\">\r\n    <label for=\"field_te352\" class=\"frm_primary_label\">Home Phone Number\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_te352\" name=\"item_meta[85]\" value=\"\"  style=\"width:160px !important\" data-invmsg=\"Home Phone Number is invalid\" class=\"auto_width\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_86_container\" class=\"frm_form_field form-field  frm_top_container frm_half\">\r\n    <label for=\"field_2lk1a\" class=\"frm_primary_label\">Spouse Name\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_2lk1a\" name=\"item_meta[86]\" value=\"\"  data-invmsg=\"Spouse Name is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_87_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third\">\r\n    <label for=\"field_3koqz\" class=\"frm_primary_label\">Medical School\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_3koqz\" name=\"item_meta[87]\" value=\"\"  data-invmsg=\"Medical School is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_88_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_j1eig\" class=\"frm_primary_label\">Degree\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_j1eig\" name=\"item_meta[88]\" value=\"\"  data-invmsg=\"Degree is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_89_container\" class=\"frm_form_field form-field  frm_top_container frm_third\">\r\n    <label for=\"field_xygdl\" class=\"frm_primary_label\">Date of Graduation\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xygdl\" name=\"item_meta[89]\" value=\"\"  maxlength=\"10\" data-invmsg=\"Date of Graduation is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_90_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Internship(s):<\/h3>\r\n\r\n<input type=\"hidden\" name=\"item_meta[90][form]\" value=\"9\" class=\"frm_dnc\" \/>\n\t\t\t<div id=\"frm_section_90-0\" class=\"frm_repeat_sec frm_repeat_90 frm_first_repeat frm_grid_container\">\n<input type=\"hidden\" name=\"item_meta[90][row_ids][]\" value=\"0\" \/><input type=\"hidden\" name=\"item_meta[90][0][0]\" value=\"\" \/><div id=\"frm_field_92-90-0_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_fourth frm_field_92_container\">\r\n    <label for=\"field_v0egg-0\" class=\"frm_primary_label\">Hospital\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_v0egg-0\" name=\"item_meta[90][0][92]\" value=\"\"  data-sectionid=\"90\" data-invmsg=\"Hospital is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_93-90-0_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_field_93_container\">\r\n    <label for=\"field_7zd0t-0\" class=\"frm_primary_label\">Type of Internship\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_7zd0t-0\" name=\"item_meta[90][0][93]\" value=\"\"  data-sectionid=\"90\" data-invmsg=\"Type of Internship is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_94-90-0_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_field_94_container\">\r\n    <label for=\"field_77uhf-0\" class=\"frm_primary_label\">Start\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_77uhf-0\" name=\"item_meta[90][0][94]\" value=\"\"  data-sectionid=\"90\" maxlength=\"10\" data-invmsg=\"Start is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_95-90-0_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_field_95_container\">\r\n    <label for=\"field_iwmjl-0\" class=\"frm_primary_label\">End\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_iwmjl-0\" name=\"item_meta[90][0][95]\" value=\"\"  data-sectionid=\"90\" maxlength=\"10\" data-invmsg=\"End is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div class=\"frm_form_field frm_hidden_container frm_repeat_buttons \"><a href=\"#\" class=\"frm_add_form_row frm_button\" data-parent=\"90\" aria-label=\"Add\"><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" class=\"frmsvg frm-svg-icon\">\n\t<title>plus1<\/title>\n\t<path d=\"M11 5H9v4H5v2h4v4h2v-4h4V9h-4V5zm-1-5a10 10 0 1 0 0 20 10 10 0 0 0 0-20zm0 18a8 8 0 1 1 0-16 8 8 0 0 1 0 16z\"><\/path>\n\n<\/svg> Add<\/a>\n<a