{"id":8388,"date":"2021-09-24T13:31:18","date_gmt":"2021-09-24T11:31:18","guid":{"rendered":"https:\/\/www.alceepilepsia.org\/?page_id=8388"},"modified":"2021-09-24T18:09:41","modified_gmt":"2021-09-24T16:09:41","slug":"hazte-test","status":"publish","type":"page","link":"https:\/\/alceepilepsia.org\/va\/hazte-test\/","title":{"rendered":"Hazte Test"},"content":{"rendered":"<p>Si por otro lado quieres realizar el alta por un formulario impreso debes:\u00a0<a href=\"https:\/\/alceepilepsia.com\/wp-content\/uploads\/2018\/07\/HazteSocio2018-2.pdf\" target=\"_blank\" rel=\"noopener\">Descargar este Impreso Aqui<\/a><\/p>\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_2' style='display:none'><div id='gf_2' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/va\/wp-json\/wp\/v2\/pages\/8388#gf_2' data-formid='2' novalidate>\n        <div id='gf_progressbar_wrapper_2' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>5<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_spring' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_spring percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_2_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_2_2\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Solicito ser dado\/a de alta como asociado\/a en la Asociaci\u00f3n de Epilepsia de la Comunidad Valenciana, ALCE y me comprometo a cumplir con lo establecido en los Estatutos de la Asociaci\u00f3n.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_2'>\n\t\t\t<div class='gchoice gchoice_2_2_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_2' type='radio' value='Si'  id='choice_2_2_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_2_0' id='label_2_2_0' class='gform-field-label gform-field-label--type-inline'>Si<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_2_3' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_2' class='gform_page' data-js='page-field-id-3' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_2_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Datos Personales<\/h3><\/div><div id=\"field_2_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_4'><span class='gform-field-label__text'>Nombre<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_2_4' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_5\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_5'><span class='gform-field-label__text'>Apellidos<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_2_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_2_8\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Edad<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_2_8' class='ginput_container ginput_complex gform-grid-row'>\n                                    <div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_2_8_2_container'>\n                                        <input type='number' maxlength='2' name='input_8[]' id='input_2_8_2' value='DD'   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                        <label for='input_2_8_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                    <\/div><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_2_8_1_container'>\n                                    <input type='number' maxlength='2' name='input_8[]' id='input_2_8_1' value='MM'   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                    <label for='input_2_8_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                               <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_2_8_3_container'>\n                                    <input type='number' maxlength='4' name='input_8[]' id='input_2_8_3' value='AAAA'   aria-required='true'   placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                    <label for='input_2_8_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                               <\/div>\n                            <\/div><div class='gfield_description' id='gfield_description_2_8'>Solo se pueden introducir n\u00fameros en este campo.\n<\/div><\/fieldset><div id=\"field_2_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_10'><span class='gform-field-label__text'>DNI \/ NIF<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_2_10' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_2_12' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Anterior<\/button> <button type='button' id='gform_next_button_2_12' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_3' class='gform_page' data-js='page-field-id-12' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_2_13\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Datos de Contacto<\/h3><\/div><div id=\"field_2_14\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_14'><span class='gform-field-label__text'>Correo electr\u00f3nico<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_14' id='input_2_14' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_2_14\" \/>\n                        <\/div><div class='gfield_description' id='gfield_description_2_14'> Por favor compruebe el formato de su respuesta.\n<\/div><\/div><fieldset id=\"field_2_17\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Direcci\u00f3n<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_2_17' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_2_17_1_container' >\n                                        <label for='input_2_17_1' id='input_2_17_1_label' class='gform-field-label gform-field-label--type-sub '>Calle, n\u00famero, piso, letra<\/label>\n                                        <input type='text' name='input_17.1' id='input_2_17_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_2_17_3_container' >\n                                    <label for='input_2_17_3' id='input_2_17_3_label' class='gform-field-label gform-field-label--type-sub '>Poblaci\u00f3n<\/label>\n                                    <input type='text' name='input_17.3' id='input_2_17_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_2_17_4_container' >\n                                        <label for='input_2_17_4' id='input_2_17_4_label' class='gform-field-label gform-field-label--type-sub '>Provincia<\/label>\n                                        <input type='text' name='input_17.4' id='input_2_17_4' value=''      