{"id":311,"date":"2024-02-05T18:06:15","date_gmt":"2024-02-05T18:06:15","guid":{"rendered":"https:\/\/bask.org.uk\/?page_id=311"},"modified":"2024-02-07T16:11:53","modified_gmt":"2024-02-07T16:11:53","slug":"licence-application","status":"publish","type":"page","link":"https:\/\/bask.org.uk\/index.php\/licence-application\/","title":{"rendered":"LICENCE APPLICATION \/ RENEWAL FORM"},"content":{"rendered":"<div class=\"forminator-ui forminator-custom-form forminator-custom-form-522 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-522\" data-uid=\"69e764fcf1962\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-522\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-522 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"522\"\n\t\t\t\t\n\t\t\t\tdata-design=\"default\"\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\tdata-grid=\"open\"\n\t\t\t\tenctype=\"multipart\/form-data\"\n\t\t\t\t\n\t\t\t\tstyle=\"display: none;\"\n\t\t\t\t\n\t\t\t\tdata-uid=\"69e764fcf1962\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_69e764fcf1962\" id=\"forminator-field-name-1_69e764fcf1962-label\" class=\"forminator-label\">First Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"\" id=\"forminator-field-name-1_69e764fcf1962\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-2\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-2_69e764fcf1962\" id=\"forminator-field-name-2_69e764fcf1962-label\" class=\"forminator-label\">Surname <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-2\" value=\"\" placeholder=\"\" id=\"forminator-field-name-2_69e764fcf1962\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-6\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-6_69e764fcf1962\" id=\"forminator-field-text-6_69e764fcf1962-label\" class=\"forminator-label\">Club\/ Class<\/label><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\" id=\"forminator-field-text-6_69e764fcf1962\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-picker_69e764fcf1962\" id=\"forminator-field-date-1-picker_69e764fcf1962-label\" class=\"forminator-label\">Date of Birth <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><label for=\"forminator-field-date-1-picker_69e764fcf1962\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><\/label><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-1\" value=\"\" placeholder=\"\" id=\"forminator-field-date-1-picker_69e764fcf1962\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_69e764fcf1962\" id=\"forminator-field-phone-1_69e764fcf1962-label\" class=\"forminator-label\">Mobile <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"Mobile\" id=\"forminator-field-phone-1_69e764fcf1962\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-69e764fcf1962-label\" aria-describedby=\"forminator-radiogroup-69e764fcf1962-description\"><span id=\"forminator-radiogroup-69e764fcf1962-label\" class=\"forminator-label\">Gender <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-69e764fcf1962\" class=\"forminator-radio\" title=\"Male\"><input type=\"radio\" name=\"radio-1\" value=\"one\" id=\"forminator-field-radio-1-1-69e764fcf1962\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\" aria-describedby=\"forminator-field-radio-1-69e764fcf1962-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Male<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-69e764fcf1962\" class=\"forminator-radio\" title=\"Female\"><input type=\"radio\" name=\"radio-1\" value=\"two\" id=\"forminator-field-radio-1-2-69e764fcf1962\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\" aria-describedby=\"forminator-field-radio-1-69e764fcf1962-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Female<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-1\" class=\"forminator-field-address forminator-col forminator-col-12 \"><div class=\"forminator-row\"><div id=\"address-1-street_address\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-street_address_69e764fcf1962\" id=\"forminator-field-address-1-street_address_69e764fcf1962-label\" class=\"forminator-label\">Address<\/label><input type=\"text\" name=\"address-1-street_address\" placeholder=\"\" id=\"forminator-field-address-1-street_address_69e764fcf1962\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-1-city\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-city_69e764fcf1962\" id=\"forminator-field-address-1-city_69e764fcf1962-label\" class=\"forminator-label\">City<\/label><input type=\"text\" name=\"address-1-city\" placeholder=\"\" id=\"forminator-field-address-1-city_69e764fcf1962\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-1-zip\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-zip_69e764fcf1962\" id=\"forminator-field-address-1-zip_69e764fcf1962-label\" class=\"forminator-label\">Post Code<\/label><input type=\"text\" name=\"address-1-zip\" placeholder=\"\" id=\"forminator-field-address-1-zip_69e764fcf1962\" class=\"forminator-input\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_69e764fcf1962\" id=\"forminator-field-email-1_69e764fcf1962-label\" class=\"forminator-label\">Email Address <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"\" id=\"forminator-field-email-1_69e764fcf1962\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_69e764fcf1962\" id=\"forminator-field-text-1_69e764fcf1962-label\" class=\"forminator-label\">Last Grading Date:<\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1_69e764fcf1962\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_69e764fcf1962\" id=\"forminator-field-text-2_69e764fcf1962-label\" class=\"forminator-label\">Place