href=\"#\" class=\"frm_remove_form_row frm_button\" data-key=\"0\" data-parent=\"90\" aria-label=\"Remove\"><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" class=\"frmsvg frm-svg-icon\">\n\t<title>minus1<\/title>\n\t<path d=\"M5 9v2h10V9H5zm5-9a10 10 0 1 0 0 20 10 10 0 0 0 0-20zm0 18a8 8 0 1 1 0-16 8 8 0 0 1 0 16z\"><\/path>\n\n<\/svg> Remove<\/a> <\/div><\/div>\n\r\n<\/div>\n<div id=\"frm_field_98_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Residencies:<\/h3>\r\n\r\n<input type=\"hidden\" name=\"item_meta[98][form]\" value=\"11\" class=\"frm_dnc\" \/>\n\t\t\t<div id=\"frm_section_98-0\" class=\"frm_repeat_sec frm_repeat_98 frm_first_repeat frm_grid_container\">\n<input type=\"hidden\" name=\"item_meta[98][row_ids][]\" value=\"0\" \/><input type=\"hidden\" name=\"item_meta[98][0][0]\" value=\"\" \/><div id=\"frm_field_99-98-0_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_fourth frm_field_99_container\">\r\n    <label for=\"field_jot0k-0\" class=\"frm_primary_label\">Hospital\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_jot0k-0\" name=\"item_meta[98][0][99]\" value=\"\"  data-sectionid=\"98\" data-invmsg=\"Hospital is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_100-98-0_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_field_100_container\">\r\n    <label for=\"field_glgzm-0\" class=\"frm_primary_label\">Type of Residency\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_glgzm-0\" name=\"item_meta[98][0][100]\" value=\"\"  data-sectionid=\"98\" data-invmsg=\"Type of Residency is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_101-98-0_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_field_101_container\">\r\n    <label for=\"field_bpoeb-0\" class=\"frm_primary_label\">Start\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_bpoeb-0\" name=\"item_meta[98][0][101]\" value=\"\"  data-sectionid=\"98\" maxlength=\"10\" data-invmsg=\"Start is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_102-98-0_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_field_102_container\">\r\n    <label for=\"field_98dfd-0\" class=\"frm_primary_label\">End\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_98dfd-0\" name=\"item_meta[98][0][102]\" value=\"\"  data-sectionid=\"98\" maxlength=\"10\" data-invmsg=\"End is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div class=\"frm_form_field frm_hidden_container frm_repeat_buttons \"><a href=\"#\" class=\"frm_add_form_row frm_button\" data-parent=\"98\" aria-label=\"Add\"><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" class=\"frmsvg frm-svg-icon\">\n\t<title>plus1<\/title>\n\t<path d=\"M11 5H9v4H5v2h4v4h2v-4h4V9h-4V5zm-1-5a10 10 0 1 0 0 20 10 10 0 0 0 0-20zm0 18a8 8 0 1 1 0-16 8 8 0 0 1 0 16z\"><\/path>\n\n<\/svg> Add<\/a>\n<a href=\"#\" class=\"frm_remove_form_row frm_button\" data-key=\"0\" data-parent=\"98\" aria-label=\"Remove\"><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" class=\"frmsvg frm-svg-icon\">\n\t<title>minus1<\/title>\n\t<path d=\"M5 9v2h10V9H5zm5-9a10 10 0 1 0 0 20 10 10 0 0 0 0-20zm0 18a8 8 0 1 1 0-16 8 8 0 0 1 0 16z\"><\/path>\n\n<\/svg> Remove<\/a> <\/div><\/div>\n\r\n<\/div>\n<div id=\"frm_field_104_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Fellowship:<\/h3>\r\n\r\n<input type=\"hidden\" name=\"item_meta[104][form]\" value=\"14\" class=\"frm_dnc\" \/>\n\t\t\t<div id=\"frm_section_104-0\" class=\"frm_repeat_sec frm_repeat_104 frm_first_repeat frm_grid_container\">\n<input type=\"hidden\" name=\"item_meta[104][row_ids][]\" value=\"0\" \/><input type=\"hidden\" name=\"item_meta[104][0][0]\" value=\"\" \/><div id=\"frm_field_106-104-0_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_third frm_field_106_container\">\r\n    <label for=\"field_hbv7f-0\" class=\"frm_primary_label\">Type of Fellowship\/Institution\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_hbv7f-0\" name=\"item_meta[104][0][106]\" value=\"\"  data-invmsg=\"Type of Fellowship\/Institution