aria-required='true'    \/>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_2_17_5_container' >\n                                    <label for='input_2_17_5' id='input_2_17_5_label' class='gform-field-label gform-field-label--type-sub '>C\u00f3digo Postal<\/label>\n                                    <input type='text' name='input_17.5' id='input_2_17_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_17.6' id='input_2_17_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_2_18\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_18'><span class='gform-field-label__text'>Tel\u00e9fono-1<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_18' id='input_2_18' type='tel' value='xxx xxx xxx' class='medium'  placeholder='Fijo' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_2_18\"   \/><\/div><div class='gfield_description' id='gfield_description_2_18'>Movil\/ Fijo<\/div><\/div><div id=\"field_2_19\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_19'><span class='gform-field-label__text'>Tel\u00e9fono-2<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_19' id='input_2_19' type='tel' value='xxx xxx xxx' class='medium'  placeholder='Movil'  aria-invalid=\"false\" aria-describedby=\"gfield_description_2_19\"   \/><\/div><div class='gfield_description' id='gfield_description_2_19'>Movil\/ Fijo<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_2_20' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Anterior<\/button> <button type='button' id='gform_next_button_2_20' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_4' class='gform_page' data-js='page-field-id-20' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_2_21\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Otros Datos (Menor)<\/h3><div class='gsection_description' id='gfield_description_2_21'>Introduzca los datos del menor o seleccione 'Siguiente'\n<\/div><\/div><div id=\"field_2_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_22'><span class='gform-field-label__text'>Nombre del Menor<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_2_22' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_2_23\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Edad<\/span><\/legend><div id='input_2_23' class='ginput_container ginput_complex gform-grid-row'>\n                                    <div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_2_23_2_container'>\n                                        <input type='number' maxlength='2' name='input_23[]' id='input_2_23_2' value=''   aria-required='false'   placeholder='dd' min='1' max='31' step='1'\/>\n                                        <label for='input_2_23_2' class='gform-field-label gform-field-label--type-sub '>DD<\/label>\n                                    <\/div><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_2_23_1_container'>\n                                    <input type='number' maxlength='2' name='input_23[]' id='input_2_23_1' value=''   aria-required='false'   placeholder='mm' min='1' max='12' step='1'\/>\n                                    <label for='input_2_23_1' class='gform-field-label gform-field-label--type-sub '>MM<\/label>\n                               <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_2_23_3_container'>\n                                    <input type='number' maxlength='4' name='input_23[]' id='input_2_23_3' value=''   aria-required='false'   placeholder='aaaa' min='1920' max='2027' step='1'\/>\n                                    <label for='input_2_23_3' class='gform-field-label gform-field-label--type-sub '>YYYY<\/label>\n                               <\/div>\n                            <\/div><\/fieldset><div id=\"field_2_24\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_24'><span class='gform-field-label__text'>Observaciones<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_2_24' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_2_26' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Anterior<\/button> <button type='button' id='gform_next_button_2_26' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Siguiente<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_5' class='gform_page' data-js='page-field-id-26' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_2_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_2_25\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Formas de Pago Para Darse de Alta Como Asociados<\/h3><div class='gsection_description' id='gfield_description_2_25'>Domiciliaci\u00f3n Bancaria online\n<\/div><\/div><fieldset id=\"field_2_27\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>ELIGE UNA OPCION<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_2_27'> Seleccione una de las siguientes opciones\n<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_27'>\n\t\t\t<div class='gchoice gchoice_2_27_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='60\u20ac Anual'  id='choice_2_27_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_2_27\"   \/>\n\t\t\t\t\t<label for='choice_2_27_0' id='label_2_27_0' class='gform-field-label gform-field-label--type-inline'>60\u20ac Anual<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_27_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_27' type='radio' value='30\u20ac Semestral'  id='choice_2_27_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_27_1' id='label_2_27_1' class='gform-field-label gform-field-label--type-inline'>30\u20ac Semestral<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_28\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_28'><span class='gform-field-label__text'>Titular de la Cuenta<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_2_28' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_2_36\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Datos Bancarios<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_2_36'>\n\t\t\t<div class='gchoice gchoice_2_36_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Completa los datos bancarios por campos individuales' checked='checked' id='choice_2_36_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_36_0' id='label_2_36_0' class='gform-field-label gform-field-label--type-inline'>Completa los datos bancarios por campos