{"id":6369,"date":"2024-03-22T20:49:11","date_gmt":"2024-03-23T00:49:11","guid":{"rendered":"https:\/\/prbany.com\/?page_id=6369"},"modified":"2025-08-15T09:27:32","modified_gmt":"2025-08-15T13:27:32","slug":"membership-renewal","status":"publish","type":"page","link":"https:\/\/prbany.com\/es\/membership-renewal\/","title":{"rendered":"Renovaci\u00f3n de la afiliaci\u00f3n"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;0px||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; width=&#8221;90%&#8221; max_width=&#8221;1150px&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;||||||||&#8221; text_text_color=&#8221;#000000&#8243; global_colors_info=&#8221;{}&#8221;]<span><span><a href=\"https:\/\/prbany.com\/\">Home<\/a><\/span><\/span>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.22.2&#8243; custom_margin=&#8221;0px||||false|false&#8221; custom_padding=&#8221;0px||10px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.22.2&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; max_width=&#8221;1150px&#8221; custom_padding=&#8221;0px||||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text _builder_version=&#8221;4.24.2&#8243; _module_preset=&#8221;default&#8221; header_font=&#8221;|||on|||||&#8221; header_font_size=&#8221;42px&#8221; custom_margin=&#8221;||5px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h1 style=\"text-align: left;\">Membership Renewal Form<\/h1>\n<p>[\/et_pb_text][et_pb_divider color=&#8221;#DB1C22&#8243; divider_weight=&#8221;2px&#8221; _builder_version=&#8221;4.22.2&#8243; _module_preset=&#8221;default&#8221; width=&#8221;100px&#8221; custom_margin=&#8221;||10px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_divider][et_pb_text _builder_version=&#8221;4.24.2&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; display_conditions=&#8221;W10=&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<p><b class=\"rm-shortcode-tour\"><strong>Please complete the form below to renew your PRBANY Membership.<br \/>Please note: This form is only for previous members who need to renew their credentials. If you are unsure if you have a prior membership due for renewal, please contact Julia Galban-Carter at <a href=\"mailto:executivedirector@prbany.com\">executivedirector@prbany.com<\/a>.<br \/><\/strong><\/b><\/p>\n<p><b class=\"rm-shortcode-tour\"><!--noptimize--><div class=\"rmagic rm_theme_matchmytheme rm_layout_label_top\"><style><\/style><style><\/style><div class=\"rmcontent\"><pre class='rm-pre-wrapper-for-script-tags'><script>\r\n        \r\n   \/*form specific onload functionality*\/\r\njQuery(document).ready(function () {\r\nif(jQuery(\"#form_13_1 [name='rm_payment_method']\").length>0 && jQuery(\"#form_13_1 [name='rm_payment_method']:checked\").val()=='stripe'){jQuery('#rm_stripe_fields_container_13_1').show();}\r\n\r\n    jQuery('[data-rm-unique=\"1\"]').change(function(event) {\r\n        rm_unique_field_check(jQuery(this));\r\n    });\r\n    \r\n   });\r\n                \r\nif (typeof window['rm_multipage'] == 'undefined') {\r\n\r\n    rm_multipage = {\r\n        global_page_no_form_13_1: 1\r\n    };\r\n\r\n}\r\nelse\r\n rm_multipage.global_page_no_form_13_1 = 1;\r\n\r\nfunction gotonext_form_13_1(){\r\n        \/* Making sure action attribute is empty *\/\r\n        jQuery(\"form.rmagic-form\").attr(\"action\",\"\");\r\n        var maxpage = 4 ;\r\n        jQuery.validator.setDefaults({errorClass: 'rm-form-field-invalid-msg',\n                ignore:':hidden,.ignore,:not(:visible),.rm_untouched',wrapper:'div',\n                errorPlacement: function(error, element) {\n                    \/\/error.appendTo(element.closest('.rminput'));\n                    error.appendTo(element.closest('div'));\n                },\n                rules: {\n                    email_confirmation: {\n                        required: true,\n                        equalTo: \"#rm_reg_form_email_13_1\"\n                    }\n                },\n                messages: {\n                    email_confirmation: {\n                        equalTo: \"Emails do not match\"\n                    }\n                }\n            });        \r\n        \r\n        var jq_prev_button = jQuery(\"#rm_prev_form_page_button_13_1\");\r\n        var jq_next_button = jQuery(\"#rm_next_form_page_button_13_1\");\r\n        \r\n        var next_label = jq_next_button.data(\"label-next\");\r\n        var payment_method = jQuery('[name=rm_payment_method]:checked').val();\r\n        var form_object= jQuery(\"#rm_form_page_form_13_1_\"+rm_multipage.global_page_no_form_13_1).closest(\"form\");\r\n        var submit_btn= form_object.find(\"[type=submit]:not(.rm_noscript_btn)\");\r\n        var sub_label = submit_btn.data(\"label-sub\");\r\n        form_object.find('input.rm_price_field_quantity').each(function() {\r\n            if(typeof jQuery(this).attr('min') == 'undefined') {\r\n                jQuery(this).attr('min', 0);\r\n            }\r\n        });\r\n        if(form_object.find('.rm_privacy_cb').is(':visible') && !form_object.find('.rm_privacy_cb').prop('checked')){\r\n             \/\/form_object.find('.rm_privacy_cb').trigger('change');\r\n             form_object.find('.rm_privacy_cb').focus();\r\n             form_object.find('.rm_privacy_cb').parent().parent().siblings('div.rm-form-error-message').show();\r\n             return false;\r\n        } \r\n        if(typeof payment_method == 'undefined' || payment_method != 'stripe')\r\n        {            \r\n            elements_to_validate = jQuery(\"#rm_form_page_form_13_1_\"+rm_multipage.global_page_no_form_13_1+\" :input\").not('#rm_stripe_fields_container_13_1 :input');\r\n        }\r\n        else\r\n            var elements_to_validate = jQuery(\"#rm_form_page_form_13_1_\"+rm_multipage.global_page_no_form_13_1+\" :input\");\r\n        \r\n        if(elements_to_validate.length > 0)\r\n        {\r\n            var valid = elements_to_validate.valid();\r\n            elements_to_validate.each(function(){\r\n            var if_mobile= jQuery(this).attr('data-mobile-intel-field');\r\n                if(if_mobile){\r\n                    var tel_error = rm_toggle_tel_error(this.dataset.validnumber,jQuery(this),jQuery(this).data('error-message'));\r\n                    if(tel_error){\r\n                        valid= false;\r\n                    }\r\n                    else\r\n                    {\r\n                        jQuery(this).val(this.dataset.fullnumber);\r\n                    }\r\n                }\r\n            });\r\n\r\n            if(!valid)\r\n            {   \r\n                setTimeout(function(){ submit_btn.prop('disabled',false); }, 1000);\r\n                var error_element= jQuery(document).find(\"input.rm-form-field-invalid-msg\")[0];\r\n                if(error_element){\r\n                    error_element.focus();\r\n                }\r\n                return false;\r\n            }\r\n            else{\r\n                if(maxpage==rm_multipage.global_page_no_form_13_1){\r\n                    return true;\r\n                }\r\n            }\r\n           \r\n        } else{\r\n            if(maxpage==rm_multipage.global_page_no_form_13_1){\r\n                    return true;\r\n            }\r\n        }\r\n        \r\n        \/* Server validation for Username and Email field *\/\r\n        for(var i=0;i<rm_validation_attr.length;i++){\r\n            var validation_flag= true;\r\n            jQuery(\"[\" + rm_validation_attr[i] + \"=0]\").each(function(){\r\n               validation_flag= false;\r\n               return false;\r\n            });\r\n            \r\n           \r\n            if(!validation_flag)\r\n              return;\r\n        }\r\n        \r\n       \r\n        rm_multipage.global_page_no_form_13_1++;\r\n        if(rm_multipage.global_page_no_form_13_1>=maxpage){\r\n            submit_btn.prop('value',sub_label);\r\n            submit_btn.addClass('rm-submit-btn-show');\r\n        }\r\n        else{\r\n            submit_btn.prop('value','Next');\r\n            submit_btn.removeClass('rm-submit-btn-show');\r\n        }\r\n       \r\n        \/*skip blank form pages*\/\r\n        \/*while(jQuery(\"#rm_form_page_form_13_1_\"+rm_multipage.global_page_no_form_13_1+\" :input\").length == 0)\r\n        {\r\n            if(maxpage <= rm_multipage.global_page_no_form_13_1)\r\n            {\r\n                    if(jQuery(\"#rm_form_page_form_13_1_\"+rm_multipage.global_page_no_form_13_1+\" :input\").length == 0){\r\n                        jq_next_button.prop('type','submit');\r\n                        jq_prev_button.prop('disabled',true);\r\n                        return;\r\n                    }        \r\n                    else\r\n                        break;\r\n            }    \r\n           rm_multipage.global_page_no_form_13_1++;\t\t       \r\n        }*\/\r\n          \t\t\r\n\tif(rm_multipage.global_page_no_form_13_1 >= maxpage){\r\n            jq_next_button.attr(\"value\", sub_label);\r\n        }\r\n\tif(maxpage < rm_multipage.global_page_no_form_13_1)\r\n\t{\r\n\t\trm_multipage.global_page_no_form_13_1 = maxpage;\r\n\t\tjq_next_button.prop('type','submit');\r\n                jq_prev_button.prop('disabled',true);\r\n\t}\r\n        \r\n\tjQuery(\".rmformpage_form_13_1\").each(function (){\r\n        \r\n\t\tvar visibledivid = \"rm_form_page_form_13_1_\"+rm_multipage.global_page_no_form_13_1;\r\n\t\tvar current_page= jQuery(this);\r\n                    if(jQuery(this).attr('id') == visibledivid){\r\n                        setTimeout(function(){ \/\/ Delaying field show to skip validation for untouched fields\r\n                            current_page.show();\r\n                            current_page.find(':input').addClass('rm_untouched');\r\n                            setTimeout(function(){ current_page.find(':input').removeClass('rm_untouched'); }, 1000);\r\n                        },100);\r\n                }\r\n\t\telse\r\n                    current_page.hide();  \r\n        });         \r\n        \r\n        jQuery('.rmformpage_form_13_1').find(':input').filter(':visible').eq(0).focus();\r\n        jQuery('#rmagic-progressbar').animate({\r\n            scrollTop: (jQuery('.rmformpage_form_13_1').first().offset().top)\r\n        },500);\r\n        \r\n        jQuery('ul#rmagic-progressbar').children('li').each(function(index) {\r\n            if(!jQuery(this).hasClass('active')) {\r\n                jQuery(this).addClass('active');\r\n                return false;\r\n            }\r\n        });\r\n    \r\n        jq_prev_button.prop('disabled',false);\r\n        rmInitGoogleApi();\r\n        \r\n        setTimeout(function(){ submit_btn.prop('disabled',false); }, 1000);\r\n        \r\n        if(jq_prev_button.length > 0 && rm_multipage.global_page_no_form_13_1>=1){\r\n            jq_prev_button.show();\r\n        }\r\n        \r\n        if(rm_multipage.global_page_no_form_13_1 == maxpage){\r\n            return false;\r\n        }\r\n        \r\n        if(maxpage=='1'){\r\n            return true;\r\n        }\r\n        return false;\r\n           \r\n}\r\n    <\/script><\/pre><pre class='rm-pre-wrapper-for-script-tags'><script>\r\nfunction gotoprev_form_13_1(){\r\n\t\r\n\tvar maxpage = 4 ;\r\n        var jq_prev_button = jQuery(\"#rm_prev_form_page_button_13_1\");\r\n        var jq_next_button = jQuery(\"#rm_next_form_page_button_13_1\");\r\n        \/\/var sub_label = jq_next_button.data(\"label-sub\");\r\n        var next_label = jq_next_button.data(\"label-next\");\r\n        var form_object= jQuery(\"#rm_form_page_form_13_1_\"+rm_multipage.global_page_no_form_13_1).closest(\"form\");\r\n        var submit_btn= form_object.find(\"[type=submit]:not(.rm_noscript_btn)\");\r\n        var sub_label = submit_btn.data(\"label-sub\");\r\n        \/*\r\n        if(form_object.find('.rm_privacy_cb').is(':visible') && !form_object.find('.rm_privacy_cb').prop('checked')){\r\n            \/\/form_object.find('.rm_privacy_cb').trigger('change');\r\n            form_object.find('.rm_privacy_cb').focus();\r\n            form_object.find('.rm_privacy_cb').parent().parent().siblings('div.rm-form-error-message').show();\r\n            return false;\r\n        }\r\n        *\/\r\n\trm_multipage.global_page_no_form_13_1--;\r\n        jq_next_button.attr('type','button');        \r\n        \r\n        if(maxpage==rm_multipage.global_page_no_form_13_1){\r\n            submit_btn.prop('value',sub_label);\r\n            submit_btn.addClass('rm-submit-btn-show');\r\n        }\r\n        else{\r\n            submit_btn.prop('value','Next');\r\n            submit_btn.removeClass('rm-submit-btn-show');\r\n        }\r\n        \/*skip blank form pages*\/\r\n        