is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_107-104-0_container\" class=\"frm_form_field form-field  frm_top_container frm_third frm_field_107_container\">\r\n    <label for=\"field_ss4o1-0\" class=\"frm_primary_label\">Start\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ss4o1-0\" name=\"item_meta[104][0][107]\" value=\"\"  maxlength=\"10\" data-invmsg=\"Start is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_108-104-0_container\" class=\"frm_form_field form-field  frm_top_container frm_third frm_field_108_container\">\r\n    <label for=\"field_z3d63-0\" class=\"frm_primary_label\">End\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_z3d63-0\" name=\"item_meta[104][0][108]\" value=\"\"  maxlength=\"10\" data-invmsg=\"End is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div class=\"frm_form_field frm_hidden_container frm_repeat_buttons \"><a href=\"#\" class=\"frm_add_form_row frm_button\" data-parent=\"104\" aria-label=\"Add\"><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" class=\"frmsvg frm-svg-icon\">\n\t<title>plus1<\/title>\n\t<path d=\"M11 5H9v4H5v2h4v4h2v-4h4V9h-4V5zm-1-5a10 10 0 1 0 0 20 10 10 0 0 0 0-20zm0 18a8 8 0 1 1 0-16 8 8 0 0 1 0 16z\"><\/path>\n\n<\/svg> Add<\/a>\n<a href=\"#\" class=\"frm_remove_form_row frm_button\" data-key=\"0\" data-parent=\"104\" aria-label=\"Remove\"><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" class=\"frmsvg frm-svg-icon\">\n\t<title>minus1<\/title>\n\t<path d=\"M5 9v2h10V9H5zm5-9a10 10 0 1 0 0 20 10 10 0 0 0 0-20zm0 18a8 8 0 1 1 0-16 8 8 0 0 1 0 16z\"><\/path>\n\n<\/svg> Remove<\/a> <\/div><\/div>\n\r\n<\/div>\n<div id=\"frm_field_111_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Positions held since completion of residency\/fellowship:<\/h3>\r\n\r\n<input type=\"hidden\" name=\"item_meta[111][form]\" value=\"13\" class=\"frm_dnc\" \/>\n\t\t\t<div id=\"frm_section_111-0\" class=\"frm_repeat_sec frm_repeat_111 frm_first_repeat frm_grid_container\">\n<input type=\"hidden\" name=\"item_meta[111][row_ids][]\" value=\"0\" \/><input type=\"hidden\" name=\"item_meta[111][0][0]\" value=\"\" \/><div id=\"frm_field_113-111-0_container\" class=\"frm_form_field form-field  frm_top_container frm_first frm_fourth frm_field_113_container\">\r\n    <label for=\"field_ribni-0\" class=\"frm_primary_label\">Position\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ribni-0\" name=\"item_meta[111][0][113]\" value=\"\"  data-sectionid=\"111\" data-invmsg=\"Position is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_114-111-0_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_field_114_container\">\r\n    <label for=\"field_c3ntf-0\" class=\"frm_primary_label\">Location\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_c3ntf-0\" name=\"item_meta[111][0][114]\" value=\"\"  data-sectionid=\"111\" data-invmsg=\"Location is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_116-111-0_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_field_116_container\">\r\n    <label for=\"field_v2x1t-0\" class=\"frm_primary_label\">Start\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_v2x1t-0\" name=\"item_meta[111][0][116]\" value=\"\"  data-sectionid=\"111\" maxlength=\"10\" data-invmsg=\"Start is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_115-111-0_container\" class=\"frm_form_field form-field  frm_top_container frm_fourth frm_field_115_container\">\r\n    <label for=\"field_dtdjc-0\" class=\"frm_primary_label\">End\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_dtdjc-0\" name=\"item_meta[111][0][115]\" value=\"\"  data-sectionid=\"111\" maxlength=\"10\" data-invmsg=\"End is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div class=\"frm_form_field frm_hidden_container frm_repeat_buttons \"><a href=\"#\" class=\"frm_add_form_row frm_button\" data-parent=\"111\" aria-label=\"Add\"><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" class=\"frmsvg frm-svg-icon\">\n\t<title>plus1<\/title>\n\t<path d=\"M11 5H9v4H5v2h4v4h2v-4h4V9h-4V5zm-1-5a10 10 0 1 0 0 20 