{"id":8178,"date":"2021-09-08T12:53:30","date_gmt":"2021-09-08T12:53:30","guid":{"rendered":"https:\/\/esa.org\/ldc\/?page_id=8178"},"modified":"2022-11-29T15:32:12","modified_gmt":"2022-11-29T15:32:12","slug":"vaccination-record","status":"publish","type":"page","link":"https:\/\/esa.org\/ldc\/covid-19-policy\/vaccination-record\/","title":{"rendered":"Covid-19 Vaccine Record"},"content":{"rendered":"<p>Please upload a copy of your Covid-19 vaccination card below. If you have any questions or concerns, please email us at <a href=\"mailto:ldc@esa.org\">ldc@esa.org<\/a>.\u00a0<\/p>\n<link rel='stylesheet' id='formidable-css' href='https:\/\/esa.org\/ldc\/wp-content\/plugins\/formidable\/css\/formidableforms79.css?ver=6181857' media='all' \/>\n<div class=\"frm_forms  with_frm_style frm_style_formidable-style-2\" id=\"frm_form_24_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_covid-19vaccinerecord\" >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Covid-19 Vaccine Record<\/legend>\n\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"24\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_24\" id=\"frm_hide_fields_24\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"covid-19vaccinerecord\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_24\" name=\"frm_submit_entry_24\" value=\"d3cce8355a\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/ldc\/wp-json\/wp\/v2\/pages\/8178\" \/><div id=\"frm_field_839_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\n    <div  id=\"field_xl4qn_label\" class=\"frm_primary_label\">Name\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n    <\/div>\n    <fieldset aria-labelledby=\"field_xl4qn_label\">\n\t<legend class=\"frm_screen_reader frm_hidden\">\n\t\tName\t<\/legend>\n\n\t<div  class=\"frm_combo_inputs_container\" id=\"frm_combo_inputs_container_839\" data-name-layout=\"first_last\">\n\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_839-first_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-first  frm6\"\n\t\t\t\tdata-sub-field-name=\"first\"\n\t\t\t>\n\t\t\t\t<label for=\"field_xl4qn_first\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tFirst\t\t\t\t<\/label>\n\n\t\t\t\t<input  type=\"text\" id=\"field_xl4qn_first\" value=\"\" name=\"item_meta[839][first]\" autocomplete=\"given-name\" data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"  \/><div class=\"frm_description\" id=\"frm_field_839_first_desc\">First<\/div>\t\t\t<\/div>\n\t\t\t\t\t\t<div\n\t\t\t\tid=\"frm_field_839-last_container\"\n\t\t\t\tclass=\"frm_form_field form-field frm_form_subfield-last  frm6\"\n\t\t\t\tdata-sub-field-name=\"last\"\n\t\t\t>\n\t\t\t\t<label for=\"field_xl4qn_last\" class=\"frm_screen_reader frm_hidden\">\n\t\t\t\t\tLast\t\t\t\t<\/label>\n\n\t\t\t\t<input  type=\"text\" id=\"field_xl4qn_last\" value=\"\" name=\"item_meta[839][last]\" autocomplete=\"family-name\" data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name is invalid\" aria-invalid=\"false\"  \/><div class=\"frm_description\" id=\"frm_field_839_last_desc\">Last<\/div>\t\t\t<\/div>\n\t\t\t\t<\/div>\n<\/fieldset>\n\n    \n    \n<\/div>\n<div id=\"frm_field_840_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm12\">\n    <label for=\"field_eaaep\" id=\"field_eaaep_label\" class=\"frm_primary_label\">Covid-19 Vaccination Record\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n    <\/label>\n    <input type=\"hidden\"  data-reqmsg=\"Covid-19 Vaccination Record cannot be blank.\" data-invmsg=\"File Upload is invalid\" class=\"auto_width\" aria-invalid=\"false\"   name=\"item_meta[840]\"  data-reqmsg=\"Covid-19 Vaccination Record cannot be blank.