while(jQuery(\"#rm_form_page_form_13_1_\"+rm_multipage.global_page_no_form_13_1+\" :input,.rm-total-price \").length == 0)\r\n        {\r\n            if(1 >= rm_multipage.global_page_no_form_13_1)\r\n            {\r\n                    if(jQuery(\"#rm_form_page_form_13_1_\"+rm_multipage.global_page_no_form_13_1+\" :input,.rm-total-price \").length == 0){\r\n                        rm_multipage.global_page_no_form_13_1 = 1;\r\n                        \/\/jq_prev_button.prop('disabled',true);\r\n                        return;\r\n                    }        \r\n                    else\r\n                        break;\r\n            }\r\n        \r\n            rm_multipage.global_page_no_form_13_1--;\r\n        }\r\n        \r\n        if(rm_multipage.global_page_no_form_13_1 <= maxpage-1)\r\n            jq_next_button.attr(\"value\", next_label);\r\n            \r\n\tjQuery(\".rmformpage_form_13_1\").each(function (){\r\n\t\tvar visibledivid = \"rm_form_page_form_13_1_\"+rm_multipage.global_page_no_form_13_1;\r\n\t\tif(jQuery(this).attr('id') == visibledivid){\r\n\t\t\tjQuery(this).show();\r\n                }\r\n\t\telse\r\n\t\t\tjQuery(this).hide();\r\n\t});\r\n        jQuery('.rmformpage_form_13_1').find(':input').filter(':visible').eq(0).focus();\r\n        if(rm_multipage.global_page_no_form_13_1 <= 1)\r\n        {\r\n            rm_multipage.global_page_no_form_13_1 = 1;\r\n           \/\/ jq_prev_button.prop('disabled',true);\r\n        }\r\n        jQuery('#rmagic-progressbar').animate({\r\n            scrollTop: (jQuery('.rmformpage_form_13_1').first().offset().top)\r\n        },500);\r\n        \r\n        jQuery('ul#rmagic-progressbar').children('li').each(function(index) {\r\n            if(!jQuery(this).next().hasClass('active')) {\r\n                jQuery(this).removeClass('active');\r\n                return false;\r\n            }\r\n        });\r\n        \r\n        if(rm_multipage.global_page_no_form_13_1==1){\r\n            jq_prev_button.hide();\r\n            submit_btn.prop('disabled',false);\r\n        }\r\n}\r\n         \r\n<\/script>\r\n    <script src=\"\/\/www.youtube.com\/player_api\"><\/script>\r\n    <script>\r\n    var players = [];\r\n    function onYouTubePlayerAPIReady() {\r\n        \/\/ create the global player from the specific iframe (#video)\r\n        var pre_id = '';\r\n        jQuery(\".allow-autoplay\").each(function(){\r\n            if(pre_id!=jQuery(this).attr(\"id\")){\r\n                players.push(new YT.Player(jQuery(this).attr(\"id\")));\r\n            }\r\n            pre_id = jQuery(this).attr(\"id\");\r\n        });\r\n    }\r\n    jQuery(document).ready(function(){\r\n        var videosArr = [];\r\n        var pre_id = '';\r\n        jQuery(\".allow-autoplay\").each(function(i){\r\n            if(pre_id!=jQuery(this).attr(\"id\")){\r\n                videosArr[jQuery(this).attr(\"id\")] = i;\r\n            }\r\n            pre_id = jQuery(this).attr(\"id\");\r\n        });\r\n        jQuery('.buttonarea input').click(function(){\r\n            setTimeout(function(){\r\n                jQuery(\".rmformpage_form_13_1\").each(function(){\r\n                    if(jQuery(this).css('display')=='block'){\r\n                        var page_video_id= jQuery(this).attr(\"id\");\r\n                        if(jQuery('#'+page_video_id+' .allow-autoplay').length){\r\n                            players[videosArr[jQuery('#'+page_video_id+' .allow-autoplay').attr('id')]].playVideo();\r\n                        }\r\n                    }\r\n                });\r\n            }, 300);\r\n        });\r\n    });\r\n    <\/script> \r\n   <\/pre><style type=\"text\/css\">label span.required { color: #B94A48; }span.help-inline, span.help-block { color: #888; font-size: .9em; font-style: italic; }<\/style><form novalidate onsubmit=\"return gotonext_form_13_1()\" autocomplete=\"off\" action id=\"form_13_1\" method=\"post\" class=\"rmagic-form rmagic-form-btn-right form-vertical\" name=\"rm_form\" number=\"1\"><fieldset><input type=\"hidden\" name=\"rm_form_sub_id\" value=form_13_1><input type=\"hidden\" name=\"rm_form_sub_no\" value=1><input type=\"hidden\" name=\"rm_cond_hidden_fields\" id=\"rm_cond_hidden_fields\" value=\"\"><div id=\"rm_stat_container\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-1\" style=\"\">RM_Stats<\/label><div class=\"rminput\"><input type=\"text\" name=\"stat_id\" value=\"__uninit\" style=\"display:none\" id=\"form_13_1-element-1\"\/><\/div><\/div><\/div><ul id=\"rmagic-progressbar\"><li class=\"active\"><span class=\"rm-progressbar-counter\"><\/span><span class=\"rm-form-page-name\">Basic Details<\/span><\/li><li><span class=\"rm-progressbar-counter\"><\/span><span class=\"rm-form-page-name\">Contact Details<\/span><\/li><li><span class=\"rm-progressbar-counter\"><\/span><span class=\"rm-form-page-name\">Additional Details<\/span><\/li><li><span class=\"rm-progressbar-counter\"><\/span><span class=\"rm-form-page-name\">Membership Registration<\/span><\/li><\/ul><div class=\"rm-multi-page-form rmformpage_form_13_1\" id=\"rm_form_page_form_13_1_1\"><fieldset class='rmfieldset'><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap\"><div class=\"rmagic-col rmagic-col-6\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-14\" style=\"\">First Name<\/label><div class=\"rminput\"><input type=\"text\" name=\"Fname_226\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_1-element-14\"\/><\/div><\/div><\/div><div class=\"rmagic-col rmagic-col-6\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-17\" style=\"\">Last Name<\/label><div class=\"rminput\"><input type=\"text\" name=\"Lname_227\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_1-element-17\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"rm_reg_form_email_13_1\" style=\"\">Email<\/label><div class=\"rminput\"><input type=\"email\" name=\"Email_210\" required id=\"rm_reg_form_email_13_1\"\/><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div><div class=\"rm_form_page rmformpage_form_13_1\" id=\"rm_form_page_form_13_1_2\"><fieldset class='rmfieldset'><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"autocompleteAddress_212\" style=\"\">Home Address<\/label><div class=\"rminput\">\r\n        <div id=\"address\" class=\"rm_address_type_ca\">\r\n            <div class=\"rm_ad_container\">       \r\n                                                    <div class=\"slimField rm-address-fw\">\r\n                                <input type=\"text\"  class=\"field\" id=\"Address_212_address1\"\r\n                                placeholder=\"\"\r\n                                required                                name=\"Address_212[address1]\" value=\"\" ><\/input>\r\n\r\n                                                                    <div class=\"label\">Address Line 1                                        \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                 \r\n                                    \r\n                                    <\/div>\r\n                                 \r\n                           \r\n                            <\/div>\r\n                                                \r\n                                                    <div class=\"wideField rm-semi-field rm-address-fw\" colspan=\"2\">\r\n                                <input type=\"text\"  class=\"field\" id=\"Address_212_route\"\r\n                                                                              placeholder=\"\"\r\n                                       name=\"Address_212[address2]\" value=\"\" ><\/input>\r\n                                                                    <div class=\"label\">Address Line 2                                      \r\n                                    \r\n                                    <\/div>\r\n                                    \r\n                            \r\n                            <\/div>\r\n                                    <\/div>\r\n            \r\n                        \r\n            <div class=\"rm_ad_container\">\r\n                                            <div class=\"wideField rm-alone rm-address-hw\" colspan=\"3\">\r\n                            <input type=\"text\" class=\"\" name=\"Address_212[city]\" \r\n                                   id=\"Address_212_locality\" name=\"Address_212[city]\"                      \r\n                                   required                                   placeholder=\"\"\r\n                                   value=\"\" \/>    \r\n                                                            <div class=\"label\">City                                    \r\n                                <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                                               \r\n                                <\/div>\r\n                                                     \r\n                        <\/div>\r\n                                        \r\n                                                                \r\n                \r\n                                                    <div class=\"slimField rm-address-hw\">\r\n                                <select  class=\"field\" required                                        id=\"Address_212_administrative_area_level_1\"  \r\n                                        name=\"Address_212[state]\" value=\"\" >\r\n                                    <option value=\"\">State or Region<\/option>\r\n                                                                                                                                                                   \r\n                                                 <option>Alabama<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Alaska<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Arizona<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Arkansas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces America<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces Europe<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces Pacific<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>California<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Colorado<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Connecticut<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Delaware<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>District Of Columbia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Florida<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Georgia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Hawaii<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Idaho<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Illinois<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Indiana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Iowa<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Kansas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Kentucky<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Louisiana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Maine<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Maryland<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Massachusetts<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Michigan<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Minnesota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Mississippi<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Missouri<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Montana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Nebraska<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Nevada<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Hampshire<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Jersey<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Mexico<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New York<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>North Carolina<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>North Dakota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Ohio<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Oklahoma<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Oregon<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Pennsylvania<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Rhode Island<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>South Carolina<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>South Dakota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Tennessee<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Texas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Utah<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Vermont<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Virginia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Washington<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>West