{"id":3242,"date":"2024-11-11T15:21:19","date_gmt":"2024-11-11T21:21:19","guid":{"rendered":"https:\/\/chapters.theprimetimersww.com\/stlouis\/?page_id=3242"},"modified":"2024-11-11T19:30:13","modified_gmt":"2024-11-12T01:30:13","slug":"online-application","status":"publish","type":"page","link":"https:\/\/chapters.theprimetimersww.com\/stlouis\/online-application\/","title":{"rendered":"Online Application"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3242\" class=\"elementor elementor-3242\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e3962b0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e3962b0\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-733ec95\" data-id=\"733ec95\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ecd5e20 elementor-widget elementor-widget-text-editor\" data-id=\"ecd5e20\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1><strong><span style=\"color: #800080;\">Apply Online<\/span><\/strong><\/h1><h4 style=\"padding-left: 40px;\"><span style=\"color: #000000;\">Fill in the fields below.\u00a0 Any field with a <strong><span style=\"color: #ff0000;\">red<\/span><\/strong> &#8220;<strong><span style=\"color: #ff0000;\">*<\/span><\/strong>&#8221; asterisk is a required field.<\/span><\/h4><h4 style=\"padding-left: 40px;\"><span style=\"color: #000000;\">Click the submit button after completing your application.<\/span><\/h4><h4 style=\"padding-left: 40px;\"><span style=\"color: #000000;\"><strong><span style=\"color: #ff0000;\">Important note:<\/span><\/strong>\u00a0 \u00a0Your application has not been submitted until you receive the &#8220;Thank you for submitting your application to Prime Timers St. Louis!&#8221; message.<\/span><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8d2afaa elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8d2afaa\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9567434\" data-id=\"9567434\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a7c5036 elementor-widget elementor-widget-shortcode\" data-id=\"a7c5036\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><style id=\"wpforms-css-vars-3255\">\n\t\t\t\t#wpforms-3255 {\n\t\t\t\t\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-3255\"><form id=\"wpforms-form-3255\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"3255\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/stlouis\/wp-json\/wp\/v2\/pages\/3242\" data-token=\"00ca40a10bb40bac5d497caace4f9289\" data-token-time=\"1776248030\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-3255-field_1-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"1\"><div id=\"wpforms-3255-field_1\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-3255-field_1-error\"><h1><strong><span style=\"text-decoration: underline\">Prime Timers St. Louis (PTSL) New Membership and Renewal Form<\/span><\/strong><\/h1>\n<h6><em><strong> A nonprofit St. Louis area social organization for mature Gay and Bisexual men 21 and older.&nbsp; &nbsp; &nbsp;<\/strong><\/em><em><strong>website: <span style=\"text-decoration: underline;color: #0000ff\"><a rel=\"noopener\" target=\"_blank\" href=\"https:\/\/chapters.theprimetimersww.com\/stlouis\/\" style=\"color: #0000ff;text-decoration: underline\">PrimeTimersSTL.org<\/a><\/span><\/strong><\/em><\/h6>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-3255-field_2-container\" class=\"wpforms-field wpforms-field-payment-checkbox wpforms-conditional-trigger\" data-field-id=\"2\"><fieldset><legend class=\"wpforms-field-label\">Choose One (Your selection will determine which fields appear): <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3255-field_2\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_2_1\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][2][]\" value=\"1\" aria-errormessage=\"wpforms-3255-field_2_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_2_1\">New Member - Complete this entire application; sign and return<\/label><\/li><li class=\"choice-2\"><input type=\"checkbox\" id=\"wpforms-3255-field_2_2\" class=\"wpforms-payment-price\" data-amount=\"0.00\" name=\"wpforms[fields][2][]\" value=\"2\" aria-errormessage=\"wpforms-3255-field_2_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_2_2\">Current Member - Only fill out if there are any changes; sign and return<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-3255-field_31-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"31\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_9\">Last Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3255-field_9\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][9]\" aria-errormessage=\"wpforms-3255-field_9-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_10\">First Name <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3255-field_10\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][10]\" aria-errormessage=\"wpforms-3255-field_10-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_11\">Middle Initial<\/label><input type=\"text\" id=\"wpforms-3255-field_11\" class=\"wpforms-field-small\" name=\"wpforms[fields][11]\" aria-errormessage=\"wpforms-3255-field_11-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_32-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"32\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_32\">Birthday (MM\/DD)<\/label><input type=\"text\" id=\"wpforms-3255-field_32\" class=\"wpforms-field-small\" name=\"wpforms[fields][32]\" aria-errormessage=\"wpforms-3255-field_32-error\" ><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-3255-field_25-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"25\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_25\">Spouse\/Partner&#039;s Name (If applicable. Be sure to have him fill out a separate application)<\/label><input type=\"text\" id=\"wpforms-3255-field_25\" class=\"wpforms-field-medium\" name=\"wpforms[fields][25]\" aria-errormessage=\"wpforms-3255-field_25-error\" ><\/div>\t\t<div id=\"wpforms-3255-field_3-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"3\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-3255-field_3\" >photo phone PTSL<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-3255-field_3\" class=\"wpforms-field-medium\" name=\"wpforms[fields][3]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-3255-field_13-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"13\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-3255-field_38-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"38\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_38\">Street Address <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3255-field_38\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][38]\" aria-errormessage=\"wpforms-3255-field_38-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-3255-field_39-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"39\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_39\">Apt\/Unit<\/label><input type=\"text\" id=\"wpforms-3255-field_39\" class=\"wpforms-field-medium\" name=\"wpforms[fields][39]\" aria-errormessage=\"wpforms-3255-field_39-error\" ><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-3255-field_47-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"47\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_47\">Street Address<\/label><input type=\"text\" id=\"wpforms-3255-field_47\" class=\"wpforms-field-medium\" name=\"wpforms[fields][47]\" aria-errormessage=\"wpforms-3255-field_47-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-3255-field_48-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"48\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_48\">Apt\/Unit<\/label><input type=\"text\" id=\"wpforms-3255-field_48\" class=\"wpforms-field-medium\" name=\"wpforms[fields][48]\" aria-errormessage=\"wpforms-3255-field_48-error\" ><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-3255-field_33-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"33\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_18-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"18\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_18\">City <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3255-field_18\" class=\"wpforms-field-small wpforms-field-required\" name=\"wpforms[fields][18]\" aria-errormessage=\"wpforms-3255-field_18-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_17-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"17\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_17\">State <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3255-field_17\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][17]\" aria-errormessage=\"wpforms-3255-field_17-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_16-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"16\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_16\">Zip Code <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3255-field_16\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][16]\" aria-errormessage=\"wpforms-3255-field_16-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_49-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"49\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_49\">City<\/label><input type=\"text\" id=\"wpforms-3255-field_49\" class=\"wpforms-field-small\" name=\"wpforms[fields][49]\" aria-errormessage=\"wpforms-3255-field_49-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_50-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"50\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_50\">State<\/label><input type=\"text\" id=\"wpforms-3255-field_50\" class=\"wpforms-field-medium\" name=\"wpforms[fields][50]\" aria-errormessage=\"wpforms-3255-field_50-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_51-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"51\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_51\">Zip Code<\/label><input type=\"text\" id=\"wpforms-3255-field_51\" class=\"wpforms-field-medium\" name=\"wpforms[fields][51]\" aria-errormessage=\"wpforms-3255-field_51-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><\/div><\/div><\/div><\/div><div id=\"wpforms-3255-field_40-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"40\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_15-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"15\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_15\">Contact Phone <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3255-field_15\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][15]\" aria-errormessage=\"wpforms-3255-field_15-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_24-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"24\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Does PTSL have permission to leave voicemails on this phone number? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3255-field_24\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_24_1\" name=\"wpforms[fields][24][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_24_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_24_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_24_2\" name=\"wpforms[fields][24][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_24_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_24_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_23-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"23\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Does PTSL have permission to send you texts? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3255-field_23\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_23_1\" name=\"wpforms[fields][23][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_23_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_23_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_23_2\" name=\"wpforms[fields][23][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_23_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_23_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_26-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"26\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Do you have access to the Internet with a Home Computer or Smartphone? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3255-field_26\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_26_1\" name=\"wpforms[fields][26][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_26_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_26_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_26_2\" name=\"wpforms[fields][26][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_26_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_26_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_52-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"52\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_52\">Contact Phone<\/label><input type=\"text\" id=\"wpforms-3255-field_52\" class=\"wpforms-field-medium\" name=\"wpforms[fields][52]\" aria-errormessage=\"wpforms-3255-field_52-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_53-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"53\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Does PTSL have permission to leave voicemails on this phone number?