{"id":71913,"date":"2024-03-03T20:07:20","date_gmt":"2024-03-04T01:07:20","guid":{"rendered":"https:\/\/www.iaff.org\/prix-des-medias\/prix-mediatiques-formulaire-des-affilies\/"},"modified":"2026-11-05T13:03:11","modified_gmt":"2026-11-05T18:03:11","slug":"prix-mediatiques-formulaire-des-affilies","status":"publish","type":"page","link":"https:\/\/www.iaff.org\/fr-ca\/prix-des-medias\/prix-mediatiques-formulaire-des-affilies\/","title":{"rendered":"Prix des m\u00e9dias &#8211; Formulaire d\u2019affiliation"},"content":{"rendered":"<section\n\t class=\"secondary-hero align wp-block-acf-secondary-hero\" id=\"secondary-hero_block_6beb5dd1dd388713b940c46801bab680\">\n\t\n<header\n\tclass=\"w-full u-bg-full-width px-[22px] md:ps-bleed md:pe-0 py-[60px] bg-smoke-5 text-black u-has-rivets u-rivets-dark\"\n\tdata-theme=\"gray\"\n>\n\t<div class=\"flex flex-col !px-0 !max-w-[1440px] w-full lg:!ps-indent\">\n\t\t<div class=\"border-t-[6px] w-full my-0 flex flex-col md:flex-row gap-x-[62px] gap-y-[22px] border-red\">\n\t\t\t\t\t\t<div class=\"w-full md:w-1\/2 md:py-[45px]\">\n\t\t\t\t<div class=\"max-w-[600px] flex flex-col gap-[22px]\">\n\t\t\t\t\t\t\t\t\t\t\t<h1 class=\"has-[.u-halftone-shadow--dark]:mb-divider has-[.u-halftone-shadow--light]:mb-divider pt-[22px] md:pt-0\">\n\t\t\t\t\t\t\t<span class=\"inline-flex text-heading-200 u-halftone-shadow--dark\">\n\t\t\t\t\t\t\t\tFormulaire d\u2019adh\u00e9sion d\u2019affili\u00e9\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/h1>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\n\t\t<\/div>\n\t\t\t\t\t<div class=\"order-first flex justify-start w-full pb-[22px]\">\n\t\t\t\t<div\n\tclass=\"wp-block-button is-style-tertiary text-smoke is-style-tertiary-back\"\n>\n\t\t\t<a\n\t\t\thref=\"https:\/\/www.iaff.org\/fr-ca\/prix-des-medias\/\"\n\t\t\tclass=\"wp-block-button__link wp-element-button group\"\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t>\n\t\t\t<span\n\t\t\tclass=\"leading-none decoration-transparent underline underline-offset-2 group-hover:decoration-inherit group-focus-visible:decoration-inherit transition duration-hover\"\n\t\t>\n\t\t\tPrix m\u00e9diatiques\t\t<\/span>\n\n\t\t<span\n\t\t\tclass=\"bg-inherit transition-colors duration-hover group-hover:bg-gold group-focus:bg-gold inline-flex items-center rotate-180 order-first pb-0.5\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"21\" height=\"22\" fill=\"none\" viewBox=\"0 0 21 22\"><path stroke=\"currentColor\" stroke-linecap=\"round\" stroke-width=\"2\" d=\"M20 20.75L20 2.25L1.5 2.25L1.5 20.75L20 20.75Z\" clip-rule=\"evenodd\"\/><path stroke=\"currentColor\" stroke-linecap=\"square\" stroke-width=\"2\" d=\"M14.0883 11.5L6.66406 11.5\"\/><path stroke=\"currentColor\" stroke-linecap=\"square\" stroke-width=\"2\" d=\"M11.0723 7.75205L14.8363 11.5L11.0723 15.248\"\/><\/svg>\t\t<\/span>\n\t<\/a><\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n<\/header>\n<\/section>\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 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class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indique les champs obligatoires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_33'  action='\/fr-ca\/wp-json\/wp\/v2\/pages\/71913#gf_33' data-formid='33' novalidate>\t\t\t\t\t<div style=\"display: none !important;\" class=\"akismet-fields-container gf_invisible\" data-prefix=\"ak_\">\n\t\t\t\t\t\t<label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label>\n\t\t\t\t\t\t<input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"162\" \/>\n\t\t\t\t\t\t<script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n\n\t\t\t\t\t<\/div>\n        <div id='gf_progressbar_wrapper_33' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">\u00c9tape <span class='gf_step_current_page'>1<\/span> de <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_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_33_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_33' class='gform_fields top_label form_sublabel_below description_above validation_below' data-column-layout='fill'><div id=\"field_33_22\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"00c58aad\" data-field-span=\"12\"><h3 class=\"gsection_title\">La candidature<\/h3><\/div><div id=\"field_33_1\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full select-field gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"91a41ae8\" data-field-span=\"12\"><label id='gfield_label_33_1' class='gfield_label gform-field-label' for='input_33_1'><span