Virginia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Wisconsin<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Wyoming<\/option>\r\n                                                 \r\n                                       \r\n                                <\/select>\r\n                                                                    <div class=\"label\">State or Region                                                \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                 \r\n                                    <\/div>\r\n                                 \r\n                           \r\n                            <\/div>\r\n                        \r\n                                                \r\n                \r\n                                 <\/div>\r\n            \r\n            <div class=\"rm_ad_container\">\r\n                     \r\n                    \r\n                                            <div class=\"wideField rm-semi-field-with-label rm-address-hw\">\r\n                                <input type=\"text\" onchange=\"rm_validate_zipcode('Address_212')\"  class=\"field\" id=\"Address_212_postal_code\" \r\n                                        required                                        placeholder=\"\"\r\n                                        name=\"Address_212[zip]\" value=\"\" ><\/input> \r\n                                                                    <div class=\"label label-short\">Zip                                    \r\n                                               \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                   \r\n                                    <\/div>\r\n                                                          \r\n                        <\/div>\r\n                     \r\n                    \r\n            <\/div>\r\n            \r\n        <\/div>\r\n\r\n        <\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-6\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-42\" style=\"\">Business Phone<\/label><div class=\"rminput\"><input type=\"text\" name=\"Phone_213\" placeholder=\"000-000-0000\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation pattern=\"^(\\d[\\s-]?)?[\\(\\[\\s-]{0,2}?\\d{3}[\\)\\]\\s-]{0,2}?\\d{3}[\\s-]?\\d{4}$\" id=\"form_13_1-element-42\"\/><\/div><\/div><\/div><div class=\"rmagic-col rmagic-col-6\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"rm_mobile_214_13_2\" style=\"\">Mobile Phone<\/label><div class=\"rminput\"><input type=\"text\" name=\"Mobile_214\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"rm_mobile_214_13_2\" data-error-message=\"This does not appear to be a valid mobile number.\" placeholder=\"(999) 999-9999\" pattern=\".{14}\"\/><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div><div class=\"rm_form_page rmformpage_form_13_1\" id=\"rm_form_page_form_13_1_3\"><fieldset class='rmfieldset'><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-56\" style=\"\">Title<\/label><div class=\"rminput\"><input type=\"text\" name=\"Textbox_215\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_1-element-56\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-63\" style=\"\">Employer<\/label><div class=\"rminput\"><input type=\"text\" name=\"Textbox_216\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_1-element-63\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"autocompleteAddress_217\" style=\"\">Business Address<\/label><div class=\"rminput\">\r\n        <div id=\"address\" class=\"rm_address_type_ca\">\r\n            <div class=\"rm_ad_container\">       \r\n                                                    <div class=\"slimField rm-address-fw\">\r\n                                <input type=\"text\"  class=\"field\" id=\"Address_217_address1\"\r\n                                placeholder=\"\"\r\n                                required                                name=\"Address_217[address1]\" value=\"\" ><\/input>\r\n\r\n                                                                    <div class=\"label\">Address Line 1                                        \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                 \r\n                                    \r\n                                    <\/div>\r\n                                 \r\n                           \r\n                            <\/div>\r\n                                                \r\n                                                    <div class=\"wideField rm-semi-field rm-address-fw\" colspan=\"2\">\r\n                                <input type=\"text\"  class=\"field\" id=\"Address_217_route\"\r\n                                                                              placeholder=\"\"\r\n                                       name=\"Address_217[address2]\" value=\"\" ><\/input>\r\n                                                                    <div class=\"label\">Address Line 2                                      \r\n                                    \r\n                                    <\/div>\r\n                                    \r\n                            \r\n                            <\/div>\r\n                                    <\/div>\r\n            \r\n                        \r\n            <div class=\"rm_ad_container\">\r\n                                            <div class=\"wideField rm-alone rm-address-hw\" colspan=\"3\">\r\n                            <input type=\"text\" class=\"\" name=\"Address_217[city]\" \r\n                                   id=\"Address_217_locality\" name=\"Address_217[city]\"                      \r\n                                   required                                   placeholder=\"\"\r\n                                   value=\"\" \/>    \r\n                                                            <div class=\"label\">City                                    \r\n                                <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                                               \r\n                                <\/div>\r\n                                                     \r\n                        <\/div>\r\n                                        \r\n                                                                \r\n                \r\n                                                    <div class=\"slimField rm-address-hw\">\r\n                                <select  class=\"field\" required                                        id=\"Address_217_administrative_area_level_1\"  \r\n                                        name=\"Address_217[state]\" value=\"\" >\r\n                                    <option value=\"\">State<\/option>\r\n                                                                                                                                                                   \r\n                                                 <option>Alabama<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Alaska<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Arizona<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Arkansas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces America<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces Europe<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces Pacific<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>California<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Colorado<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Connecticut<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Delaware<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>District Of Columbia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Florida<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Georgia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Hawaii<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Idaho<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Illinois<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Indiana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Iowa<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Kansas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Kentucky<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Louisiana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Maine<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Maryland<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Massachusetts<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Michigan<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Minnesota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Mississippi<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Missouri<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Montana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Nebraska<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Nevada<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Hampshire<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Jersey<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Mexico<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New York<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>North Carolina<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>North Dakota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Ohio<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Oklahoma<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Oregon<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Pennsylvania<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Rhode Island<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>South Carolina<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>South Dakota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Tennessee<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Texas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Utah<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Vermont<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Virginia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Washington<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>West Virginia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Wisconsin<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Wyoming<\/option>\r\n                                                 \r\n                                       \r\n                                <\/select>\r\n                                                                    <div class=\"label\">State                                                \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                 \r\n                                    <\/div>\r\n                                 \r\n                           \r\n                            <\/div>\r\n                        \r\n                                                \r\n                \r\n                                 <\/div>\r\n            \r\n            <div class=\"rm_ad_container\">\r\n                     \r\n                    \r\n                                            <div class=\"wideField rm-semi-field-with-label rm-address-hw\">\r\n                                <input type=\"text\" onchange=\"rm_validate_zipcode('Address_217')\"  class=\"field\" id=\"Address_217_postal_code\" \r\n                                        required                                        placeholder=\"\"\r\n                                        name=\"Address_217[zip]\" value=\"\" ><\/input> \r\n                                                                    <div class=\"label label-short\">Zip                                    \r\n                                               \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                   \r\n                                    <\/div>\r\n                                                          \r\n                        <\/div>\r\n                     \r\n                    \r\n            <\/div>\r\n            \r\n        <\/div>\r\n\r\n        <\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-8\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-77\" style=\"\">Law School<\/label><div class=\"rminput\"><input type=\"text\" name=\"Textbox_218\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_1-element-77\"\/><\/div><\/div><\/div><div class=\"rmagic-col rmagic-col-4\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-80\" style=\"\">Graduation Year<\/label><div class=\"rminput\"><input type=\"number\" min=\"0\" name=\"Number_219\" placeholder=\"2001\" required_max_range