10 10 0 0 0 0-20zm0 18a8 8 0 1 1 0-16 8 8 0 0 1 0 16z\"><\/path>\n\n<\/svg> Add<\/a>\n<a href=\"#\" class=\"frm_remove_form_row frm_button\" data-key=\"0\" data-parent=\"111\" aria-label=\"Remove\"><svg  viewBox=\"0 0 20 20\" width=\"1em\" height=\"1em\" class=\"frmsvg frm-svg-icon\">\n\t<title>minus1<\/title>\n\t<path d=\"M5 9v2h10V9H5zm5-9a10 10 0 1 0 0 20 10 10 0 0 0 0-20zm0 18a8 8 0 1 1 0-16 8 8 0 0 1 0 16z\"><\/path>\n\n<\/svg> Remove<\/a> <\/div><\/div>\n\r\n<\/div>\n<div id=\"frm_field_117_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_ltfh2\" class=\"frm_primary_label\">Membership in Medical Societies\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[117]\" id=\"field_ltfh2\" rows=\"5\"  data-invmsg=\"Membership in Medical Societies is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_121_container\" class=\"frm_form_field  frm_first frm_half frm_html_container form-field\">American Board of Orthopaedic Surgery Board Certification Date<\/div>\n<div id=\"frm_field_118_container\" class=\"frm_form_field form-field  frm_top_container frm_half\">\r\n    <label for=\"field_t28eh\" class=\"frm_primary_label\">Certification Date\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_t28eh\" name=\"item_meta[118]\" value=\"\"  maxlength=\"10\" data-invmsg=\"American Board of Orthopaedic Surgery Board Certification Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_119_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_17igw\" class=\"frm_primary_label\">\"Signature\" (Type your name)\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_17igw\" name=\"item_meta[119]\" value=\"\"  data-reqmsg=\"&quot;Signature&quot; (Type your name) cannot be blank.\" aria-required=\"true\" data-invmsg=\"&quot;Signature&quot; (Type your name) is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_120_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_7gwlk\" class=\"frm_primary_label\">Date\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_7gwlk\" name=\"item_meta[120]\" value=\"\"  maxlength=\"10\" data-reqmsg=\"Date 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\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t\t<div class=\"frm__655e115356bec\">\n\t\t\t\t<label for=\"frm_email_8\" >\n\t\t\t\t\tIf you are human, leave this field blank.\t\t\t\t<\/label>\n\t\t\t\t<input  id=\"frm_email_8\" type=\"text\" class=\"frm_verify\" name=\"frm__655e115356bec\" value=\"\" autocomplete=\"false\"  \/>\n\t\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"i+5q+Vmog3wn85RHa4m\/g71Fn+Q9SGVcq7jsvUXVQWU=\" \/><div class=\"frm_submit\">\r\n\r\n<input type=\"submit\" value=\"Submit\"  class=\"frm_final_submit\" formnovalidate=\"formnovalidate\" \/>\r\n<img decoding=\"async\" class=\"frm_ajax_loading\" src=\"https:\/\/iowaorthopaedic.org\/wp-content\/plugins\/formidable\/images\/ajax_loader.gif\" alt=\"Sending\"\/>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>APPLICATION FOR MEMBERSHIP After submitting the form online we will contact you for payment.\u00a0<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Join-General Membership - Iowa Orthopaedic Society<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/iowaorthopaedic.org\/join-general-membership\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Join-General Membership - Iowa Orthopaedic Society\" \/>\n<meta property=\"og:description\" content=\"APPLICATION FOR MEMBERSHIP After submitting the form online we will contact you for payment.\u00a0\" \/>\n<meta property=\"og:url\" content=\"https:\/\/iowaorthopaedic.org\/join-general-membership\/\" \/>\n<meta property=\"og:site_name\" content=\"Iowa Orthopaedic Society\" \/>\n<meta property=\"article:modified_time\" content=\"2024-03-19T13:17:09+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/iowaorthopaedic.org\/join-general-membership\/\",\"url\":\"https:\/\/iowaorthopaedic.org\/join-general-membership\/\",\"name\":\"Join-General Membership - Iowa Orthopaedic 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