{"id":674,"date":"2017-12-27T18:34:13","date_gmt":"2017-12-27T18:34:13","guid":{"rendered":"http:\/\/temp.nddla.org\/?page_id=674"},"modified":"2018-01-19T23:54:47","modified_gmt":"2018-01-19T23:54:47","slug":"application","status":"publish","type":"page","link":"https:\/\/www.nddla.org\/index.php\/home\/application\/","title":{"rendered":"NDDLA Application"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;margin-bottom: 0px;margin-top: 0px;border-width: 0px 0px 0px 0px;border-color:rgba(97,158,133,0);border-style:solid;\" ><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"margin-top:0px;margin-bottom:20px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><style type=\"text\/css\"><\/style><div class=\"fusion-title title fusion-title-1 sep-underline sep-solid fusion-title-text fusion-title-size-one\" style=\"border-bottom-color:#353535;margin-top:0px;margin-right:0px;margin-bottom:40px;margin-left:0px;\"><h1 class=\"title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;--fontSize:40;line-height:1.4;\"><h2 style=\"text-align: center;\">NDDLA &#8211; Application for Membership<\/h2><\/h1><\/div><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_3_4 3_4 fusion-three-fourth fusion-column-first\" style=\"width:75%;width:calc(75% - ( ( 4% ) * 0.75 ) );margin-right: 4%;margin-top:0px;margin-bottom:20px;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\">* Indicates a required field.\n\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f729-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/674#wpcf7-f729-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"729\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.8.5\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f729-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/div>\n<div class=\"one-half-name\">\n\t<p><label> First Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"one-third-name\">\n\t<p><label> M.I.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"middle-name\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"middle-name\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"one-half-name last\">\n\t<p><label> Last Name*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"one-third\">\n\t<p><label> Email*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"example@example.com\" type=\"email\" name=\"email\" \/><\/span><\/label>\n\t<\/p>\n<\/div>\n<div class=\"one-third\">\n\t<p><label> Phone*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"phone\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"phone\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"one-third last\">\n\t<p><label> Fax<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"fax\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"fax\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"one-half\">\n\t<p><label> Firm*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"firm\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"firm\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"one-half\">\n\t<p><label> Address*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"one-half\">\n\t<p><label> P.O. Box<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"po-box\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"po-box\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div class=\"one-half\">\n\t<p><label> City*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div style=\"width:10%;margin-bottom: 20px;\">\n\t<p><label> State*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"state\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"ND\" type=\"text\" name=\"state\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div style=\"width:10%;margin-bottom: 20px;\">\n\t<p><label> Zip Code*<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"zip\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zip\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<div style=\"width:30%;margin-bottom: 20px;\">\n\t<p><label> Year Admitted to Practice<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"start-year\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"start-year\" \/><\/span> <\/label>\n\t<\/p>\n<\/div>\n<p><label><b>Area(s) of Practice* (select up to six)<\/b><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"areas-of-practice\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Alt. Dispute Resolution\" \/><span class=\"wpcf7-list-item-label\">Alt. Dispute Resolution<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Civil Defense Litigation\" \/><span class=\"wpcf7-list-item-label\">Civil Defense Litigation<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Commercial Litigation\" \/><span class=\"wpcf7-list-item-label\">Commercial Litigation<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Construction Law\" \/><span class=\"wpcf7-list-item-label\">Construction Law<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Creditor&#039;s Rights\" \/><span class=\"wpcf7-list-item-label\">Creditor&#039;s Rights<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Employment Law\" \/><span class=\"wpcf7-list-item-label\">Employment Law<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Family Law\" \/><span class=\"wpcf7-list-item-label\">Family Law<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Government Liability\" \/><span class=\"wpcf7-list-item-label\">Government Liability<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Governmental Relations\" \/><span class=\"wpcf7-list-item-label\">Governmental