required_min_range field_validation custom_validation id=\"form_13_1-element-80\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-8\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-87\" style=\"\">College or University<\/label><div class=\"rminput\"><input type=\"text\" name=\"Textbox_220\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_1-element-87\"\/><\/div><\/div><\/div><div class=\"rmagic-col rmagic-col-4\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-90\" style=\"\">Degree<\/label><div class=\"rminput\"><input type=\"text\" name=\"Textbox_221\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_1-element-90\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-97\" style=\"\">Bar Admission(s) - Year<\/label><div class=\"rminput\"><div class=\"rm_field_type_repeatable_container\" id=\"rm_field_type_repeatable_container_form_13_1-element-97\"><div class=\"appendable_options\"><input type=\"text\" name=\"Repeatable_222[]\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_1-element-97\"\/><div class=\"rm_actions\" id=\"rm_add_repeatable_field\" onClick=\"rm_append_field('div','rm_field_type_repeatable_container_form_13_1-element-97')\"><a>Add<\/a><\/div><div class=\"rm_actions\" onClick=\"rm_delete_appended_field(this,'rm_field_type_repeatable_container_form_13_1-element-97')\"><a href=\"javascript:void(0)\">Delete<\/a><\/div><\/div><\/div><\/div><div class=\"rmnote\"><div class=\"rmprenote\"><\/div><div class=\"rmnotecontent\">Ex.: New York - 2021 Click \"Add\" to enter additional Bar Admission - Year<\/div><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div><div class=\"rm_form_page rmformpage_form_13_1\" id=\"rm_form_page_form_13_1_4\"><fieldset class='rmfieldset'><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-108\" style=\"\">Today's Date<\/label><div class=\"rminput\"><input type=\"text\" autocomplete=\"off\" readonly=\"1\" name=\"jQueryUIDate_229\" required required_max_range required_min_range field_validation custom_validation date_format=\"mm\/dd\/yy\" data-dateformat=\"mm\/dd\/yy\" id=\"form_13_1-element-108\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field rm_pricefield_row\"><label class=\"rmfield\" for=\"id_rm_multisel_paypal_field_224\" style=\"\">Select Membership Level<\/label><div class=\"rminput\"><select name=\"Price_224_1\" required data-rmfieldtype=\"price\" data-rmfieldprice=\"{&quot;_0&quot;:&quot;125.00&quot;,&quot;_1&quot;:&quot;100.00&quot;,&quot;_2&quot;:&quot;50.00&quot;,&quot;_3&quot;:&quot;0.00&quot;,&quot;_4&quot;:&quot;100.00&quot;,&quot;_5&quot;:&quot;25.00&quot;}\" id=\"id_rm_multisel_paypal_field_224\" class><option value=\"\">Select an option<\/option><option value=\"_0\">Attorneys Admitted 10+ Years ($ 125.00)<\/option><option value=\"_1\">Attorneys Admitted 6-10 Years ($ 100.00)<\/option><option value=\"_2\">Attorneys Admitted 1-5 Years ($ 50.00)<\/option><option value=\"_3\">New Attorneys and Law Students ($ 0.00)<\/option><option value=\"_4\">Judiciary, Government &amp; Non-Profit Employees ($ 100.00)<\/option><option value=\"_5\">Non-Attorneys ($ 25.00)<\/option><\/select><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class='rmrow'><div class='rm-total-price-widget ' data-rmpriceformat='{\"loc_total_text\":\"Total Price: %s\",\"symbol\":\"$\",\"pos\":\"before\"}'><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_1-element-129\" style=\"\">\u26a0 Payment Confirmation Required<\/label><div class=\"rminput\"><div id='rm_terms_textarea' class='rm_terms_textarea'><textarea  onscroll='' readonly  id='rm_terms_area_Terms_235' class='rm_terms_area'>Do not close or leave this page until the payment window appears. After submitting this form the payment window will pop up in a few seconds. Your membership will not be activated unless payment is successfully processed.<\/textarea><\/div><div class='rm_terms_checkbox'><input   value='on' type='checkbox' rows=\"5\" name=\"Terms_235\" required required_max_range required_min_range field_validation custom_validation id=\"form_13_1-element-129\" class='rm_check_box'>I understand and will complete payment before closing this page.<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row rm_payment_options\"><input type=\"hidden\" name=\"rm_payment_method\" value=\"anet_sim\" id=\"form_13_1-element-134\"\/><\/div><\/fieldset><\/div><div class=\"buttonarea\"><input   type=\"button\" value=\"Prev\" name=\"rm_prev_btn\" class=\"rm_prev_btn rm-btn\" id=\"rm_prev_form_page_button_13_1\" onclick=\"gotoprev_form_13_1()\" disabled=\"1\"\/> <input   type=\"submit\" value=\"Next\" name=\"rm_sb_btn\" class=\"rm_next_btn rm-btn rm-btn-primary button button-primary\" data-label-next=\"Next\" data-label-sub=\"Submit\" id=\"form_13_1-element-139\"\/> <input   type=\"submit\" value=\"Submit\" name class=\"rm_noscript_btn rm-btn rm-btn-primary button button-primary\" id=\"form_13_1-element-140\"\/><\/div><\/fieldset><\/form><pre class=\"rm-pre-wrapper-for-script-tags\"><script type=\"text\/javascript\">jQuery(document).ready(function() {\t\tjQuery(\"#form_13_1\").bind(\"submit\", function(){\n                        \/\/jQuery(this).find(\"input[name=rm_slug]\").attr(\"value\",jQuery(this).find(\"input[name=submit]\").attr(\"value\"));\n\t\t\tjQuery(this).find(\"input[type=submit]\").attr(\"disabled\", \"disabled\"); \n\t\t});            \n                   \n                   jQuery(\"#rm_reg_form_email_13_1\").change(function(){\n                   var data = {\n                           'action': 'rm_user_exists',\n                           'rm_sec_nonce': '1b66a91f8d',\n                           'rm_slug': 'rm_user_exists',\n                           'email': jQuery(this).val(),\n                           'attr': 'data-rm-valid-email',\n                           'form_id':\"13\"\n                   };\n                   \n                   rm_user_exists(this,rm_ajax_url,data);\n                  \n                 });\n                   jQuery(\"#form_13_1-element-108\").datepicker({\n                                        dateFormat:\"mm\/dd\/yy\",\n                                        changeMonth:true,\n                                        changeYear:true,\n                                        yearRange: '1900:+50',\n                                        beforeShow: function(input, inst){\n                                                        if(inst.id === \"form_13_1-element-108\") {\n                                                            jQuery(\"#ui-datepicker-div\").addClass(\"rm_jqui_element\");\n                                                        } else {\n                                                            jQuery(\"#ui-datepicker-div\").removeClass(\"rm_jqui_element\");\n                                                        }\n                                                    }\n                                    });}); <\/script><\/pre>        <noscript>\n            <div class=\"rm-js-disabled\"><b>Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.<\/b><\/div>\n            <style>\n                .rm_next_btn {display:none !important}\n                .rm_noscript_btn {display: block !important}\n            <\/style>\n        <\/noscript>\n    <\/div><\/div><!--\/noptimize--><\/b><\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p><span><span><a href=\"https:\/\/prbany.com\/\">Home<\/a><\/span><\/span>Membership Renewal FormPlease complete the form below to renew your PRBANY Membership.Please note: This form is only for previous members who need to renew their credentials. If you are unsure if you have a prior membership due for renewal, please contact Julia Galban-Carter at executivedirector@prbany.com. <!--noptimize--><div class=\"rmagic rm_theme_matchmytheme rm_layout_label_top\"><style><\/style><style><\/style><div class=\"rmcontent\"><pre class='rm-pre-wrapper-for-script-tags'><script>\r\n        \r\n   \/*form specific onload functionality*\/\r\njQuery(document).ready(function () {\r\nif(jQuery(\"#form_13_2 [name='rm_payment_method']\").length>0 && jQuery(\"#form_13_2 [name='rm_payment_method']:checked\").val()=='stripe'){jQuery('#rm_stripe_fields_container_13_2').show();}\r\n\r\n    jQuery('[data-rm-unique=\"1\"]').change(function(event) {\r\n        rm_unique_field_check(jQuery(this));\r\n    });\r\n    \r\n   });\r\n                \r\nif (typeof window['rm_multipage'] == 'undefined') {\r\n\r\n    rm_multipage = {\r\n        global_page_no_form_13_2: 1\r\n    };\r\n\r\n}\r\nelse\r\n rm_multipage.global_page_no_form_13_2 = 1;\r\n\r\nfunction gotonext_form_13_2(){\r\n        \/* Making sure action attribute is empty *\/\r\n        jQuery(\"form.rmagic-form\").attr(\"action\",\"\");\r\n        var maxpage = 4 ;\r\n        jQuery.validator.setDefaults({errorClass: 'rm-form-field-invalid-msg',\n                ignore:':hidden,.ignore,:not(:visible),.rm_untouched',wrapper:'div',\n                errorPlacement: function(error, element) {\n                    \/\/error.appendTo(element.closest('.rminput'));\n                    error.appendTo(element.closest('div'));\n                },\n                rules: {\n                    email_confirmation: {\n                        required: true,\n                        equalTo: \"#rm_reg_form_email_13_2\"\n                    }\n                },\n                messages: {\n                    email_confirmation: {\n                        equalTo: \"Emails do not match\"\n                    }\n                }\n            });        \r\n        \r\n        var jq_prev_button = jQuery(\"#rm_prev_form_page_button_13_2\");\r\n        var jq_next_button = jQuery(\"#rm_next_form_page_button_13_2\");\r\n        \r\n        var next_label = jq_next_button.data(\"label-next\");\r\n        var payment_method = jQuery('[name=rm_payment_method]:checked').val();\r\n        var form_object= jQuery(\"#rm_form_page_form_13_2_\"+rm_multipage.global_page_no_form_13_2).closest(\"form\");\r\n        var submit_btn= form_object.find(\"[type=submit]:not(.rm_noscript_btn)\");\r\n        var sub_label = submit_btn.data(\"label-sub\");\r\n        form_object.find('input.rm_price_field_quantity').each(function() {\r\n            if(typeof jQuery(this).attr('min') == 'undefined') {\r\n                jQuery(this).attr('min', 0);\r\n            }\r\n        });\r\n        if(form_object.find('.rm_privacy_cb').is(':visible') && !form_object.find('.rm_privacy_cb').prop('checked')){\r\n             \/\/form_object.find('.rm_privacy_cb').trigger('change');\r\n             form_object.find('.rm_privacy_cb').focus();\r\n             form_object.find('.rm_privacy_cb').parent().parent().siblings('div.rm-form-error-message').show();\r\n             return false;\r\n        } \r\n        if(typeof payment_method == 'undefined' || payment_method != 'stripe')\r\n        {            \r\n            elements_to_validate = jQuery(\"#rm_form_page_form_13_2_\"+rm_multipage.global_page_no_form_13_2+\" :input\").not('#rm_stripe_fields_container_13_2 :input');\r\n        }\r\n        else\r\n            var elements_to_validate = jQuery(\"#rm_form_page_form_13_2_\"+rm_multipage.global_page_no_form_13_2+\" :input\");\r\n        \r\n        if(elements_to_validate.length > 0)\r\n        {\r\n            var valid = elements_to_validate.valid();\r\n            elements_to_validate.each(function(){\r\n            var if_mobile= jQuery(this).attr('data-mobile-intel-field');\r\n                if(if_mobile){\r\n                    var tel_error = rm_toggle_tel_error(this.dataset.validnumber,jQuery(this),jQuery(this).data('error-message'));\r\n                    if(tel_error){\r\n                        valid= false;\r\n                    }\r\n                    else\r\n                    {\r\n                        jQuery(this).val(this.dataset.fullnumber);\r\n                    }\r\n                }\r\n            });\r\n\r\n            if(!valid)\r\n            {   \r\n                setTimeout(function(){ submit_btn.prop('disabled',false); }, 1000);\r\n                var error_element= jQuery(document).find(\"input.rm-form-field-invalid-msg\")[0];\r\n                if(error_element){\r\n                    error_element.focus();\r\n                }\r\n                return false;\r\n            }\r\n            else{\r\n                if(maxpage==rm_multipage.global_page_no_form_13_2){\r\n                    return true;\r\n                }\r\n            }\r\n           \r\n        } else{\r\n            if(maxpage==rm_multipage.global_page_no_form_13_2){\r\n                    return true;\r\n            }\r\n        }\r\n        \r\n        \/* Server validation for Username