{"id":2,"date":"2022-08-18T14:32:35","date_gmt":"2022-08-18T14:32:35","guid":{"rendered":"http:\/\/firearmsguardian.co.za\/?page_id=2"},"modified":"2026-07-08T13:59:51","modified_gmt":"2026-07-08T13:59:51","slug":"join","status":"publish","type":"page","link":"https:\/\/firearmsguardian.co.za\/af\/join\/","title":{"rendered":"Sluit Aan"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2\" class=\"elementor elementor-2\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-412a91d elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"412a91d\" 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-d2a0bff\" data-id=\"d2a0bff\" 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-a05dec7 elementor--h-position-center elementor--v-position-middle elementor-arrows-position-inside elementor-pagination-position-inside elementor-widget elementor-widget-slides\" data-id=\"a05dec7\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;navigation&quot;:&quot;both&quot;,&quot;autoplay&quot;:&quot;yes&quot;,&quot;pause_on_hover&quot;:&quot;yes&quot;,&quot;pause_on_interaction&quot;:&quot;yes&quot;,&quot;autoplay_speed&quot;:5000,&quot;infinite&quot;:&quot;yes&quot;,&quot;transition&quot;:&quot;slide&quot;,&quot;transition_speed&quot;:500}\" data-widget_type=\"slides.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-swiper\">\n\t\t\t\t\t<div class=\"elementor-slides-wrapper elementor-main-swiper swiper\" role=\"region\" aria-roledescription=\"carousel\" aria-label=\"Slides\" dir=\"ltr\" data-animation=\"fadeInUp\">\n\t\t\t\t<div class=\"swiper-wrapper elementor-slides\">\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-repeater-item-8a7fa4e swiper-slide\" role=\"group\" aria-roledescription=\"slide\"><div class=\"swiper-slide-bg\" role=\"img\"><\/div><div class=\"elementor-background-overlay\"><\/div><div class=\"swiper-slide-inner\" ><div class=\"swiper-slide-contents\"><div class=\"elementor-slide-heading\">Join Today<\/div><\/div><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\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-a03a699 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a03a699\" 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-95bbf4a\" data-id=\"95bbf4a\" 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-fc7642f elementor-widget elementor-widget-text-editor\" data-id=\"fc7642f\" 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<p>We understand how busy you are, so we have made it as simple as possible to join Firearms Guardian.<\/p><p>*Policyholders are registered immediately after the application form is completed and submitted. The policyholder will get confirmation via email.<\/p>\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-b962831 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"b962831\" 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-ff4b752\" data-id=\"ff4b752\" 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-575b735 elementor-button-align-start elementor-widget elementor-widget-form\" data-id=\"575b735\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t        <input type=\"hidden\" class=\"conditional_logic_data_js hidden\" data-form-id=\"Join Today\" value=\"{&quot;field_a7997c7&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;referrer_source&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;Broker&quot;,&quot;_id&quot;:&quot;cda207a&quot;}]}}\" \/>\r\n\t\t<form class=\"elementor-form\" method=\"post\" name=\"Join Today\" aria-label=\"Join Today\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"2\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"575b735\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_f4ca384 elementor-col-100\">\n\t\t\t\t\t<b><big>Personal Details<\/big><\/b>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-referrer_source elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-referrer_source\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHow did you hear about us?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[referrer_source]\" id=\"form-field-referrer_source\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please select <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Aim and Fire\">Aim and Fire<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Bravo Tactical Africa\">Bravo Tactical Africa<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Broker\">Broker<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Burre Burger\">Burre Burger<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Canik\">Canik<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Civil Society South Africa (CSSA)\">Civil Society South Africa (CSSA)<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Dave Sheer\">Dave Sheer<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Elton Weise\">Elton Weise<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"ERSC Benoni\">ERSC Benoni<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Family and friends \/ colleagues\">Family and friends \/ colleagues<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Facebook\">Facebook<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Firearms Guardian Call Centre\">Firearms Guardian Call Centre<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Fortis\">Fortis<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Grey Man Operations\">Grey Man Operations<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Gunlicence.co.za\">Gunlicence.co.za<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Gunnery Arms &amp; Ammo\">Gunnery Arms &amp; Ammo<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Guns@Work\">Guns@Work<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Instagram\">Instagram<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Internet Search\">Internet Search<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"King of Arms\">King of Arms<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Natshoot\">Natshoot<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Own research\">Own research<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Parow Arms\">Parow Arms<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Real Deal Resources\">Real Deal Resources<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"RPO\">RPO<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Rudi Spamers\">Rudi