\"  value=\"\" data-frmfile=\"840\" \/>\n\n<div class=\"frm_dropzone frm_single_upload frm_clearfix\" id=\"file840_dropzone\" role=\"group\"  aria-describedby=\"frm_desc_field_eaaep\">\n\t<div class=\"fallback\">\n\t\t<input type=\"file\" name=\"file840\" id=\"field_eaaep\"\n\t\t\t data-reqmsg=\"Covid-19 Vaccination Record cannot be blank.\" data-invmsg=\"File Upload is invalid\" class=\"auto_width\" aria-invalid=\"false\"  \t\t\t\/>\n\t\t\t\t<div class=\"frm_clearfix \"><\/div>\n\t<\/div>\n\t<div class=\"dz-message needsclick\">\n\t\t\t\t<svg  viewBox=\"0 0 18 18\" class=\"frmsvg frm-svg-icon\">\n\t<path viewBox=\"0 0 18 18\" fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M8.2 4v8a.8.8 0 001.5 0V4l2.1 2.2A.7.7 0 1013 5L9.5 1.7a.7.7 0 00-1.1 0L5.1 5.2a.8.8 0 001 1l2.1-2zm7.6 4.3c.4 0 .7.3.7.7v6.8c0 .4-.3.7-.8.7H2.3a.8.8 0 01-.8-.8V9A.8.8 0 013 9v6h12V9c0-.4.3-.8.8-.8z\"><\/path>\n<\/svg>\t\t<span class=\"frm_upload_text\"><button type=\"button\" aria-label=\"Covid-19 Vaccination Record. Drop a file here or click to upload. Maximum file size: 200MB\">Drop a file here or click to upload<\/button><\/span>\n\t\t<span class=\"frm_compact_text\"><button type=\"button\" aria-label=\"Covid-19 Vaccination Record. Choose File. Maximum file size: 200MB\">Choose File<\/button><\/span>\n\t\t<div class=\"frm_small_text\">\n\t\t\t<p>Maximum file size: 200MB<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\n    <div class=\"frm_description\" id=\"frm_desc_field_eaaep\">Please upload a copy of your Covid-19 vaccination card here.<\/div>\n    \n<\/div>\n<div id=\"frm_field_842_container\" class=\"frm_form_field form-field  frm_none_container\">\n    <label for=\"g-recaptcha-response\" id=\"field_2fuw9_label\" class=\"frm_primary_label\">reCAPTCHA\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n    <\/label>\n    <div  id=\"field_2fuw9\" class=\"frm-g-recaptcha\" data-sitekey=\"6LdnHQAAAAAAAF5jTSaskP-UmKyNKFYtSCbtwohV\" data-size=\"normal\" data-theme=\"light\"><\/div>\n    \n    \n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_1020_container\">\n\t\t\t<label for=\"field_mg4b5\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_mg4b5\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[1020]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"0d2E+UJWd0USSEUbGdWD00tOBahwSgUVZMt0Wsn+1xZWHhdKT4RYyY7X1HQjl7UU\" \/><div class=\"frm_submit\">\n\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"  >Submit<\/button>\n\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n\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=\"119\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>Please upload a copy of your Covid-19 vaccination card below. If you have any questions or concerns, please email us at ldc@esa.org.\u00a0<\/p>\n","protected":false},"author":1878,"featured_media":0,"parent":8126,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8178","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/esa.org\/ldc\/wp-json\/wp\/v2\/pages\/8178","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/esa.org\/ldc\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/esa.org\/ldc\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/esa.org\/ldc\/wp-json\/wp\/v2\/users\/1878"}],"replies":[{"embeddable":true,"href":"https:\/\/esa.org\/ldc\/wp-json\/wp\/v2\/comments?post=8178"}],"version-history":[{"count":0,"href":"https:\/\/esa.org\/ldc\/wp-json\/wp\/v2\/pages\/8178\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/esa.org\/ldc\/wp-json\/wp\/v2\/pages\/8126"}],"wp:attachment":[{"href":"https:\/\/esa.org\/ldc\/wp-json\/wp\/v2\/media?parent=8178"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}