and Email field *\/\r\n        for(var i=0;i<rm_validation_attr.length;i++){\r\n            var validation_flag= true;\r\n            jQuery(\"[\" + rm_validation_attr[i] + \"=0]\").each(function(){\r\n               validation_flag= false;\r\n               return false;\r\n            });\r\n            \r\n           \r\n            if(!validation_flag)\r\n              return;\r\n        }\r\n        \r\n       \r\n        rm_multipage.global_page_no_form_13_2++;\r\n        if(rm_multipage.global_page_no_form_13_2>=maxpage){\r\n            submit_btn.prop('value',sub_label);\r\n            submit_btn.addClass('rm-submit-btn-show');\r\n        }\r\n        else{\r\n            submit_btn.prop('value','Next');\r\n            submit_btn.removeClass('rm-submit-btn-show');\r\n        }\r\n       \r\n        \/*skip blank form pages*\/\r\n        \/*while(jQuery(\"#rm_form_page_form_13_2_\"+rm_multipage.global_page_no_form_13_2+\" :input\").length == 0)\r\n        {\r\n            if(maxpage <= rm_multipage.global_page_no_form_13_2)\r\n            {\r\n                    if(jQuery(\"#rm_form_page_form_13_2_\"+rm_multipage.global_page_no_form_13_2+\" :input\").length == 0){\r\n                        jq_next_button.prop('type','submit');\r\n                        jq_prev_button.prop('disabled',true);\r\n                        return;\r\n                    }        \r\n                    else\r\n                        break;\r\n            }    \r\n           rm_multipage.global_page_no_form_13_2++;\t\t       \r\n        }*\/\r\n          \t\t\r\n\tif(rm_multipage.global_page_no_form_13_2 >= maxpage){\r\n            jq_next_button.attr(\"value\", sub_label);\r\n        }\r\n\tif(maxpage < rm_multipage.global_page_no_form_13_2)\r\n\t{\r\n\t\trm_multipage.global_page_no_form_13_2 = maxpage;\r\n\t\tjq_next_button.prop('type','submit');\r\n                jq_prev_button.prop('disabled',true);\r\n\t}\r\n        \r\n\tjQuery(\".rmformpage_form_13_2\").each(function (){\r\n        \r\n\t\tvar visibledivid = \"rm_form_page_form_13_2_\"+rm_multipage.global_page_no_form_13_2;\r\n\t\tvar current_page= jQuery(this);\r\n                    if(jQuery(this).attr('id') == visibledivid){\r\n                        setTimeout(function(){ \/\/ Delaying field show to skip validation for untouched fields\r\n                            current_page.show();\r\n                            current_page.find(':input').addClass('rm_untouched');\r\n                            setTimeout(function(){ current_page.find(':input').removeClass('rm_untouched'); }, 1000);\r\n                        },100);\r\n                }\r\n\t\telse\r\n                    current_page.hide();  \r\n        });         \r\n        \r\n        jQuery('.rmformpage_form_13_2').find(':input').filter(':visible').eq(0).focus();\r\n        jQuery('#rmagic-progressbar').animate({\r\n            scrollTop: (jQuery('.rmformpage_form_13_2').first().offset().top)\r\n        },500);\r\n        \r\n        jQuery('ul#rmagic-progressbar').children('li').each(function(index) {\r\n            if(!jQuery(this).hasClass('active')) {\r\n                jQuery(this).addClass('active');\r\n                return false;\r\n            }\r\n        });\r\n    \r\n        jq_prev_button.prop('disabled',false);\r\n        rmInitGoogleApi();\r\n        \r\n        setTimeout(function(){ submit_btn.prop('disabled',false); }, 1000);\r\n        \r\n        if(jq_prev_button.length > 0 && rm_multipage.global_page_no_form_13_2>=1){\r\n            jq_prev_button.show();\r\n        }\r\n        \r\n        if(rm_multipage.global_page_no_form_13_2 == maxpage){\r\n            return false;\r\n        }\r\n        \r\n        if(maxpage=='2'){\r\n            return true;\r\n        }\r\n        return false;\r\n           \r\n}\r\n    <\/script><\/pre><pre class='rm-pre-wrapper-for-script-tags'><script>\r\nfunction gotoprev_form_13_2(){\r\n\t\r\n\tvar maxpage = 4 ;\r\n        var jq_prev_button = jQuery(\"#rm_prev_form_page_button_13_2\");\r\n        var jq_next_button = jQuery(\"#rm_next_form_page_button_13_2\");\r\n        \/\/var sub_label = jq_next_button.data(\"label-sub\");\r\n        var next_label = jq_next_button.data(\"label-next\");\r\n        var form_object= jQuery(\"#rm_form_page_form_13_2_\"+rm_multipage.global_page_no_form_13_2).closest(\"form\");\r\n        var submit_btn= form_object.find(\"[type=submit]:not(.rm_noscript_btn)\");\r\n        var sub_label = submit_btn.data(\"label-sub\");\r\n        \/*\r\n        if(form_object.find('.rm_privacy_cb').is(':visible') && !form_object.find('.rm_privacy_cb').prop('checked')){\r\n            \/\/form_object.find('.rm_privacy_cb').trigger('change');\r\n            form_object.find('.rm_privacy_cb').focus();\r\n            form_object.find('.rm_privacy_cb').parent().parent().siblings('div.rm-form-error-message').show();\r\n            return false;\r\n        }\r\n        *\/\r\n\trm_multipage.global_page_no_form_13_2--;\r\n        jq_next_button.attr('type','button');        \r\n        \r\n        if(maxpage==rm_multipage.global_page_no_form_13_2){\r\n            submit_btn.prop('value',sub_label);\r\n            submit_btn.addClass('rm-submit-btn-show');\r\n        }\r\n        else{\r\n            submit_btn.prop('value','Next');\r\n            submit_btn.removeClass('rm-submit-btn-show');\r\n        }\r\n        \/*skip blank form pages*\/\r\n        while(jQuery(\"#rm_form_page_form_13_2_\"+rm_multipage.global_page_no_form_13_2+\" :input,.rm-total-price \").length == 0)\r\n        {\r\n            if(1 >= rm_multipage.global_page_no_form_13_2)\r\n            {\r\n                    if(jQuery(\"#rm_form_page_form_13_2_\"+rm_multipage.global_page_no_form_13_2+\" :input,.rm-total-price \").length == 0){\r\n                        rm_multipage.global_page_no_form_13_2 = 1;\r\n                        \/\/jq_prev_button.prop('disabled',true);\r\n                        return;\r\n                    }        \r\n                    else\r\n                        break;\r\n            }\r\n        \r\n            rm_multipage.global_page_no_form_13_2--;\r\n        }\r\n        \r\n        if(rm_multipage.global_page_no_form_13_2 <= maxpage-1)\r\n            jq_next_button.attr(\"value\", next_label);\r\n            \r\n\tjQuery(\".rmformpage_form_13_2\").each(function (){\r\n\t\tvar visibledivid = \"rm_form_page_form_13_2_\"+rm_multipage.global_page_no_form_13_2;\r\n\t\tif(jQuery(this).attr('id') == visibledivid){\r\n\t\t\tjQuery(this).show();\r\n                }\r\n\t\telse\r\n\t\t\tjQuery(this).hide();\r\n\t});\r\n        jQuery('.rmformpage_form_13_2').find(':input').filter(':visible').eq(0).focus();\r\n        if(rm_multipage.global_page_no_form_13_2 <= 1)\r\n        {\r\n            rm_multipage.global_page_no_form_13_2 = 1;\r\n           \/\/ jq_prev_button.prop('disabled',true);\r\n        }\r\n        jQuery('#rmagic-progressbar').animate({\r\n            scrollTop: (jQuery('.rmformpage_form_13_2').first().offset().top)\r\n        },500);\r\n        \r\n        jQuery('ul#rmagic-progressbar').children('li').each(function(index) {\r\n            if(!jQuery(this).next().hasClass('active')) {\r\n                jQuery(this).removeClass('active');\r\n                return false;\r\n            }\r\n        });\r\n        \r\n        if(rm_multipage.global_page_no_form_13_2==1){\r\n            jq_prev_button.hide();\r\n            submit_btn.prop('disabled',false);\r\n        }\r\n}\r\n         \r\n<\/script>\r\n    <script src=\"\/\/www.youtube.com\/player_api\"><\/script>\r\n    <script>\r\n    var players = [];\r\n    function onYouTubePlayerAPIReady() {\r\n        \/\/ create the global player from the specific iframe (#video)\r\n        var pre_id = '';\r\n        jQuery(\".allow-autoplay\").each(function(){\r\n            if(pre_id!=jQuery(this).attr(\"id\")){\r\n                players.push(new YT.Player(jQuery(this).attr(\"id\")));\r\n            }\r\n            pre_id = jQuery(this).attr(\"id\");\r\n        });\r\n    }\r\n    jQuery(document).ready(function(){\r\n        var videosArr = [];\r\n        var pre_id = '';\r\n        jQuery(\".allow-autoplay\").each(function(i){\r\n            if(pre_id!=jQuery(this).attr(\"id\")){\r\n                videosArr[jQuery(this).attr(\"id\")] = i;\r\n            }\r\n            pre_id = jQuery(this).attr(\"id\");\r\n        });\r\n        jQuery('.buttonarea input').click(function(){\r\n            setTimeout(function(){\r\n                jQuery(\".rmformpage_form_13_2\").each(function(){\r\n                    if(jQuery(this).css('display')=='block'){\r\n                        var page_video_id= jQuery(this).attr(\"id\");\r\n                        if(jQuery('#'+page_video_id+' .allow-autoplay').length){\r\n                            players[videosArr[jQuery('#'+page_video_id+' .allow-autoplay').attr('id')]].playVideo();\r\n                        }\r\n                    }\r\n                });\r\n            }, 300);\r\n        });\r\n    });\r\n    <\/script> \r\n   <\/pre><style type=\"text\/css\">label span.required { color: #B94A48; }span.help-inline, span.help-block { color: #888; font-size: .9em; font-style: italic; }<\/style><form novalidate onsubmit=\"return gotonext_form_13_2()\" autocomplete=\"off\" action id=\"form_13_2\" method=\"post\" class=\"rmagic-form rmagic-form-btn-right form-vertical\" name=\"rm_form\" number=\"2\"><fieldset><input type=\"hidden\" name=\"rm_form_sub_id\" value=form_13_2><input type=\"hidden\" name=\"rm_form_sub_no\" value=2><input type=\"hidden\" name=\"rm_cond_hidden_fields\" id=\"rm_cond_hidden_fields\" value=\"\"><div id=\"rm_stat_container\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-1\" style=\"\">RM_Stats<\/label><div class=\"rminput\"><input type=\"text\" name=\"stat_id\" value=\"__uninit\" style=\"display:none\" id=\"form_13_2-element-1\"\/><\/div><\/div><\/div><ul id=\"rmagic-progressbar\"><li class=\"active\"><span class=\"rm-progressbar-counter\"><\/span><span class=\"rm-form-page-name\">Basic Details<\/span><\/li><li><span class=\"rm-progressbar-counter\"><\/span><span class=\"rm-form-page-name\">Contact Details<\/span><\/li><li><span class=\"rm-progressbar-counter\"><\/span><span class=\"rm-form-page-name\">Additional Details<\/span><\/li><li><span class=\"rm-progressbar-counter\"><\/span><span class=\"rm-form-page-name\">Membership Registration<\/span><\/li><\/ul><div class=\"rm-multi-page-form rmformpage_form_13_2\" id=\"rm_form_page_form_13_2_1\"><fieldset class='rmfieldset'><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap\"><div class=\"rmagic-col rmagic-col-6\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-14\" style=\"\">First Name<\/label><div class=\"rminput\"><input type=\"text\" name=\"Fname_226\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_2-element-14\"\/><\/div><\/div><\/div><div class=\"rmagic-col rmagic-col-6\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-17\" style=\"\">Last Name<\/label><div class=\"rminput\"><input type=\"text\" name=\"Lname_227\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_2-element-17\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"rm_reg_form_email_13_2\" style=\"\">Email<\/label><div class=\"rminput\"><input type=\"email\" name=\"Email_210\" required id=\"rm_reg_form_email_13_2\"\/><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div><div class=\"rm_form_page rmformpage_form_13_2\" id=\"rm_form_page_form_13_2_2\"><fieldset class='rmfieldset'><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"autocompleteAddress_212\" style=\"\">Home Address<\/label><div class=\"rminput\">\r\n        <div id=\"address\" class=\"rm_address_type_ca\">\r\n            <div class=\"rm_ad_container\">       \r\n                                                    <div class=\"slimField rm-address-fw\">\r\n                                <input type=\"text\"  class=\"field\" id=\"Address_212_address1\"\r\n                                placeholder=\"\"\r\n                                required                                name=\"Address_212[address1]\" value=\"\" ><\/input>\r\n\r\n                                                                    <div class=\"label\">Address Line 1                                        \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                 \r\n                                    \r\n                                    <\/div>\r\n                                 \r\n                           \r\n                            <\/div>\r\n                                                \r\n                                                    <div class=\"wideField rm-semi-field rm-address-fw\" colspan=\"2\">\r\n                                <input type=\"text\"  class=\"field\" id=\"Address_212_route\"\r\n                                                                              placeholder=\"\"\r\n                                       name=\"Address_212[address2]\" value=\"\" ><\/input>\r\n                                                                    <div class=\"label\">Address Line 2                                      \r\n                                    \r\n                                    <\/div>\r\n                                    \r\n                            \r\n                            <\/div>\r\n                                    <\/div>\r\n            \r\n                        \r\n            <div class=\"rm_ad_container\">\r\n                                            <div class=\"wideField rm-alone rm-address-hw\" colspan=\"3\">\r\n                            <input type=\"text\" class=\"\" name=\"Address_212[city]\" \r\n                                   id=\"Address_212_locality\" name=\"Address_212[city]\"                      \r\n                                   required                                   placeholder=\"\"\r\n                                   value=\"\" \/>    \r\n                                                            <div class=\"label\">City                                    \r\n                                <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                                               \r\n                                <\/div>\r\n                                                     \r\n                        <\/div>\r\n                                        \r\n                                                                \r\n                \r\n                                                    <div class=\"slimField rm-address-hw\">\r\n                                <select  class=\"field\" required                                        id=\"Address_212_administrative_area_level_1\"  \r\n                                        name=\"Address_212[state]\" value=\"\" >\r\n                                    <option value=\"\">State or Region<\/option>\r\n                                                                                                                                                                   \r\n                                                 <option>Alabama<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Alaska<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Arizona<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Arkansas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces America<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces Europe<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces Pacific<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>California<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Colorado<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Connecticut<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Delaware<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>District Of Columbia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Florida<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Georgia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Hawaii<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Idaho<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Illinois<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Indiana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Iowa<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Kansas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Kentucky<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Louisiana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Maine<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Maryland<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Massachusetts<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Michigan<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Minnesota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Mississippi<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Missouri<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Montana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Nebraska<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Nevada<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Hampshire<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Jersey<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Mexico<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New York<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>North Carolina<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>North Dakota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Ohio<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Oklahoma<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Oregon<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Pennsylvania<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Rhode Island<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>South Carolina<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>South Dakota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Tennessee<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Texas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Utah<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Vermont<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Virginia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Washington<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>West Virginia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Wisconsin<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Wyoming<\/option>\r\n                                                 \r\n                                       \r\n                                <\/select>\r\n                                                                    <div class=\"label\">State or Region                                                \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                 \r\n                                    <\/div>\r\n                                 \r\n                           \r\n                            <\/div>\r\n                        \r\n                                                \r\n                \r\n                                 <\/div>\r\n            \r\n            <div class=\"rm_ad_container\">\r\n                     \r\n                    \r\n                                            <div class=\"wideField rm-semi-field-with-label rm-address-hw\">\r\n                                <input type=\"text\" onchange=\"rm_validate_zipcode('Address_212')\"  class=\"field\" id=\"Address_212_postal_code\" \r\n                                        required                                        placeholder=\"\"\r\n                                        name=\"Address_212[zip]\" value=\"\" ><\/input> \r\n                                                                    <div class=\"label label-short\">Zip                                    \r\n                                               \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                   \r\n                                    <\/div>\r\n                                                          \r\n                        <\/div>\r\n                     \r\n                    \r\n            <\/div>\r\n            \r\n        <\/div>\r\n\r\n        <\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-6\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-42\" style=\"\">Business Phone<\/label><div class=\"rminput\"><input type=\"text\" name=\"Phone_213\" placeholder=\"000-000-0000\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation pattern=\"^(\\d[\\s-]?)?[\\(\\[\\s-]{0,2}?\\d{3}[\\)\\]\\s-]{0,2}?\\d{3}[\\s-]?\\d{4}$\" id=\"form_13_2-element-42\"\/><\/div><\/div><\/div><div class=\"rmagic-col rmagic-col-6\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"rm_mobile_214_13_2\" style=\"\">Mobile Phone<\/label><div class=\"rminput\"><input type=\"text\" name=\"Mobile_214\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"rm_mobile_214_13_2\" data-error-message=\"This does not appear to be a valid mobile number.\" placeholder=\"(999) 999-9999\" pattern=\".{14}\"\/><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div><div class=\"rm_form_page rmformpage_form_13_2\" id=\"rm_form_page_form_13_2_3\"><fieldset class='rmfieldset'><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-56\" style=\"\">Title<\/label><div class=\"rminput\"><input type=\"text\" name=\"Textbox_215\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_2-element-56\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-63\" style=\"\">Employer<\/label><div class=\"rminput\"><input type=\"text\" name=\"Textbox_216\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_2-element-63\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"autocompleteAddress_217\" style=\"\">Business Address<\/label><div class=\"rminput\">\r\n        <div id=\"address\" class=\"rm_address_type_ca\">\r\n            <div class=\"rm_ad_container\">       \r\n                                                    <div class=\"slimField rm-address-fw\">\r\n                                <input type=\"text\"  class=\"field\" id=\"Address_217_address1\"\r\n                                placeholder=\"\"\r\n                                required                                name=\"Address_217[address1]\" value=\"\" ><\/input>\r\n\r\n                                                                    <div class=\"label\">Address Line 1                                        \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                 \r\n                                    \r\n                                    <\/div>\r\n                                 \r\n                           \r\n                            <\/div>\r\n                                                \r\n                                                    <div class=\"wideField rm-semi-field rm-address-fw\" colspan=\"2\">\r\n                                <input type=\"text\"  class=\"field\" id=\"Address_217_route\"\r\n                                                                              placeholder=\"\"\r\n                                       name=\"Address_217[address2]\" value=\"\" ><\/input>\r\n                                                                    <div class=\"label\">Address Line 2                                      \r\n                                    \r\n                                    <\/div>\r\n                                    \r\n                            \r\n                            <\/div>\r\n                                    <\/div>\r\n            \r\n                        \r\n            <div class=\"rm_ad_container\">\r\n                                            <div class=\"wideField rm-alone rm-address-hw\" colspan=\"3\">\r\n                            <input type=\"text\" class=\"\" name=\"Address_217[city]\" \r\n                                   id=\"Address_217_locality\" name=\"Address_217[city]\"                      \r\n                                   required                                   placeholder=\"\"\r\n                                   value=\"\" \/>    \r\n                                                            <div class=\"label\">City                                    \r\n                                <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                                               \r\n                                <\/div>\r\n                                                     \r\n                        <\/div>\r\n                                        \r\n                                                                \r\n                \r\n                                                    <div class=\"slimField rm-address-hw\">\r\n                                <select  class=\"field\" required                                        id=\"Address_217_administrative_area_level_1\"  \r\n                                        name=\"Address_217[state]\" value=\"\" >\r\n                                    <option value=\"\">State<\/option>\r\n                                                                                                                                                                   \r\n                                                 <option>Alabama<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Alaska<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Arizona<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Arkansas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces America<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces Europe<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Armed Forces Pacific<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>California<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Colorado<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Connecticut<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Delaware<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>District Of Columbia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Florida<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Georgia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Hawaii<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Idaho<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Illinois<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Indiana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Iowa<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Kansas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Kentucky<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Louisiana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Maine<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Maryland<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Massachusetts<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Michigan<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Minnesota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Mississippi<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Missouri<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Montana<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Nebraska<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Nevada<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Hampshire<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Jersey<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New Mexico<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>New York<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>North Carolina<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>North Dakota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Ohio<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Oklahoma<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Oregon<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Pennsylvania<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Rhode Island<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>South Carolina<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>South Dakota<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Tennessee<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Texas<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Utah<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Vermont<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Virginia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Washington<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>West Virginia<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Wisconsin<\/option>\r\n                                                 \r\n                                                                                                                               \r\n                                                 <option>Wyoming<\/option>\r\n                                                 \r\n                                       \r\n                                <\/select>\r\n                                                                    <div class=\"label\">State                                                \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                 \r\n                                    <\/div>\r\n                                 \r\n                           \r\n                            <\/div>\r\n                        \r\n                                                \r\n                \r\n                                 <\/div>\r\n            \r\n            <div class=\"rm_ad_container\">\r\n                     \r\n                    \r\n                                            <div class=\"wideField rm-semi-field-with-label rm-address-hw\">\r\n                                <input type=\"text\" onchange=\"rm_validate_zipcode('Address_217')\"  class=\"field\" id=\"Address_217_postal_code\" \r\n                                        required                                        placeholder=\"\"\r\n                                        name=\"Address_217[zip]\" value=\"\" ><\/input> \r\n                                                                    <div class=\"label label-short\">Zip                                    \r\n                                               \r\n                                    <sup class=\"address_req required\">&nbsp;*<\/sup>\r\n                                   \r\n                                    <\/div>\r\n                                                          \r\n                        <\/div>\r\n                     \r\n                    \r\n            <\/div>\r\n            \r\n        <\/div>\r\n\r\n        <\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-8\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-77\" style=\"\">Law School<\/label><div class=\"rminput\"><input type=\"text\" name=\"Textbox_218\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_2-element-77\"\/><\/div><\/div><\/div><div class=\"rmagic-col rmagic-col-4\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-80\" style=\"\">Graduation Year<\/label><div class=\"rminput\"><input type=\"number\" min=\"0\" name=\"Number_219\" placeholder=\"2001\" required_max_range required_min_range field_validation custom_validation id=\"form_13_2-element-80\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-8\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-87\" style=\"\">College or University<\/label><div class=\"rminput\"><input type=\"text\" name=\"Textbox_220\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_2-element-87\"\/><\/div><\/div><\/div><div class=\"rmagic-col rmagic-col-4\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-90\" style=\"\">Degree<\/label><div class=\"rminput\"><input type=\"text\" name=\"Textbox_221\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_2-element-90\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-97\" style=\"\">Bar Admission(s) - Year<\/label><div class=\"rminput\"><div class=\"rm_field_type_repeatable_container\" id=\"rm_field_type_repeatable_container_form_13_2-element-97\"><div class=\"appendable_options\"><input type=\"text\" name=\"Repeatable_222[]\" required_max_range required_min_range rm_textbox=\"User Input\" field_validation custom_validation id=\"form_13_2-element-97\"\/><div class=\"rm_actions\" id=\"rm_add_repeatable_field\" onClick=\"rm_append_field('div','rm_field_type_repeatable_container_form_13_2-element-97')\"><a>Add<\/a><\/div><div class=\"rm_actions\" onClick=\"rm_delete_appended_field(this,'rm_field_type_repeatable_container_form_13_2-element-97')\"><a href=\"javascript:void(0)\">Delete<\/a><\/div><\/div><\/div><\/div><div class=\"rmnote\"><div class=\"rmprenote\"><\/div><div class=\"rmnotecontent\">Ex.: New York - 2021 Click \"Add\" to enter additional Bar Admission - Year<\/div><\/div><\/div><\/div><\/div><\/div><\/fieldset><\/div><div class=\"rm_form_page rmformpage_form_13_2\" id=\"rm_form_page_form_13_2_4\"><fieldset class='rmfieldset'><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-108\" style=\"\">Today's Date<\/label><div class=\"rminput\"><input type=\"text\" autocomplete=\"off\" readonly=\"1\" name=\"jQueryUIDate_229\" required required_max_range required_min_range field_validation custom_validation date_format=\"mm\/dd\/yy\" data-dateformat=\"mm\/dd\/yy\" id=\"form_13_2-element-108\"\/><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field rm_pricefield_row\"><label class=\"rmfield\" for=\"id_rm_multisel_paypal_field_224\" style=\"\">Select Membership Level<\/label><div class=\"rminput\"><select name=\"Price_224_1\" required data-rmfieldtype=\"price\" data-rmfieldprice=\"{&quot;_0&quot;:&quot;125.00&quot;,&quot;_1&quot;:&quot;100.00&quot;,&quot;_2&quot;:&quot;50.00&quot;,&quot;_3&quot;:&quot;0.00&quot;,&quot;_4&quot;:&quot;100.00&quot;,&quot;_5&quot;:&quot;25.00&quot;}\" id=\"id_rm_multisel_paypal_field_224\" class><option value=\"\">Select an option<\/option><option value=\"_0\">Attorneys Admitted 10+ Years ($ 125.00)<\/option><option value=\"_1\">Attorneys Admitted 6-10 Years ($ 100.00)<\/option><option value=\"_2\">Attorneys Admitted 1-5 Years ($ 50.00)<\/option><option value=\"_3\">New Attorneys and Law Students ($ 0.00)<\/option><option value=\"_4\">Judiciary, Government &amp; Non-Profit Employees ($ 100.00)<\/option><option value=\"_5\">Non-Attorneys ($ 25.00)<\/option><\/select><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class='rmrow'><div class='rm-total-price-widget ' data-rmpriceformat='{\"loc_total_text\":\"Total Price: %s\",\"symbol\":\"$\",\"pos\":\"before\"}'><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row\" data-bmargin=\"0\"><div class=\"rmagic-fields-wrap rm-gutter-10\"><div class=\"rmagic-col rmagic-col-12\"><div class=\"rmagic-field\"><label class=\"rmfield\" for=\"form_13_2-element-129\" style=\"\">\u26a0 Payment Confirmation Required<\/label><div class=\"rminput\"><div id='rm_terms_textarea' class='rm_terms_textarea'><textarea  onscroll='' readonly  id='rm_terms_area_Terms_235' class='rm_terms_area'>Do not close or leave this page until the payment window appears. After submitting this form the payment window will pop up in a few seconds. Your membership will not be activated unless payment is successfully processed.<\/textarea><\/div><div class='rm_terms_checkbox'><input   value='on' type='checkbox' rows=\"5\" name=\"Terms_235\" required required_max_range required_min_range field_validation custom_validation id=\"form_13_2-element-129\" class='rm_check_box'>I understand and will complete payment before closing this page.<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"rmagic-row rm_payment_options\"><input type=\"hidden\" name=\"rm_payment_method\" value=\"anet_sim\" id=\"form_13_2-element-134\"\/><\/div><\/fieldset><\/div><div class=\"buttonarea\"><input   type=\"button\" value=\"Prev\" name=\"rm_prev_btn\" class=\"rm_prev_btn rm-btn\" id=\"rm_prev_form_page_button_13_2\" onclick=\"gotoprev_form_13_2()\" disabled=\"1\"\/> <input   type=\"submit\" value=\"Next\" name=\"rm_sb_btn\" class=\"rm_next_btn rm-btn rm-btn-primary button button-primary\" data-label-next=\"Next\" data-label-sub=\"Submit\" id=\"form_13_2-element-139\"\/> <input   type=\"submit\" value=\"Submit\" name class=\"rm_noscript_btn rm-btn rm-btn-primary button button-primary\" id=\"form_13_2-element-140\"\/><\/div><\/fieldset><\/form><pre class=\"rm-pre-wrapper-for-script-tags\"><script type=\"text\/javascript\">jQuery(document).ready(function() {\t\tjQuery(\"#form_13_2\").bind(\"submit\", function(){\n                        \/\/jQuery(this).find(\"input[name=rm_slug]\").attr(\"value\",jQuery(this).find(\"input[name=submit]\").attr(\"value\"));\n\t\t\tjQuery(this).find(\"input[type=submit]\").attr(\"disabled\", \"disabled\"); \n\t\t});            \n                   \n                   jQuery(\"#rm_reg_form_email_13_2\").change(function(){\n                   var data = {\n                           'action': 'rm_user_exists',\n                           'rm_sec_nonce': '1b66a91f8d',\n                           'rm_slug': 'rm_user_exists',\n                           'email': jQuery(this).val(),\n                           'attr': 'data-rm-valid-email',\n                           'form_id':\"13\"\n                   };\n                   \n                   rm_user_exists(this,rm_ajax_url,data);\n                  \n                 });\n                   jQuery(\"#form_13_2-element-108\").datepicker({\n                                        dateFormat:\"mm\/dd\/yy\",\n                                        changeMonth:true,\n                                        changeYear:true,\n                                        yearRange: '1900:+50',\n                                        beforeShow: function(input, inst){\n                                                        if(inst.id === \"form_13_2-element-108\") {\n                                                            jQuery(\"#ui-datepicker-div\").addClass(\"rm_jqui_element\");\n                                                        } else {\n                                                            jQuery(\"#ui-datepicker-div\").removeClass(\"rm_jqui_element\");\n                                                        }\n                                                    }\n                                    });}); <\/script><\/pre>        <noscript>\n            <div class=\"rm-js-disabled\"><b>Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.