Spamers<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Saai\">Saai<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Suburban Guns\">Suburban Guns<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"TLU SA\">TLU SA<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Wildman\">Wildman<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Word of mouth\">Word of mouth<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Yusuf Abramjee\">Yusuf Abramjee<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-referrer_email elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[referrer_email]\" id=\"form-field-referrer_email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a7997c7 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a7997c7\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName of Broker\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_a7997c7]\" id=\"form-field-field_a7997c7\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_21fe3a4 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_21fe3a4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSurname\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_21fe3a4]\" id=\"form-field-field_21fe3a4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_4dc5c87 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4dc5c87\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tID Number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_4dc5c87]\" id=\"form-field-field_4dc5c87\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_2aa8742 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2aa8742\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMobile Number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_2aa8742]\" id=\"form-field-field_2aa8742\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail Address\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_f5f958f elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_f5f958f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tStreet Address\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_f5f958f]\" id=\"form-field-field_f5f958f\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a640464 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a640464\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSuburb\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_a640464]\" id=\"form-field-field_a640464\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_0873ef1 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0873ef1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCity\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_0873ef1]\" id=\"form-field-field_0873ef1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_044c3df elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_044c3df\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProvince\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_044c3df]\" id=\"form-field-field_044c3df\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please select <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Eastern Cape\">Eastern Cape<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Free State\">Free State<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Gauteng\">Gauteng<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"KwaZulu-Natal\">KwaZulu-Natal<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Limpopo\">Limpopo<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Mpumalanga\">Mpumalanga<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Northern Cape\">Northern Cape<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"North West\">North West<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Western Cape\">Western Cape<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_2d4f333 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2d4f333\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b><big>Bank Account Details<\/big><\/b><br><br><small>Please provide your bank account information<\/small><br><br>Account Holder\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_2d4f333]\" id=\"form-field-field_2d4f333\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_417e9d3 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_417e9d3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tBank Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_417e9d3]\" id=\"form-field-field_417e9d3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_aec0c1a elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_aec0c1a\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAccount Type\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_aec0c1a]\" id=\"form-field-field_aec0c1a\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please select <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Cheque\">Cheque<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Savings\">Savings<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Transmission\">Transmission<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a0c58fd elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a0c58fd\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAccount Number (Not Card Number)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_a0c58fd]\" id=\"form-field-field_a0c58fd\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_f2771d8 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_f2771d8\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tChoose an option of cover\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_f2771d8]\" id=\"form-field-field_f2771d8\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please select <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Firearms Guardian - Option 1: R135.00 p\/m\">Firearms Guardian - Option 1: R135.00 p\/m<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Firearms Guardian - Option 2: R245.00 p\/m\">Firearms Guardian - Option 2: R245.00 p\/m<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Firearms Guardian - Option 3: R325.00 p\/m\">Firearms Guardian - Option 3: R325.00 p\/m<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_71c9590 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_71c9590\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDebit Date (Your 1st debit order will be your policy