of Grading:<\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"\" id=\"forminator-field-text-2_69e764fcf1962\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_69e764fcf1962\" id=\"forminator-field-text-3_69e764fcf1962-label\" class=\"forminator-label\">Grade Awarded:<\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3_69e764fcf1962\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-5\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-5_69e764fcf1962\" id=\"forminator-field-text-5_69e764fcf1962-label\" class=\"forminator-label\">Previous Licence Expiry Date:<\/label><input type=\"text\" name=\"text-5\" value=\"\" placeholder=\"\" id=\"forminator-field-text-5_69e764fcf1962\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_69e764fcf1962\" id=\"forminator-field-text-4_69e764fcf1962-label\" class=\"forminator-label\">Previous Licence Serial Number:<\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"\" id=\"forminator-field-text-4_69e764fcf1962\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-2\" class=\"forminator-field-upload forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-2_69e764fcf1962\" id=\"forminator-field-upload-2_69e764fcf1962-label\" class=\"forminator-label\">Signature of the Club Instructor:<\/label><div class=\"forminator-file-upload \" data-element=\"upload-2_69e764fcf1962\" aria-describedby=\"forminator-field-upload-2_69e764fcf1962-description\"><input type=\"file\" name=\"upload-2\" id=\"forminator-field-upload-2_69e764fcf1962\" class=\"forminator-input-file\" accept=\".webp,.css,.htm,.html,.dfxp,.js,.jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif\"><button id=\"forminator-field-upload-2_69e764fcf1962_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-2_69e764fcf1962\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><div id=\"date-2\" class=\"forminator-field-date forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-2-picker_69e764fcf1962\" id=\"forminator-field-date-2-picker_69e764fcf1962-label\" class=\"forminator-label\">Date<\/label><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-2\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-2-picker_69e764fcf1962\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-1\" class=\"forminator-field-upload forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-1_69e764fcf1962\" id=\"forminator-field-upload-1_69e764fcf1962-label\" class=\"forminator-label\">Applicant\u2019s Signature:<\/label><div class=\"forminator-file-upload \" data-element=\"upload-1_69e764fcf1962\" aria-describedby=\"forminator-field-upload-1_69e764fcf1962-description\"><input type=\"file\" name=\"upload-1\" id=\"forminator-field-upload-1_69e764fcf1962\" class=\"forminator-input-file\" accept=\".webp,.css,.htm,.html,.dfxp,.js,.jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif\"><button id=\"forminator-field-upload-1_69e764fcf1962_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-1_69e764fcf1962\">Choose File<\/button><span data-empty-text=\"No file chosen\">No file chosen<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><span id=\"forminator-field-upload-1_69e764fcf1962-description\" class=\"forminator-description\">(Signature of the Parent\/Guardian if applicant is under 18 Years) *A surcharge of \u00a35-00 is applicable for all renewal applications made after the expiry date.<\/span><\/div><\/div><div id=\"date-3\" class=\"forminator-field-date forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-3-picker_69e764fcf1962\" id=\"forminator-field-date-3-picker_69e764fcf1962-label\" class=\"forminator-label\">Date<\/label><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-3\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-3-picker_69e764fcf1962\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"captcha-1\" class=\"forminator-field-captcha forminator-col forminator-col-12 \"><div class=\"forminator-g-recaptcha\" data-theme=\"light\"  data-sitekey=\"6LfAyIMpAAAAACXlSlsumBl9p400kZhp6R7bBZ6G\" data-size=\"normal\"><\/div> <\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Submit<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"22215ed391\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/311\" \/><input type=\"hidden\" name=\"form_id\" value=\"522\"><input type=\"hidden\" name=\"page_id\" value=\"311\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/bask.org.uk\/index.php\/licence-application\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline\"><a class=\"wp-block-button__link wp-element-button\" href=\"http:\/\/bask.org.uk\/wp-content\/uploads\/2024\/02\/LICENCE-APPLICATION-RENEWAL-FORM.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">LICENCE APPLICATION \/ RENEWAL FORM<\/a><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/bask.org.uk\/index.php\/wp-json\/wp\/v2\/pages\/311"}],"collection":[{"href":"https:\/\/bask.org.uk\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bask.org.uk\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bask.org.uk\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bask.org.uk\/index.php\/wp-json\/wp\/v2\/comments?post=311"}],"version-history":[{"count":22,"href":"https:\/\/bask.org.uk\/index.php\/wp-json\/wp\/v2\/pages\/311\/revisions"}],"predecessor-version":[{"id":547,"href":"https:\/\/bask.org.uk\/index.php\/wp-json\/wp\/v2\/pages\/311\/revisions\/547"}],"wp:attachment":[{"href":"https:\/\/bask.org.uk\/index.php\/wp-json\/wp\/v2\/media?parent=311"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}