individuales<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_2_36_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_36' type='radio' value='Introduce IBAN Completo'  id='choice_2_36_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_2_36_1' id='label_2_36_1' class='gform-field-label gform-field-label--type-inline'>Introduce IBAN Completo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_2_34\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_34'><span class='gform-field-label__text'>Datos Bancarios - IBAN<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='4' data-text-counter-template='{current} of {max} max characters'><input name='input_34' id='input_2_34' type='text' value='ES..' class='small' maxlength='4'   placeholder='ESxx' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_29'><span class='gform-field-label__text'>Entidad<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='4' data-text-counter-template='{current} of {max} max characters'><input name='input_29' id='input_2_29' type='text' value='' class='medium' maxlength='4'   placeholder='xxxx' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_30'><span class='gform-field-label__text'>Oficina<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='4' data-text-counter-template='{current} of {max} max characters'><input name='input_30' id='input_2_30' type='text' value='' class='medium' maxlength='4'   placeholder='xxxx' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_31\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_31'><span class='gform-field-label__text'>DC<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='2' data-text-counter-template='{current} of {max} max characters'><input name='input_31' id='input_2_31' type='text' value='' class='medium' maxlength='2'   placeholder='xxxx' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_2_32\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_32'><span class='gform-field-label__text'>N\u00famero de Cuenta<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='10' data-text-counter-template='{current} of {max} max characters'><input name='input_32' id='input_2_32' type='text' value='' class='large' maxlength='10' aria-describedby=\"gfield_description_2_32\"  placeholder='xxxxxxxxxx' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_2_32'>Introduce los 10 d\u00edgitos del n\u00famero de cuenta<\/div><\/div><div id=\"field_2_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_37'><span class='gform-field-label__text'>IBAN<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='29' data-text-counter-template='{current} of {max} max characters'><input name='input_37' id='input_2_37' type='text' value='' class='large' maxlength='29' aria-describedby=\"gfield_description_2_37\"  placeholder='ESXX-XXXX-XXXX-XXXX-XXXX-XXXX' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_2_37'>Indica los 24 digitos del IBAN <\/div><\/div><div id=\"field_2_35\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_35'><span class='gform-field-label__text'>Comentarios adicionales<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_35' id='input_2_35' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_2' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Anterior<\/button> <button type='submit' id='gform_submit_button_2' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Enviar<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_2' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_2' id='gform_theme_2' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_2' id='gform_style_settings_2' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_2' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='2' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='EUR' value='JuH\/Nksn9yqx9n+Ydmfc1FrxTVfokv3THwwQ2fM0NGDdrJsKB1XTJPHNJOSODjJDRc26H26odlAXxSBZRXHk2yl4L2LUUXtJnT0f7Ids2nayxU4=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_2' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_2' id='gform_target_page_number_2' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_2' id='gform_source_page_number_2' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"10\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><\/form>\n                        <\/div>\n<p>AVISO LEGAL.<br \/>\nEn cumplimiento de lo establecido en la Ley Org\u00e1nica de Protecci\u00f3n de Datos 15\/99 de 13 de diciembre y el RD 1720\/2007 de 21 de diciembre, le informamos que sus datos forman parte de un fichero automatizado titularidad de ALCE, Asociaci\u00f3n de Epilepsia de la Comunidad Valenciana para informarle de las actividades de la entidad y de temas relacionados con la misma. En cualquier momento usted puede ejercitar sus derechos de acceso, oposici\u00f3n, rectificaci\u00f3n y cancelaci\u00f3n, mediante escrito dirigido a: ALCE, C\/ Periodista Llorente, n\u00ba3 bajo derecha, 46009 Valencia o enviando un e-mail a\u00a0<a href=\"mailto:comunicacion@alceepilepsia.org\">comunicacion@alceepilepsia.org<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Si por otro lado quieres realizar el alta por un formulario impreso debes:\u00a0Descargar este Impreso Aqui AVISO LEGAL. En cumplimiento de lo establecido en la Ley Org\u00e1nica de Protecci\u00f3n de Datos 15\/99 de 13 de diciembre y el RD 1720\/2007 de 21 de diciembre, le informamos que sus datos forman parte de un fichero automatizado [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8388","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/alceepilepsia.org\/va\/wp-json\/wp\/v2\/pages\/8388","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/alceepilepsia.org\/va\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/alceepilepsia.org\/va\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/alceepilepsia.org\/va\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/alceepilepsia.org\/va\/wp-json\/wp\/v2\/comments?post=8388"}],"version-history":[{"count":3,"href":"https:\/\/alceepilepsia.org\/va\/wp-json\/wp\/v2\/pages\/8388\/revisions"}],"predecessor-version":[{"id":8392,"href":"https:\/\/alceepilepsia.org\/va\/wp-json\/wp\/v2\/pages\/8388\/revisions\/8392"}],"wp:attachment":[{"href":"https:\/\/alceepilepsia.org\/va\/wp-json\/wp\/v2\/media?parent=8388"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}