inception)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_71c9590]\" id=\"form-field-field_71c9590\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Please enter your preferred debit order date\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_55c5026 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_55c5026\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b><big>Debit Order Authorisation<\/big><\/b><br><br><small>I hereby request and authorise the Administrator, Firearms Guardian (Pty) Ltd, or its agent\/s, to draw against my bank account as indicated herein each month and to debit my account with the amount equivalent to the premium due by me to in respect of the Firearms Guardian policy, until cancelled by me in writing. In the event of an increase of the premium, Firearms Guardian, or its agent\/s, have my authority to deduct from my account the increased premium. All such debits against my account shall be treated as though I have signed and done them personally. If, in the event of payment from my bank account, such payment day falls on a Sunday or public holiday, the payment day will automatically be the following ordinary business day.<\/small>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Agree\" id=\"form-field-field_55c5026-0\" name=\"form_fields[field_55c5026]\"> <label for=\"form-field-field_55c5026-0\">Agree<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_ac05ef2 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ac05ef2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b><big>Declaration<\/big><\/b><br><br><small>I hereby apply for a Firearms Guardian policy in accordance with all applicable terms and conditions. I personally completed this application. I acknowledge that payment of premiums on the due dates is my responsibility. I warrant that all information given in this application form is true and complete. I understand and accept the implications of this application and I accept that this application, together with the applicable terms and conditions, represent the agreement between myself and the underwriter of the Firearms Guardian policy, GENRIC Insurance Company Limited (GENRIC). I further understand that the acceptance of my application is in the sole discretion of Firearms Guardian and GENRIC.<\/small>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Agree\" id=\"form-field-field_ac05ef2-0\" name=\"form_fields[field_ac05ef2]\"> <label for=\"form-field-field_ac05ef2-0\">Agree<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_12836f2 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_12836f2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b><big>Declaration and informed consent in terms of the Protection of Personal Information Act 4, of 2013 (POPIA)<\/big><\/b><br><br><small>We at GENRIC Insurance Company Limited (GENRIC) and Firearms Guardian (Pty) Ltd respect your right to privacy. We need to collect and process some of your personal information in terms of various Privacy and Data Management laws and are bound by the terms and provisions of the Protection of Personal Information Act, regarding the acquisition, usage, retention, transmission and deletion of your personal information. All information obtained or acquired from \/about you shall remain confidential unless you provide written consent, or unless we are required by law to disclose such information. Your personal information collected is for the primary purpose of providing you with insurance cover and for all other activities and processes incidental to and relevant to this purpose. As this information forms the basis of our assessment and terms, we offer you, it must be correct, complete, and up to date. We will always comply with all relevant regulations in dealing with your information and keep it secure and confidential at all times. Your information shall be kept confidential; however, we shall disclose it to certain third parties as required and other insurers for the specific purpose of insurance and to reduce and prevent any form of fraudulent activity. We may disclose your personal information to our service providers who are involved in the delivery of products or services to you. We have agreements in place to ensure that they comply with the privacy requirements as required by the Protection of Personal Information Act. When we contract with third parties, we impose appropriate security, privacy and confidentiality obligations on them to ensure that personal information that we remain responsible for, is kept secure. We will ensure that anyone to whom we pass your personal information agrees to treat your information with the same level of protection as we are obliged to do. We may also disclose your information: 1. Where we have a duty or a right to disclose in terms of law or industry codes; and 2. Where we believe it is necessary to protect our rights. You have the right to ask us to update, correct or delete your personal information. Should you decide not to accept the proposal, the information collected, will be de-identified and only used for statistical and research purposes. Should you decide to cancel this insurance contract you further consent to GENRIC and Firearms Guardian, in retaining the information in line with the legally permitted retention period, for statistical and reporting purposes only. Our Privacy Notice and POPIA Policy provides the details of how we deal with the personal information of our clients, and it is available on our website at the following address: https:\/\/www.genric.co.za. I hereby voluntary consent to GENRIC processing my Personal Information. I understand the purposes for which my Personal Information is required and for which it will be used. I give GENRIC permission to process my Personal Information as provided above.