<\/legend><ul id=\"wpforms-3255-field_53\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_53_1\" name=\"wpforms[fields][53][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_53_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_53_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_53_2\" name=\"wpforms[fields][53][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_53_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_53_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_54-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"54\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Does PTSL have permission to send you texts?<\/legend><ul id=\"wpforms-3255-field_54\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_54_1\" name=\"wpforms[fields][54][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_54_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_54_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_54_2\" name=\"wpforms[fields][54][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_54_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_54_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-3255-field_55-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"55\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Do you have access to the Internet with a Home Computer or Smartphone?<\/legend><ul id=\"wpforms-3255-field_55\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_55_1\" name=\"wpforms[fields][55][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_55_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_55_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_55_2\" name=\"wpforms[fields][55][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_55_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_55_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-3255-field_41-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"41\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-3255-field_20-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"20\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_20\">Email <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3255-field_20\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][20]\" aria-errormessage=\"wpforms-3255-field_20-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-3255-field_22-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"22\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Does PTSL have permission to send emails to this address? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3255-field_22\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_22_1\" name=\"wpforms[fields][22][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_22_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_22_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_22_2\" name=\"wpforms[fields][22][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_22_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_22_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-3255-field_59-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"59\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_59\">Email<\/label><input type=\"text\" id=\"wpforms-3255-field_59\" class=\"wpforms-field-medium\" name=\"wpforms[fields][59]\" aria-errormessage=\"wpforms-3255-field_59-error\" ><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-3255-field_58-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"58\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Does PTSL have permission to send emails to this address?<\/legend><ul id=\"wpforms-3255-field_58\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_58_1\" name=\"wpforms[fields][58][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_58_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_58_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_58_2\" name=\"wpforms[fields][58][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_58_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_58_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-3255-field_46-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"46\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-3255-field_27-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"27\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Do you give permission to publish the above information in the PTSL roster? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3255-field_27\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_27_1\" name=\"wpforms[fields][27][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_27_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_27_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_27_2\" name=\"wpforms[fields][27][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_27_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_27_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-3255-field_29-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"29\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Does PTSL have permission to use your photo when taken at group events? <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-3255-field_29\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_29_1\" name=\"wpforms[fields][29][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_29_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_29_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_29_2\" name=\"wpforms[fields][29][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_29_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_29_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-3255-field_56-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"56\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Do you give permission to publish the above information in the PTSL roster?