class='gform-field-label__text'>Cat\u00e9gorie d\u2019affili\u00e9s<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_1' id='input_33_1' class='gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>&#8211; S\u00e9lectionnez &#8211;<\/option><option value='1. Meilleur bulletin d\u2019information ou magazine tir\u00e9 moins de 1000' >1. Meilleur bulletin ou magazine (tirage inf\u00e9rieur \u00e0 1 000 exemplaires)<\/option><option value='2. Meilleur bulletin ou magazine tir\u00e9 plus de 1000 exemplaires' >2. Meilleur bulletin ou magazine (tirage de plus de 1 000 exemplaires)<\/option><option value='3. Meilleurs messages de campagne politique' >3. Meilleurs messages de campagne politique<\/option><option value='4. Meilleure campagne de s\u00e9curit\u00e9 publique' >4. Meilleure campagne de s\u00e9curit\u00e9 publique<\/option><option value='5. Meilleur projet de sensibilisation MDA' >5. Meilleur projet de sensibilisation MDA<\/option><option value='6. Meilleure photo du service d\u2019incendie prise par un membre de l\u2019AIP' >6. Meilleure photo du service d\u2019incendie prise par un membre de l\u2019AIP<\/option><option value='7. Meilleur compte de m\u00e9dias sociaux' >7. Meilleur compte de m\u00e9dias sociaux<\/option><option value='8. Meilleurs m\u00e9dias num\u00e9riques' >8. Meilleurs m\u00e9dias num\u00e9riques<\/option><\/select><\/div><\/div><div id=\"field_33_2\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full text-field gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"4c05ab05\" data-field-span=\"12\"><label id='gfield_label_33_2' class='gfield_label gform-field-label' for='input_33_2'><span class='gform-field-label__text'>Nom de l\u2019inscription<\/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_2' id='input_33_2' type='text' value='' class=''     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_33_3\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full textarea-field gfield_contains_required 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class='gfield_label gform-field-label' for='gform_browse_button_33_5'><span class='gform-field-label__text'>T\u00e9l\u00e9chargement de la participation<\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_33_5' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_33_5&quot;,&quot;container&quot;:&quot;gform_multifile_upload_33_5&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_33_5&quot;,&quot;filelist&quot;:&quot;gform_preview_33_5&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.iaff.org\\\/fr-ca\\\/?gf_page=154c5086cc8ed22&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.iaff.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.iaff.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Fichiers autoris\\u00e9s&quot;,&quot;extensions&quot;:&quot;pdf,jpeg,jpg,png,mov,mp4,avi,mp3&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:33,&quot;field_id&quot;:5,&quot;_gform_file_upload_nonce_33_5&quot;:&quot;e7014346e2&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;10&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_33_5&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;shtml&quot;,&quot;shtm&quot;,&quot;stm&quot;,&quot;stml&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_33_5' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>D\u00e9posez les fichiers ici ou <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_33_5' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_33_5\"  >S\u00e9lectionner les fichiers<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_33_5'>Types de fichiers accept\u00e9s :pdf, jpeg, jpg, png, mov, mp4, avi, mp3, Taille maximale du fichier :10 MB , Fichiers max. :10 .<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_33_5'><\/ul> <div id='gform_preview_33_5' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_33_31\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"7459983f\" data-field-span=\"12\"><label id='gfield_label_33_31' class='gfield_label gform-field-label' for='input_33_31'><span class='gform-field-label__text'>URL(s) d\u2019entr\u00e9e<\/span><\/label><div class='gfield_description' id='gfield_description_33_31'>Jusqu\u2019\u00e0 10 \u2014 URL ou t\u00e9l\u00e9versement requis <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_31' id='input_33_31' class='textarea small'  aria-describedby=\"gfield_description_33_31\"    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_next_button_33_21' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_33_2' class='gform_page' data-js='page-field-id-21' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_33_2' class='gform_fields