<\/small>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Agree\" id=\"form-field-field_12836f2-0\" name=\"form_fields[field_12836f2]\"> <label for=\"form-field-field_12836f2-0\">Agree<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha elementor-field-group elementor-column elementor-field-group-field_2d671e0 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_2d671e0\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LeXppQpAAAAAFuWCDCfcgd2Y7tx8rPyXY9FdFjK\" data-type=\"v2_checkbox\" data-theme=\"light\" data-size=\"normal\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-utm_source elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[utm_source]\" id=\"form-field-utm_source\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-utm_campaign elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[utm_campaign]\" id=\"form-field-utm_campaign\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Submit<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ce8b52d elementor-widget elementor-widget-html\" data-id=\"ce8b52d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script>\ndocument.addEventListener('DOMContentLoaded', function () {\n\n  const emailMap = {\n\n    'Aim and Fire': 'siratraining@aimandfire.co.za, mark@gunlicence.co.za, conrad@almega.co.za',\n\n    'Bravo Tactical Africa': 'franz@acornbrokers.co.za',\n\n    'Broker': '',\n\n    'Burre Burger': 'franz@acornbrokers.co.za, burre@droogtehulp.co.za',\n\n    'Canik': 'hn@firearmsguardian.co.za',\n\n    'Civil Society South Africa (CSSA)': 'franz@acornbrokers.co.za',\n\n    'Dave Sheer': 'mark@gunlicence.co.za, conrad@almega.co.za, ethan@davesheerct.com',\n\n    'Elton Weise': 'franz@acornbrokers.co.za, weise@breede.co.za',\n\n    'ERSC Benoni': 'franz@acornbrokers.co.za',\n\n    'Family and friends \/ colleagues': 'franz@acornbrokers.co.za',\n\n    'Facebook': 'franz@acornbrokers.co.za',\n\n    'Firearms Guardian Call Centre': 'franz@acornbrokers.co.za',\n\n    'Fortis': 'mark@gunlicence.co.za, conrad@almega.co.za',\n\n    'Grey Man Operations': 'mark@gunlicence.co.za, conrad@almega.co.za',\n\n    'Gunnery Arms & Ammo': 'mark@gunlicence.co.za, conrad@almega.co.za, accounts@gunneryguns.com',\n\n    'Gunlicence.co.za': 'mark@gunlicence.co.za, conrad@almega.co.za',\n\n    'Guns@Work': 'franz@acornbrokers.co.za',\n\n    'Instagram': 'franz@acornbrokers.co.za',\n\n    'Internet Search': 'franz@acornbrokers.co.za',\n\n    'King of Arms': 'franz@acornbrokers.co.za',\n\n    'Natshoot': 'fins@natshoot.co.za, hardus@natshoot.co.za, chene@natshoot.co.za, mark@gunlicence.co.za, conrad@almega.co.za',\n\n    'Own research': 'franz@acornbrokers.co.za',\n\n    'Parow Arms': 'franz@acornbrokers.co.za',\n\n    'Real Deal Resources': 'franz@acornbrokers.co.za, hamish@realdealresources.co.za',\n\n    'RPO': 'franz@acornbrokers.co.za',\n\n    'Rudi Spamers': 'rudi@witc.co.za, mark@gunlicence.co.za, conrad@almega.co.za',\n\n    'Saai': 'franz@acornbrokers.co.za, Francois@saai.org',\n\n    'Suburban Guns': 'mark@gunlicence.co.za, conrad@almega.co.za, 350@suburbanguns.co.za',\n\n    'TLU SA': 'franz@acornbrokers.co.za',\n\n    'Wildman': 'franz@acornbrokers.co.za',\n\n    'Word of mouth': 'franz@acornbrokers.co.za',\n\n    'Yusuf Abramjee': 'Yusuf@abramjee.com, franz@acornbrokers.co.za'\n  };\n\n  const referrerField = document.querySelector('[name=\"form_fields[referrer_source]\"]');\n  const emailField = document.querySelector('[name=\"form_fields[referrer_email]\"]');\n\n  if (!referrerField || !emailField) return;\n\n  function updateEmailField() {\n    emailField.value = emailMap[referrerField.value] || '';\n  }\n\n  referrerField.addEventListener('change', updateEmailField);\n\n  const form = referrerField.closest('form');\n\n  if (form) {\n    form.addEventListener('submit', updateEmailField, true);\n  }\n\n  updateEmailField();\n\n});\n<\/script>\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-582de41 elementor-hidden-desktop elementor-hidden-tablet elementor-hidden-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"582de41\" 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-1c3aa37\" data-id=\"1c3aa37\" 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-33c47c6 elementor-button-align-start elementor-widget elementor-widget-form\" data-id=\"33c47c6\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t        <input type=\"hidden\" class=\"conditional_logic_data_js hidden\" data-form-id=\"Join\" value=\"{&quot;field_a7997c7&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_290280d&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;Broker&quot;,&quot;_id&quot;:&quot;cda207a&quot;}]},&quot;field_2d4f333&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_fb9ad4e&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;Debit Order&quot;,&quot;_id&quot;:&quot;8847795&quot;}]},&quot;field_417e9d3&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_fb9ad4e&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;Debit Order&quot;,&quot;_id&quot;:&quot;4927b1c&quot;}]},&quot;field_aec0c1a&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_fb9ad4e&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;Debit Order&quot;,&quot;_id&quot;:&quot;aa8b3ac&quot;}]},&quot;field_a0c58fd&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_fb9ad4e&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;Debit Order&quot;,&quot;_id&quot;:&quot;425c2f1&quot;}]},&quot;field_f2771d8&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ANY&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_fb9ad4e&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;Debit Order&quot;,&quot;_id&quot;:&quot;34931f1&quot;},{&quot;conditional_logic_id&quot;:&quot;field_fb9ad4e&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;EFT&quot;,&quot;_id&quot;:&quot;7f7f981&quot;}]},&quot;field_71c9590&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_fb9ad4e&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;Debit Order&quot;,&quot;_id&quot;:&quot;84fe3cf&quot;}]},&quot;field_55c5026&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_fb9ad4e&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;Debit Order&quot;,&quot;_id&quot;:&quot;3bc28f4&quot;}]},&quot;field_184a52b&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_fb9ad4e&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;EFT&quot;,&quot;_id&quot;:&quot;84fe3cf&quot;}]},&quot;field_57a11e2&quot;:{&quot;display&quot;:&quot;show&quot;,&quot;trigger&quot;:&quot;ALL&quot;,&quot;datas&quot;:[{&quot;conditional_logic_id&quot;:&quot;field_fb9ad4e&quot;,&quot;conditional_logic_operator&quot;:&quot;==&quot;,&quot;conditional_logic_value&quot;:&quot;EFT&quot;,&quot;_id&quot;:&quot;84fe3cf&quot;}]}}\" \/>\r\n\t\t<form class=\"elementor-form\" method=\"post\" name=\"Join\" aria-label=\"Join\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"2\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"33c47c6\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_f4ca384 elementor-col-100\">\n\t\t\t\t\t<b><big>Personal Details<\/big><\/b>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_290280d elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_290280d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tHow did you hear about us?