{"id":594,"date":"2019-01-14T16:24:02","date_gmt":"2019-01-14T15:24:02","guid":{"rendered":"http:\/\/gp2a.org\/?page_id=594"},"modified":"2021-03-19T15:53:20","modified_gmt":"2021-03-19T14:53:20","slug":"group-of-medicinal-chemists-of-the-atlantic-arc-gp2a-membership-2019-2","status":"publish","type":"page","link":"https:\/\/gp2a.org\/index.php\/group-of-medicinal-chemists-of-the-atlantic-arc-gp2a-membership-2019-2\/","title":{"rendered":"GP2A MEMBERSHIP 2021 &#8211; old"},"content":{"rendered":"\n<p><\/p>\n\n\n<p>To request GP2A membership, please fill this form.<\/p>\n<div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f647-o1\" lang=\"fr-FR\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/594#wpcf7-f647-o1\" method=\"post\" class=\"wpcf7-form init\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"647\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.5.6.1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"fr_FR\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f647-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/div>\n<p><span class=\"wpcf7-form-control-wrap Investigator\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"Investigator\" value=\"Principal Investigator \u20ac30.00\" \/><span class=\"wpcf7-list-item-label\">Principal Investigator \u20ac30.00<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"Investigator\" value=\"Post-doctoral Researcher and PhD student \u20ac15.00\" \/><span class=\"wpcf7-list-item-label\">Post-doctoral Researcher and PhD student \u20ac15.00<\/span><\/span><\/span><\/span><\/p>\n<hr \/>\n<b>Membership ID (if renewal):<\/b> <span class=\"wpcf7-form-control-wrap ID2019\"><input type=\"text\" name=\"ID2019\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><\/p>\n<hr \/>\n<b>Title:<\/b> <span class=\"wpcf7-form-control-wrap title\"><select name=\"title\" class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\"><option value=\"\"><\/option><option value=\"Dr.\">Dr.<\/option><option value=\"Prof.\">Prof.<\/option><\/select><\/span><br \/>\n<b>First name:<\/b> <span class=\"wpcf7-form-control-wrap FirstName\"><input type=\"text\" name=\"FirstName\" value=\"\" size=\"20\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><br \/>\n<b>Name:<\/b> <span class=\"wpcf7-form-control-wrap Name\"><input type=\"text\" name=\"Name\" value=\"\" size=\"50\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><br \/>\n<b>Gender:<\/b> <span class=\"wpcf7-form-control-wrap gender\"><select name=\"gender\" class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><option value=\"female\">female<\/option><option value=\"male\">male<\/option><\/select><\/span><\/p>\n<hr \/>\n<b>University or Company:<\/b> <span class=\"wpcf7-form-control-wrap UniversityCompany\"><input type=\"text\" name=\"UniversityCompany\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><br \/>\n<b>Unit and\/or Department:<\/b> <span class=\"wpcf7-form-control-wrap Unit\"><input type=\"text\" name=\"Unit\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><br \/>\n<b>Address:<\/b> <span class=\"wpcf7-form-control-wrap Address\"><input type=\"text\" name=\"Address\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span> <span class=\"wpcf7-form-control-wrap Address1\"><input type=\"text\" name=\"Address1\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><br \/>\n<b>Postal code:<\/b> <span class=\"wpcf7-form-control-wrap PostalCode\"><input type=\"text\" name=\"PostalCode\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><br \/>\n<b>City:<\/b> <span class=\"wpcf7-form-control-wrap City\"><input type=\"text\" name=\"City\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><br \/>\n<b>Country:<\/b> <span class=\"wpcf7-form-control-wrap Country\"><input type=\"text\" name=\"Country\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><br \/>\n<b>Phone number:<\/b> <span class=\"wpcf7-form-control-wrap Phone\"><input type=\"tel\" name=\"Phone\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-tel\" aria-invalid=\"false\" \/><\/span><br \/>\n<b>Mobile:<\/b> <span class=\"wpcf7-form-control-wrap MobilePhone\"><input type=\"tel\" name=\"MobilePhone\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-tel\" aria-invalid=\"false\" \/><\/span><br \/>\n<B>Email address (reference email for the GP2A):<\/b> <span class=\"wpcf7-form-control-wrap email\"><input type=\"email\" name=\"email\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<hr>\n<b>FUNCTION \/ AREA OF ACTIVITY<\/b><br \/>\n<b>Activity: <b><span class=\"wpcf7-form-control-wrap Activity\"><select name=\"Activity\" class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\"><option value=\"Academic \/ Public\">Academic \/ Public<\/option><option value=\"Biotechnology company\">Biotechnology company<\/option><option value=\"Pharma Industry R&amp;D\">Pharma Industry R&amp;D<\/option><option value=\"Other\">Other<\/option><\/select><\/span><br \/>\n[group group-Activity]If other activity: specify here: <span class=\"wpcf7-form-control-wrap text-activityOther\"><input type=\"text\" name=\"text-activityOther\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span>[\/group]<br \/>\n<b>Status : <b><span class=\"wpcf7-form-control-wrap Status\"><select name=\"Status\" class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\"><option value=\"Professor\">Professor<\/option><option value=\"Associate Professor\">Associate Professor<\/option><option value=\"Assistant Professor\">Assistant Professor<\/option><option value=\"Postdoc\">Postdoc<\/option><option value=\"PhD Student\">PhD Student<\/option><option value=\"Research Engineer\">Research Engineer<\/option><option value=\"Technical staff\">Technical staff<\/option><option value=\"Retired\">Retired<\/option><option value=\"Other\">Other<\/option><\/select><\/span><br \/>\n[group group-status]If other status: specify here: <span class=\"wpcf7-form-control-wrap StatusOther\"><input type=\"text\" name=\"StatusOther\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span>[\/group]<br \/>\nActivity area <span class=\"wpcf7-form-control-wrap Activity2\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"Activity2[]\" value=\"Medicinal Chemistry\" \/><span class=\"wpcf7-list-item-label\">Medicinal Chemistry<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"Activity2[]\" value=\"Chemical biology\" \/><span class=\"wpcf7-list-item-label\">Chemical biology<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"Activity2[]\" value=\"Organic Chemistry\" \/><span class=\"wpcf7-list-item-label\">Organic Chemistry<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"Activity2[]\" value=\"Pharmacology\" \/><span class=\"wpcf7-list-item-label\">Pharmacology<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"Activity2[]\" value=\"ADMET\" \/><span class=\"wpcf7-list-item-label\">ADMET<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"Activity2[]\" value=\"Chemo-informatics\" \/><span class=\"wpcf7-list-item-label\">Chemo-informatics<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"Activity2[]\" value=\"Other activity area\" \/><span class=\"wpcf7-list-item-label\">Other activity area<\/span><\/span><\/span><\/span><br \/>\n[group group-Activity2]If other activity area specify here: <span class=\"wpcf7-form-control-wrap Activity2Other\"><input type=\"text\" name=\"Activity2Other\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span>[\/group]<br \/>\nResearch topics:  <span class=\"wpcf7-form-control-wrap ResearchTopic\"><input type=\"text\" name=\"ResearchTopic\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><br \/>\n<HR \/><br \/>\nThe registration is validated once the payment of the balance due is received by wire bank transfer.<\/p>\n<p>For payment by bank transfer only,<br \/>\nPlease use the following bank details, and send us the references of the transfer, and the names of recipients to: contact@gp2a.org<\/p>\n<div>GP2A<br \/>\nCA Anjou Maine - 49100 ANGERS<br \/>\nRIB : 17906 00032 10476016000 96<br \/>\nBIC : AGRIFRPP879<br \/>\nIBAN : FR76 1790 6000 3210 4760 1600 096<\/div>\n<p><span class=\"wpcf7-form-control-wrap acceptance\"><span class=\"wpcf7-form-control wpcf7-acceptance optional\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">I confirm that I understood that membership will be validated only after payment.<\/span><\/label><\/span><\/span><\/span> <input type=\"submit\" value=\"Submit\" class=\"wpcf7-form-control has-spinner wpcf7-submit\" \/><\/p>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div><\/form><\/div>\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>To request GP2A membership, please fill this form.<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/gp2a.org\/index.php\/wp-json\/wp\/v2\/pages\/594"}],"collection":[{"href":"https:\/\/gp2a.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/gp2a.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/gp2a.org\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/gp2a.org\/index.php\/wp-json\/wp\/v2\/comments?post=594"}],"version-history":[{"count":8,"href":"https:\/\/gp2a.org\/index.php\/wp-json\/wp\/v2\/pages\/594\/revisions"}],"predecessor-version":[{"id":2004,"href":"https:\/\/gp2a.org\/index.php\/wp-json\/wp\/v2\/pages\/594\/revisions\/2004"}],"wp:attachment":[{"href":"https:\/\/gp2a.org\/index.php\/wp-json\/wp\/v2\/media?parent=594"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}