top_label form_sublabel_below description_above validation_below' data-column-layout='fill'><div id=\"field_33_20\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"25d692fc\" data-field-span=\"12\"><h3 class=\"gsection_title\">D\u00e9charge<\/h3><\/div><fieldset id=\"field_33_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full radio-field gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"f710616f\" data-field-span=\"12\"><legend id='gfield_label_33_7' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>D\u00e9claration personnelle de renonciation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_33_7'><p>Une d\u00e9claration de consentement personnel permet \u00e0 l\u2019AIP (IAFF) d\u2019utiliser la photo ou d\u2019autres documents \u00e0 toute fin officielle de l\u2019AIP (IAFF). Si vous ne donnez pas votre permission, vous \u00eates tout de m\u00eame admissible au concours. Les Prix des m\u00e9dias sont une ressource formidable pour l\u2019AIP (IAFF) afin de mettre en valeur nos membres dans l\u2019exercice de leurs fonctions, et nous appr\u00e9cions votre consid\u00e9ration pour une autorisation compl\u00e8te. <\/p>\n<p>En soumettant une photographie ou d\u2019autre mat\u00e9riel \u00e0 l\u2019AIP (IAFF), je donne \u00e0 l\u2019AIP (IAFF) la permission d\u2019utiliser ce mat\u00e9riel sur son site Web, dans ses publications imprim\u00e9es, et pour les relations publiques, le mat\u00e9riel d\u2019\u00e9ducation et de formation, et \u00e0 toute autre fin de l\u2019AIP (IAFF) qu\u2019elle jugera appropri\u00e9e, sans autre consid\u00e9ration \u00e0 mon \u00e9gard. Je reconnais \u00e9galement le droit de l\u2019AIP (IAFF) de recadrer ou de traiter la photographie \u00e0 sa discr\u00e9tion.<br><\/p><\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_33_7'>\n\t\t\t<div class='gchoice gchoice_33_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Oui'  id='choice_33_7_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_33_7\" aria-labelledby=\"label_33_7_0 gfield_label_33_7\"   \/>\n\t\t\t\t\t<label for='choice_33_7_0' id='label_33_7_0' class='gform-field-label gform-field-label--type-inline'>Oui<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_33_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Non'  id='choice_33_7_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_33_7_1' id='label_33_7_1' class='gform-field-label gform-field-label--type-inline'>Non<\/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_previous_button_33_24' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Pr\u00e9c\u00e9dent<\/button> <button type='button' id='gform_next_button_33_24' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_33_3' class='gform_page' data-js='page-field-id-24' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_33_3' class='gform_fields top_label form_sublabel_below description_above validation_below' data-column-layout='fill'><div id=\"field_33_23\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"7e9434ab\" data-field-span=\"12\"><h3 class=\"gsection_title\">Candidat et personne-ressource<\/h3><\/div><div id=\"field_33_25\" 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\" data-group-id=\"927c1ecb\" data-field-span=\"12\"><label id='gfield_label_33_25' class='gfield_label gform-field-label' for='input_33_25'><span class='gform-field-label__text'>Nom du candidat<\/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_25' id='input_33_25' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_33_18\" 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\" data-group-id=\"4758d646\" data-field-span=\"12\"><label id='gfield_label_33_18' class='gfield_label gform-field-label' for='input_33_18'><span class='gform-field-label__text'>Nom tel qu\u2019il appara\u00eetra sur le prix<\/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_18' id='input_33_18' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_33_9\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full email-field gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e6955dfb\" data-field-span=\"12\"><label id='gfield_label_33_9' class='gfield_label gform-field-label' for='input_33_9'><span class='gform-field-label__text'>Courriel<\/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_9' id='input_33_9' type='email' value='' class=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_33_10\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-full phone-field gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"885b464c\" data-field-span=\"12\"><label id='gfield_label_33_10' class='gfield_label gform-field-label' for='input_33_10'><span class='gform-field-label__text'>Num\u00e9ro de t\u00e9l\u00e9phone<\/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_10' id='input_33_10' type='tel' value='' class=''  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_33_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full text-field gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1ea1980d\" data-field-span=\"12\"><label id='gfield_label_33_11' class='gfield_label gform-field-label' for='input_33_11'><span class='gform-field-label__text'>Adresse<\/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_11' id='input_33_11' type='text' value='' class=''     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_33_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full text-field gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"4a2d8c89\" data-field-span=\"12\"><label id='gfield_label_33_12' class='gfield_label gform-field-label' for='input_33_12'><span class='gform-field-label__text'>Ville<\/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_12' id='input_33_12' type='text' value='' class=''     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_33_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full text-field gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"9429b4fb\" data-field-span=\"12\"><label id='gfield_label_33_13' class='gfield_label gform-field-label' for='input_33_13'><span class='gform-field-label__text'>\u00c9tat\/Province<\/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_13' id='input_33_13' type='text' value='' class=''     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_33_14\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full text-field gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"21921e3d\" data-field-span=\"12\"><label id='gfield_label_33_14' class='gfield_label gform-field-label' for='input_33_14'><span class='gform-field-label__text'>Fermeture \u00e9clair<\/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_14' id='input_33_14' type='text' value='' class=''     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_33_27' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Pr\u00e9c\u00e9dent<\/button> <button type='button' id='gform_next_button_33_27' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_33_4' class='gform_page' data-js='page-field-id-27' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_33_4' class='gform_fields top_label form_sublabel_below description_above validation_below' data-column-layout='fill'><div id=\"field_33_26\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"704321fc\" data-field-span=\"12\"><h3 class=\"gsection_title\">Votre section locale<\/h3><\/div><div id=\"field_33_15\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full text-field gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"008bda20\" data-field-span=\"12\"><label id='gfield_label_33_15' class='gfield_label gform-field-label' for='input_33_15'><span class='gform-field-label__text'>Nom de la section locale\/affili\u00e9e de l\u2019AIP<\/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_15' id='input_33_15' type='text' value='' class=''     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_33_16\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full text-field gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"721beeb1\" data-field-span=\"12\"><label id='gfield_label_33_16' class='gfield_label gform-field-label' for='input_33_16'><span class='gform-field-label__text'>Section locale\/affili\u00e9e de l\u2019AIP #<\/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_16' id='input_33_16' type='text' value='' class=''     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_33_17\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"c647400f\" data-field-span=\"12\"><label id='gfield_label_33_17' class='gfield_label gform-field-label' for='input_33_17'><span class='gform-field-label__text'>District de l\u2019AIP<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_17' id='input_33_17' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='- S\u00e9lectionnez le district -' >&#8211; S\u00e9lectionnez le district &#8211;<\/option><option value='1er district (New Jersey, New York)' >1er district (New Jersey, New York)<\/option><option value='2e district (Iowa, Kansas, Missouri, Nebraska)' >2e district (Iowa, Kansas, Missouri, Nebraska)<\/option><option value='3e district (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont)' >3e district (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont)<\/option><option value='4e district (Delaware, district de Columbia, Maryland, Pennsylvanie, Virginie, Virginie-Occidentale)' >4e district (Delaware, district de Columbia, Maryland, Pennsylvanie, Virginie, Virginie-Occidentale)<\/option><option value='5e district (Minnesota, Dakota du Nord, Dakota du Sud, Wisconsin)' >5e district (Minnesota, Dakota du Nord, Dakota du Sud, Wisconsin)<\/option><option value='6e district (Alberta, Colombie-Britannique, Territoires du Nord-Ouest, Saskatchewan, Yukon)' >6e district (Alberta, Colombie-Britannique, Territoires du Nord-Ouest, Saskatchewan, Yukon)<\/option><option value='7e district (Alaska, Idaho, Montana, Washington)' >7e district (Alaska, Idaho, Montana, Washington)<\/option><option value='8e district (Illinois, Indiana, Kentucky, Michigan, Ohio)' >8e district (Illinois, Indiana, Kentucky, Michigan, Ohio)<\/option><option value='9e district (Colorado, Nevada, Oregon, Utah, Wyoming)' >9e district (Colorado, Nevada, Oregon, Utah, Wyoming)<\/option><option value='10e district (Arizona, Californie, Hawa\u00ef, Nouveau-Mexique, Guam)' >10e district (Arizona, Californie, Hawa\u00ef, Nouveau-Mexique, Guam)<\/option><option value='11e district (Canal Zone, Oklahoma, Texas)' >11e district (Canal Zone, Oklahoma, Texas)<\/option><option value='12e district (Floride, G\u00e9orgie, Caroline du Nord, Caroline du Sud, Porto Rico, \u00eeles des Cara\u00efbes)' >12e district (Floride, G\u00e9orgie, Caroline du Nord, Caroline du Sud, Porto Rico, \u00eeles des Cara\u00efbes)<\/option><option value='13e district (Manitoba, Ontario)' >13e district (Manitoba, Ontario)<\/option><option value='14e district (Alabama, Arkansas, Louisiane, Mississippi, Tennessee)' >14e district (Alabama, Arkansas, Louisiane, Mississippi, Tennessee)<\/option><option value='15e district (Nouveau-Brunswick, Terre-Neuve, Nouvelle-\u00c9cosse, \u00cele-du-Prince-\u00c9douard, Qu\u00e9bec)' >15e district (Nouveau-Brunswick, Terre-Neuve, Nouvelle-\u00c9cosse, \u00cele-du-Prince-\u00c9douard, Qu\u00e9bec)<\/option><option value='16e district (tous les pompiers f\u00e9d\u00e9raux des \u00c9tats-Unis et du Canada)' >16e district (tous les pompiers f\u00e9d\u00e9raux des \u00c9tats-Unis et du Canada)<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_33_29' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Pr\u00e9c\u00e9dent<\/button> <button type='button' id='gform_next_button_33_29' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_33_5' class='gform_page' data-js='page-field-id-29' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_33_5' class='gform_fields top_label form_sublabel_below description_above validation_below' data-column-layout='fill'><div id=\"field_33_28\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"c15f560c\" data-field-span=\"12\"><h3 class=\"gsection_title\">Accr\u00e9ditation<\/h3><\/div><fieldset id=\"field_33_30\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"5193ae22\" data-field-span=\"12\"><legend id='gfield_label_33_30' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Accr\u00e9ditation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_33_30'><div class='gchoice gchoice_33_30_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_30.1' type='checkbox'  value='Je soumets cette candidature au nom de ma propre section locale.'  id='choice_33_30_1'    aria-labelledby=\"label_33_30_1 gfield_label_33_30\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_33_30_1' id='label_33_30_1' class='gform-field-label gform-field-label--type-inline'>Je soumets cette candidature au nom de ma propre section locale.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_33_19\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"eca8aa0d\" data-field-span=\"12\"><script>gform.addFilter(\n    'gform_datepicker_options_pre_init',\n    function ( options, formId, fieldId ) {\n        if ( formId == 33 &amp;&amp; fieldId == 4 ) {\n            options.minDate = new Date( 2025, 8, 1 );\n            options.maxDate = new Date( 2026, 7, 31 );\n        }\n\n        return options;\n    }\n);\n\n<\/script><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_33' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Pr\u00e9c\u00e9dent<\/button> <button type='submit' id='gform_submit_button_33' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Soumettre<\/button> \n          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