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_290280d]\" id=\"form-field-field_290280d\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please select <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Bravo Tactical Africa\">Bravo Tactical Africa<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Broker\">Broker<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Burre Burger\">Burre Burger<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Civil Society South Africa (CSSA)\">Civil Society South Africa (CSSA)<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Elton Weise\">Elton Weise<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"ERSC Benoni\">ERSC Benoni<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Family and friends \/ colleagues\">Family and friends \/ colleagues<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Facebook\">Facebook<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Firearms Guardian Call Centre\">Firearms Guardian Call Centre<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Fortis\">Fortis<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Grey Man Operations \">Grey Man Operations <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Gunlicence.co.za\">Gunlicence.co.za<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Guns@Work\">Guns@Work<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Instagram\">Instagram<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Internet Search\">Internet Search<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"King of Arms\">King of Arms<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Natshoot\">Natshoot<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Own research\">Own research<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Parow Arms\">Parow Arms<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Real Deal Resources\">Real Deal Resources<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"RPO\">RPO<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Saai\">Saai<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"TLU SA\">TLU SA<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Wildman\">Wildman<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Word of mouth\">Word of mouth<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Yusuf Abramjee\">Yusuf Abramjee<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a7997c7 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a7997c7\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName of Broker\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_a7997c7]\" id=\"form-field-field_a7997c7\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_21fe3a4 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_21fe3a4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSurname\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_21fe3a4]\" id=\"form-field-field_21fe3a4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_4dc5c87 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4dc5c87\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tID Number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_4dc5c87]\" id=\"form-field-field_4dc5c87\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_2aa8742 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2aa8742\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMobile Number\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_2aa8742]\" id=\"form-field-field_2aa8742\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail Address\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_f5f958f elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_f5f958f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tStreet Address\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_f5f958f]\" id=\"form-field-field_f5f958f\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a640464 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a640464\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSuburb\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_a640464]\" id=\"form-field-field_a640464\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_0873ef1 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0873ef1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCity\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_0873ef1]\" id=\"form-field-field_0873ef1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_044c3df elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_044c3df\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProvince\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_044c3df]\" id=\"form-field-field_044c3df\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please select <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Eastern Cape\">Eastern Cape<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Free State\">Free State<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Gauteng\">Gauteng<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"KwaZulu-Natal\">KwaZulu-Natal<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Limpopo\">Limpopo<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Mpumalanga\">Mpumalanga<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Northern Cape\">Northern Cape<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"North West\">North West<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Western Cape\">Western Cape<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_fb9ad4e elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_fb9ad4e\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPayment Method\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_fb9ad4e]\" id=\"form-field-field_fb9ad4e\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please select payment method <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Debit Order\">Debit Order<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"EFT\">EFT<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_2d4f333 