<\/legend><ul id=\"wpforms-3255-field_56\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_56_1\" name=\"wpforms[fields][56][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_56_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_56_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_56_2\" name=\"wpforms[fields][56][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_56_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_56_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-3255-field_57-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"57\" style=\"display:none;\"><fieldset><legend class=\"wpforms-field-label\">Does PTSL have permission to use your photo when taken at group events? (copy)<\/legend><ul id=\"wpforms-3255-field_57\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_57_1\" name=\"wpforms[fields][57][]\" value=\"Yes\" aria-errormessage=\"wpforms-3255-field_57_1-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_57_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-3255-field_57_2\" name=\"wpforms[fields][57][]\" value=\"No\" aria-errormessage=\"wpforms-3255-field_57_2-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3255-field_57_2\">No<\/label><\/li><\/ul><\/fieldset><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-3255-field_30-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"30\"><div id=\"wpforms-3255-field_30\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-3255-field_30-error\"><h4><span style=\"color: #ff0000\"><strong><span style=\"text-decoration: underline\">PTSL membership Agreement:<\/span><\/strong><\/span><\/h4>\n<ul>\n<li>Prime Timers St. Louis (PTSL) is a nonprofit, noncommercial, nonsectarian and nonpartisan social organization open to mature Gay and Bisexual men (21 and older) who subscribe to our mission of promoting socialization and fellowship through activities and events in a safe, positive, and supportive environment.<\/li>\n<\/ul>\n<p>As such, PTSL does NOT host or promote activities or events of a sexual nature.<\/p>\n<ul>\n<li>PTSL does not tolerate discrimination based on race, color, ancestry, religious or political belief, sexual orientation, gender identity, national, ethnicity or social origin, marital or veteran status, income, HIV status or disability.<\/li>\n<li>Members agree NOT to share PTSL roster data with any non-members nor use it for commercial or similar purposes.<\/li>\n<li>Any person who is disruptive, disrespectful or speaks or acts in a manner contrary to these or any other PTSL policies may have their membership revoked.<\/li>\n<li>By becoming a member of PTSL, you agree that liability of PTSL will be limited, and that PTSL shall not be liable for any incidents resulting in any loss, injury or death to any persons participating in PTSL-related activities or events. All PTSL members participate at their own risk. In the event of any losses or injuries sustained by you or your property at a PTSL-related event or activity or in or on a host's property, you agree to hold harmless and wholly not liable Prime Timers St. Louis, its Board Members and\/or the host, sponsor or participants of the event.<\/li>\n<li><span style=\"text-decoration: underline;color: #ff0000\"><em><strong>Submission of this signed document affirms your full agreement to these PTSL policies <\/strong><strong>and that you are at least 21 years old. <\/strong><\/em><\/span><\/li>\n<\/ul>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-3255-field_44-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"44\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-67\"><div id=\"wpforms-3255-field_42-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"42\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_42\">Your Signature <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3255-field_42\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][42]\" aria-errormessage=\"wpforms-3255-field_42-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-3255-field_43-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"43\"><label class=\"wpforms-field-label\" for=\"wpforms-3255-field_43\">Date <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-3255-field_43\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][43]\" aria-errormessage=\"wpforms-3255-field_43-error\" required><\/div><\/div><\/div><\/div><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-3255-field_3-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-3255-field_3-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-3255-field_3-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container --><div class=\"wpforms-recaptcha-container wpforms-is-recaptcha wpforms-is-recaptcha-type-v2\" ><div class=\"g-recaptcha\" data-sitekey=\"6LfR9sMnAAAAACOlL6E6TeS8YHgd3984vGjJB0J0\"><\/div><input type=\"text\" name=\"g-recaptcha-hidden\" class=\"wpforms-recaptcha-hidden\" style=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\" data-rule-recaptcha=\"1\"><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"3255\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/chapters.theprimetimersww.com\/stlouis\/wp-json\/wp\/v2\/pages\/3242\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-3255\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img decoding=\"async\" src=\"https:\/\/chapters.theprimetimersww.com\/stlouis\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container --><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2eb0aa5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2eb0aa5\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ec5ed6e\" data-id=\"ec5ed6e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2bfb222 elementor-widget elementor-widget-text-editor\" data-id=\"2bfb222\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1><strong><span style=\"color: #800080;\">Pay Online<\/span><\/strong><\/h1><h4 style=\"padding-left: 40px;\"><span style=\"color: #000000;\">Just completed your online application.\u00a0 Why not complete the process by also paying your dues online?\u00a0 Click <span style=\"text-decoration: underline; color: #0000ff;\"><em><strong><a style=\"color: #0000ff; text-decoration: underline;\" href=\"https:\/\/prime-timers-st-louis.square.site\/\" target=\"_blank\" rel=\"noopener\">HERE<\/a><\/strong><\/em><\/span> to pay your dues via Square.<\/span><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8163fac elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8163fac\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b221ead\" data-id=\"b221ead\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Apply Online Fill in the fields below.\u00a0 Any field with a red &#8220;*&#8221; asterisk is a required field. Click the submit button after completing your application. Important note:\u00a0 \u00a0Your application has not been submitted until&hellip; <\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"footnotes":"","_tec_slr_enabled":"","_tec_slr_layout":""},"class_list":["post-3242","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Online Application - Prime Timers St. Louis<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/chapters.theprimetimersww.com\/stlouis\/online-application\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Online Application - Prime Timers St. Louis\" \/>\n<meta property=\"og:description\" content=\"Apply Online Fill in the fields below.\u00a0 Any field with a red &#8220;*&#8221; asterisk is a required field. 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