<\/b><\/div>\n            <style>\n                .rm_next_btn {display:none !important}\n                .rm_noscript_btn {display: block !important}\n            <\/style>\n        <\/noscript>\n    <\/div><\/div><!--\/noptimize--><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"[et_pb_section fb_built=\"1\" _builder_version=\"4.22.2\" _module_preset=\"default\" custom_padding=\"0px||0px||false|false\" global_colors_info=\"{}\"][et_pb_row _builder_version=\"4.22.2\" _module_preset=\"default\" width=\"90%\" max_width=\"1150px\" global_colors_info=\"{}\"][et_pb_column type=\"4_4\" _builder_version=\"4.22.2\" _module_preset=\"default\" global_colors_info=\"{}\"][et_pb_text _builder_version=\"4.22.2\" _module_preset=\"default\" text_font=\"||||||||\" text_text_color=\"#000000\" global_colors_info=\"{}\"][wpseo_breadcrumb][\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=\"1\" _builder_version=\"4.22.2\" custom_margin=\"0px||||false|false\" custom_padding=\"0px||10px||false|false\" global_colors_info=\"{}\"][et_pb_row column_structure=\"1_2,1_2\" _builder_version=\"4.23.1\" background_size=\"initial\" background_position=\"top_left\" background_repeat=\"repeat\" max_width=\"1150px\" custom_padding=\"0px||||false|false\" global_colors_info=\"{}\"][et_pb_column type=\"1_2\" _builder_version=\"4.16\" custom_padding=\"|||\" global_colors_info=\"{}\" custom_padding__hover=\"|||\"][et_pb_text _builder_version=\"4.22.2\" _module_preset=\"default\" header_font=\"|||on|||||\" header_font_size=\"42px\" custom_margin=\"||5px||false|false\" custom_padding=\"||0px||false|false\" global_colors_info=\"{}\"]<h1 style=\"text-align: left;\">Become a Member<\/h1>[\/et_pb_text][et_pb_divider color=\"#DB1C22\" divider_weight=\"2px\" _builder_version=\"4.22.2\" _module_preset=\"default\" width=\"100px\" custom_margin=\"||10px||false|false\" global_colors_info=\"{}\"][\/et_pb_divider][et_pb_text ul_item_indent=\"20px\" _builder_version=\"4.23.1\" _module_preset=\"default\" global_colors_info=\"{}\"]<h3>Membership Benefits: CLEs | Mentorship | Scholarship | Fellowship<\/h3>\n<p>Please join the PRBA as a member to access contact details on fellow PRBA members. PRBA Membership also offers access to valuable resource materials and CLE certified live and \"on demand\" content in your area of law, as well as job placement information, networking events, and career enhancing tools for success.<\/p>\n<p>As a member, you have your own personalized contact page as well as the ability to message your fellow members directly, participate in committee communications and more.<\/p>[\/et_pb_text][et_pb_text _builder_version=\"4.23.1\" _module_preset=\"default\" header_font=\"|||on|||||\" header_font_size=\"42px\" custom_margin=\"||5px||false|false\" custom_padding=\"||0px||false|false\" global_colors_info=\"{}\"]<h2 style=\"text-align: left;\">How to Become a Member<\/h2>[\/et_pb_text][et_pb_divider color=\"#DB1C22\" divider_weight=\"2px\" _builder_version=\"4.22.2\" _module_preset=\"default\" width=\"100px\" custom_margin=\"||10px||false|false\" global_colors_info=\"{}\"][\/et_pb_divider][et_pb_text ul_item_indent=\"20px\" _builder_version=\"4.24.2\" _module_preset=\"default\" global_colors_info=\"{}\"]<p>Annual Membership rates:<\/p>\n<ul>\n<li>Attorneys admitted less than 1 year | Law Students | Recent Law School Graduates: FREE<\/li>\n<li>Non-Attorneys: $25.00<\/li>\n<li>Attorneys Admitted 1-5 Years: $50.00<\/li>\n<li>Attorneys Admitted 6-10 Years: $100.00<\/li>\n<li>Attorneys Admitted 10+ Years: $125.00<\/li>\n<li>Judiciary, Government, Non-Profit Employees: $100.00<\/li>\n<\/ul>\n<p>For any questions about membership, including the PRBA hardship rate, please contact us:<\/p>\n<p>President, Jason Canales, Esq at <a href=\"mailto:president@prbany.com\">president@prbany.com<\/a><\/p>[\/et_pb_text][\/et_pb_column][et_pb_column type=\"1_2\" _builder_version=\"4.16\" custom_padding=\"|||\" global_colors_info=\"{}\" custom_padding__hover=\"|||\"][et_pb_image src=\"https:\/\/prbany.wpenginepowered.com\/wp-content\/uploads\/2023\/11\/Sample-Member-Page-Logged-In.png\" alt=\"member sample page\" title_text=\"Sample Member Page Logged In\" _builder_version=\"4.23.1\" _module_preset=\"default\" border_width_all=\"1px\" border_color_all=\"rgba(0,0,0,0.15)\" box_shadow_style=\"preset1\" box_shadow_blur=\"8px\" global_colors_info=\"{}\"][\/et_pb_image][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\"4.22.2\" background_size=\"initial\" background_position=\"top_left\" background_repeat=\"repeat\" max_width=\"1150px\" custom_padding=\"0px||||false|false\" global_colors_info=\"{}\"][et_pb_column type=\"4_4\" _builder_version=\"4.16\" custom_padding=\"|||\" global_colors_info=\"{}\" custom_padding__hover=\"|||\"][et_pb_text _builder_version=\"4.23.1\" _module_preset=\"default\" header_font=\"|||on|||||\" header_font_size=\"42px\" custom_margin=\"||5px||false|false\" custom_padding=\"||0px||false|false\" hover_enabled=\"0\" global_colors_info=\"{}\" sticky_enabled=\"0\"]<h2 style=\"text-align: left;\">Membership Enrollment Form<\/h2>[\/et_pb_text][et_pb_divider color=\"#DB1C22\" divider_weight=\"2px\" _builder_version=\"4.22.2\" _module_preset=\"default\" width=\"100px\" custom_margin=\"||10px||false|false\" global_colors_info=\"{}\"][\/et_pb_divider][et_pb_text _builder_version=\"4.22.2\" _module_preset=\"default\" global_colors_info=\"{}\"]<p><strong>Please use the form below to complete your membership and submit payment. You will receive additional instructions via email.<\/strong><\/p>[\/et_pb_text][et_pb_text _builder_version=\"4.24.2\" background_size=\"initial\" background_position=\"top_left\" background_repeat=\"repeat\" hover_enabled=\"0\" global_colors_info=\"{}\" sticky_enabled=\"0\"]<p><b class=\"rm-shortcode-tour\">[RM_Form id='3']<\/b><\/p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]","_et_gb_content_width":"","footnotes":""},"class_list":["post-6369","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Membership Renewal - Puerto Rican Bar Association of New York<\/title>\n<meta name=\"robots\" content=\"noindex, follow\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Membership Renewal - Puerto Rican Bar Association of New York\" \/>\n<meta property=\"og:description\" content=\"Membership Renewal FormPlease complete the form below to renew your PRBANY Membership.Please note: This form is only for previous members who need to renew their credentials. If you are unsure if you have a prior membership due for renewal, please contact Julia Galban-Carter at executivedirector@prbany.com.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/prbany.com\/es\/membership-renewal\/\" \/>\n<meta property=\"og:site_name\" content=\"Puerto Rican Bar Association of New York\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/puertoricanbarassoicationny\/\" \/>\n<meta property=\"article:modified_time\" content=\"2025-08-15T13:27:32+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@prbany\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minuto\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/prbany.com\\\/membership-renewal\\\/\",\"url\":\"https:\\\/\\\/prbany.com\\\/membership-renewal\\\/\",\"name\":\"Membership Renewal - Puerto Rican Bar Association of New York\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/prbany.com\\\/#website\"},\"datePublished\":\"2024-03-23T00:49:11+00:00\",\"dateModified\":\"2025-08-15T13:27:32+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/prbany.com\\\/membership-renewal\\\/#breadcrumb\"},\"inLanguage\":\"es\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/prbany.com\\\/membership-renewal\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/prbany.com\\\/membership-renewal\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/prbany.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Membership Renewal\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/prbany.com\\\/#website\",\"url\":\"https:\\\/\\\/prbany.com\\\/\",\"name\":\"Puerto Rican Bar Association of New York\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/prbany.com\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/prbany.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"es\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/prbany.com\\\/#organization\",\"name\":\"Puerto Rican Bar Association of New York\",\"url\":\"https:\\\/\\\/prbany.com\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\\\/\\\/prbany.com\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/prbany.wpenginepowered.com\\\/wp-content\\\/uploads\\\/2023\\\/09\\\/PRBA-Logo1.png\",\"contentUrl\":\"https:\\\/\\\/prbany.wpenginepowered.com\\\/wp-content\\\/uploads\\\/2023\\\/09\\\/PRBA-Logo1.png\",\"width\":563,\"height\":123,\"caption\":\"Puerto Rican Bar Association of New York\"},\"image\":{\"@id\":\"https:\\\/\\\/prbany.com\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/puertoricanbarassoicationny\\\/\",\"https:\\\/\\\/x.com\\\/prbany\",\"https:\\\/\\\/www.instagram.com\\\/prbany\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Renovaci\u00f3n de membres\u00eda - Puerto Rican Bar Association of New York","robots":{"index":"noindex","follow":"follow"},"og_locale":"es_ES","og_type":"article","og_title":"Membership Renewal - Puerto Rican Bar Association of New York","og_description":"Membership Renewal FormPlease complete the form below to renew your PRBANY Membership.Please note: This form is only for previous members who need to renew their credentials. If you are unsure if you have a prior membership due for renewal, please contact Julia Galban-Carter at executivedirector@prbany.com.","og_url":"https:\/\/prbany.com\/es\/membership-renewal\/","og_site_name":"Puerto Rican Bar Association of New York","article_publisher":"https:\/\/www.facebook.com\/puertoricanbarassoicationny\/","article_modified_time":"2025-08-15T13:27:32+00:00","twitter_card":"summary_large_image","twitter_site":"@prbany","twitter_misc":{"Est. reading time":"1 minuto"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/prbany.com\/membership-renewal\/","url":"https:\/\/prbany.com\/membership-renewal\/","name":"Renovaci\u00f3n de membres\u00eda - Puerto Rican Bar Association of New York","isPartOf":{"@id":"https:\/\/prbany.com\/#website"},"datePublished":"2024-03-23T00:49:11+00:00","dateModified":"2025-08-15T13:27:32+00:00","breadcrumb":{"@id":"https:\/\/prbany.com\/membership-renewal\/#breadcrumb"},"inLanguage":"es","potentialAction":[{"@type":"ReadAction","target":["https:\/\/prbany.com\/membership-renewal\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/prbany.com\/membership-renewal\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/prbany.com\/"},{"@type":"ListItem","position":2,"name":"Membership Renewal"}]},{"@type":"WebSite","@id":"https:\/\/prbany.com\/#website","url":"https:\/\/prbany.com\/","name":"Colegio de Abogados Puertorrique\u00f1os de Nueva York","description":"","publisher":{"@id":"https:\/\/prbany.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/prbany.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"es"},{"@type":"Organization","@id":"https:\/\/prbany.com\/#organization","name":"Colegio de Abogados Puertorrique\u00f1os de Nueva York","url":"https:\/\/prbany.com\/","logo":{"@type":"ImageObject","inLanguage":"es","@id":"https:\/\/prbany.com\/#\/schema\/logo\/image\/","url":"https:\/\/prbany.wpenginepowered.com\/wp-content\/uploads\/2023\/09\/PRBA-Logo1.png","contentUrl":"https:\/\/prbany.wpenginepowered.com\/wp-content\/uploads\/2023\/09\/PRBA-Logo1.png","width":563,"height":123,"caption":"Puerto Rican Bar Association of New York"},"image":{"@id":"https:\/\/prbany.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/puertoricanbarassoicationny\/","https:\/\/x.com\/prbany","https:\/\/www.instagram.com\/prbany\/"]}]}},"_links":{"self":[{"href":"https:\/\/prbany.com\/es\/wp-json\/wp\/v2\/pages\/6369","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/prbany.com\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/prbany.com\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/prbany.com\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/prbany.com\/es\/wp-json\/wp\/v2\/comments?post=6369"}],"version-history":[{"count":0,"href":"https:\/\/prbany.com\/es\/wp-json\/wp\/v2\/pages\/6369\/revisions"}],"wp:attachment":[{"href":"https:\/\/prbany.com\/es\/wp-json\/wp\/v2\/media?parent=6369"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}