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2d4f333\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b><big>Bank Account Details<\/big><\/b><br><br><small>Please provide your bank account information<\/small><br><br>Account Holder\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_2d4f333]\" id=\"form-field-field_2d4f333\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_417e9d3 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_417e9d3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tBank Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_417e9d3]\" id=\"form-field-field_417e9d3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_aec0c1a elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_aec0c1a\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAccount Type\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_aec0c1a]\" id=\"form-field-field_aec0c1a\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please select <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Cheque\">Cheque<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Savings\">Savings<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Transmission\">Transmission<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_a0c58fd elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a0c58fd\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAccount Number (Not Card Number)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_a0c58fd]\" id=\"form-field-field_a0c58fd\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_f2771d8 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_f2771d8\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tChoose an option of cover\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_f2771d8]\" id=\"form-field-field_f2771d8\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please select <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Firearms Guardian - Option 1: R135.00 p\/m\">Firearms Guardian - Option 1: R135.00 p\/m<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Firearms Guardian - Option 2: R245.00 p\/m\">Firearms Guardian - Option 2: R245.00 p\/m<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Firearms Guardian - Option 3: R325.00 p\/m\">Firearms Guardian - Option 3: R325.00 p\/m<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_71c9590 elementor-col-100 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_71c9590\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDebit Date (Your 1st debit order will be your policy inception)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_71c9590]\" id=\"form-field-field_71c9590\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Please enter your preferred debit order date\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_55c5026 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_55c5026\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b><big>Debit Order Authorisation<\/big><\/b><br><br><small>I hereby request and authorise the Administrator, Firearms Guardian (Pty) Ltd, or its agent\/s, to draw against my bank account as indicated herein each month and to debit my account with the amount equivalent to the premium due by me to in respect of the Firearms Guardian policy, until cancelled by me in writing. In the event of an increase of the premium, Firearms Guardian, or its agent\/s, have my authority to deduct from my account the increased premium. All such debits against my account shall be treated as though I have signed and done them personally. If, in the event of payment from my bank account, such payment day falls on a Sunday or public holiday, the payment day will automatically be the following ordinary business day.<\/small>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Agree\" id=\"form-field-field_55c5026-0\" name=\"form_fields[field_55c5026]\"> <label for=\"form-field-field_55c5026-0\">Agree<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_184a52b elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_184a52b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate of First Payment\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_184a52b]\" id=\"form-field-field_184a52b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Please enter your preferred first payment date\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-field_57a11e2 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_57a11e2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPayment Frequency\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"eicon-caret-down\"><\/i>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[field_57a11e2]\" id=\"form-field-field_57a11e2\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">Please select a monthly or annual payment option <\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Monthly\">Monthly<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Annual\">Annual<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_ac05ef2 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ac05ef2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b><big>Declaration<\/big><\/b><br><br><small>I hereby apply for a Firearms Guardian policy in accordance with all applicable terms and conditions. I personally completed this application. I acknowledge that payment of premiums on the due dates is my responsibility. I warrant that all information given in this application form is true and complete. I understand and accept the implications of this application and I accept that this application, together with the applicable terms and conditions, represent the agreement between myself and the underwriter of the Firearms Guardian policy, GENRIC Insurance Company Limited (GENRIC). I further understand that the acceptance of my application is in the sole discretion of Firearms Guardian and GENRIC.