Relations<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Healthcare\" \/><span class=\"wpcf7-list-item-label\">Healthcare<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Indian Law\" \/><span class=\"wpcf7-list-item-label\">Indian Law<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Insurance Coverage\" \/><span class=\"wpcf7-list-item-label\">Insurance Coverage<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Insurance Defense\" \/><span class=\"wpcf7-list-item-label\">Insurance Defense<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Medical Malpractice\" \/><span class=\"wpcf7-list-item-label\">Medical Malpractice<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Personal Injury\" \/><span class=\"wpcf7-list-item-label\">Personal Injury<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Product Liability Defense\" \/><span class=\"wpcf7-list-item-label\">Product Liability Defense<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Professional Malpractice\" \/><span class=\"wpcf7-list-item-label\">Professional Malpractice<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"areas-of-practice[]\" value=\"Tort Liability\" \/><span class=\"wpcf7-list-item-label\">Tort Liability<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><label><b> Organizational Memberships* (please respond to all questions)<\/b><\/label><br \/>\n<label>I am a member of the North Dakota Association for Justice (\"NDAJ\"): <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"ndaj-option\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"ndaj-option\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"ndaj-option\" value=\"No\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span><br \/>\n<label>I am a member of the American Association for Justice (\"AAJ\"): <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"aaj-option\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"aaj-option\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"aaj-option\" value=\"No\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><label>If you are a member of either NDAJ or AAJ, please explain why you believe you qualify for membership in NDDLA: <span class=\"wpcf7-form-control-wrap\" data-name=\"option-explain\"><textarea cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"option-explain\"><\/textarea><\/span><\/label>\n<\/p>\n<p><label>I am a member of the Defense Research Institute(\"DRI\"): <\/label><span class=\"wpcf7-form-control-wrap\" data-name=\"DRI-option\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"DRI-option\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"DRI-option\" value=\"No\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><label><b> Annual NDDLA Membership Dues<\/b><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"membership-dues\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"membership-dues\" value=\"$100 - New Member\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">$100 - New Member<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"membership-dues\" value=\"$100 - Associate Member\" \/><span class=\"wpcf7-list-item-label\">$100 - Associate Member<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"membership-dues\" value=\"$50 - Retired Member\" \/><span class=\"wpcf7-list-item-label\">$50 - Retired Member<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<input class=\"wpcf7-form-control wpcf7-hidden\" value=\"No\" type=\"hidden\" name=\"approved\" \/>\n<input class=\"wpcf7-form-control wpcf7-hidden\" value=\"No\" type=\"hidden\" name=\"paid\" \/>\n<span class=\"wpcf7-form-control-wrap recaptcha\" data-name=\"recaptcha\"><span data-sitekey=\"6LdPqZUUAAAAAO3mrqEv00LNmykSeGInqznbb43X\" class=\"wpcf7-form-control wpcf7-recaptcha g-recaptcha\"><\/span>\r\n<noscript>\r\n\t<div class=\"grecaptcha-noscript\">\r\n\t\t<iframe src=\"https:\/\/www.google.com\/recaptcha\/api\/fallback?k=6LdPqZUUAAAAAO3mrqEv00LNmykSeGInqznbb43X\" frameborder=\"0\" scrolling=\"no\" width=\"310\" height=\"430\">\r\n\t\t<\/iframe>\r\n\t\t<textarea name=\"g-recaptcha-response\" rows=\"3\" cols=\"40\" placeholder=\"reCaptcha Response Here\">\r\n\t\t<\/textarea>\r\n\t<\/div>\r\n<\/noscript>\r\n<\/span>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><p style=\"display: none !important;\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"129\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"fusion-alert alert custom alert-custom 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class=\"fusion-clearfix\"><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":393,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-674","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.nddla.org\/index.php\/wp-json\/wp\/v2\/pages\/674","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nddla.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.nddla.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.nddla.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nddla.org\/index.php\/wp-json\/wp\/v2\/comments?post=674"}],"version-history":[{"count":19,"href":"https:\/\/www.nddla.org\/index.php\/wp-json\/wp\/v2\/pages\/674\/revisions"}],"predecessor-version":[{"id":988,"href":"https:\/\/www.nddla.org\/index.php\/wp-json\/wp\/v2\/pages\/674\/revisions\/988"}],"up":[{"embeddable":true,"href":"https:\/\/www.nddla.org\/index.php\/wp-json\/wp\/v2\/pages\/393"}],"wp:attachment":[{"href":"https:\/\/www.nddla.org\/index.php\/wp-json\/wp\/v2\/media?parent=674"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}