<\/small>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Agree\" id=\"form-field-field_ac05ef2-0\" name=\"form_fields[field_ac05ef2]\"> <label for=\"form-field-field_ac05ef2-0\">Agree<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_12836f2 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_12836f2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t<b><big>Declaration and informed consent in terms of the Protection of Personal Information Act 4, of 2013 (POPIA)<\/big><\/b><br><br><small>We at GENRIC Insurance Company Limited (GENRIC) and Firearms Guardian (Pty) Ltd respect your right to privacy. We need to collect and process some of your personal information in terms of various Privacy and Data Management laws and are bound by the terms and provisions of the Protection of Personal Information Act, regarding the acquisition, usage, retention, transmission and deletion of your personal information. All information obtained or acquired from \/about you shall remain confidential unless you provide written consent, or unless we are required by law to disclose such information. Your personal information collected is for the primary purpose of providing you with insurance cover and for all other activities and processes incidental to and relevant to this purpose. As this information forms the basis of our assessment and terms, we offer you, it must be correct, complete, and up to date. We will always comply with all relevant regulations in dealing with your information and keep it secure and confidential at all times. Your information shall be kept confidential; however, we shall disclose it to certain third parties as required and other insurers for the specific purpose of insurance and to reduce and prevent any form of fraudulent activity. We may disclose your personal information to our service providers who are involved in the delivery of products or services to you. We have agreements in place to ensure that they comply with the privacy requirements as required by the Protection of Personal Information Act. When we contract with third parties, we impose appropriate security, privacy and confidentiality obligations on them to ensure that personal information that we remain responsible for, is kept secure. We will ensure that anyone to whom we pass your personal information agrees to treat your information with the same level of protection as we are obliged to do. We may also disclose your information: 1. Where we have a duty or a right to disclose in terms of law or industry codes; and 2. Where we believe it is necessary to protect our rights. You have the right to ask us to update, correct or delete your personal information. Should you decide not to accept the proposal, the information collected, will be de-identified and only used for statistical and research purposes. Should you decide to cancel this insurance contract you further consent to GENRIC and Firearms Guardian, in retaining the information in line with the legally permitted retention period, for statistical and reporting purposes only. Our Privacy Notice and POPIA Policy provides the details of how we deal with the personal information of our clients, and it is available on our website at the following address: https:\/\/www.genric.co.za. I hereby voluntary consent to GENRIC processing my Personal Information. I understand the purposes for which my Personal Information is required and for which it will be used. I give GENRIC permission to process my Personal Information as provided above.<\/small>\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Agree\" id=\"form-field-field_12836f2-0\" name=\"form_fields[field_12836f2]\"> <label for=\"form-field-field_12836f2-0\">Agree<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha elementor-field-group elementor-column elementor-field-group-field_2d671e0 elementor-col-100\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_2d671e0\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LeXppQpAAAAAFuWCDCfcgd2Y7tx8rPyXY9FdFjK\" data-type=\"v2_checkbox\" data-theme=\"light\" data-size=\"normal\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-utm_source elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[utm_source]\" id=\"form-field-utm_source\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-hidden elementor-field-group elementor-column elementor-field-group-utm_campaign elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"hidden\" name=\"form_fields[utm_campaign]\" id=\"form-field-utm_campaign\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Submit<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b24c0cf elementor-hidden-desktop elementor-hidden-tablet elementor-hidden-mobile elementor-widget elementor-widget-shortcode\" data-id=\"b24c0cf\" 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\"><script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme' id='gform_wrapper_1' >\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_1'  action='\/af\/wp-json\/wp\/v2\/pages\/2' novalidate>\n                        <div class='gform_body gform-body'><div id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_1_97\"  class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_97\"><h3 class=\"gsection_title\">Personal Details<\/h3><div class='gsection_description' id='gfield_description_1_97'>Electronic debit order agreement<\/div><\/div><div id=\"field_1_188\"  class=\"gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_188\"><label class='gfield_label' for='input_1_188' >How did you hear about us?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_188' id='input_1_188' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select one of the following<\/option><option value='Gun Licence' >Gun Licence<\/option><option value='Acorn Brokers' >Acorn Brokers<\/option><option value='GunOwnerCovered' >GunOwnerCovered<\/option><option value='SAPCOR' >SAPCOR<\/option><option value='Bravo Tactical Africa' >Bravo Tactical Africa<\/option><option value='Personal Safety' >Personal Safety<\/option><option value='TLUSA' >TLUSA<\/option><option value='Associated Broker' >Associated Broker<\/option><option value='Facebook' >Facebook<\/option><option value='Internet Search' >Internet Search<\/option><option value='Firearm Store' >Firearm Store<\/option><option value='Word of Mouth' >Word of Mouth<\/option><option value='Family or Friends' >Family or Friends<\/option><option value='Fortis' >Fortis<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_1_133\"  class=\"gfield gfield--width-full gf_right_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_133\"><label class='gfield_label' for='input_1_133' >Surname<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_133' id='input_1_133' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_132\"  class=\"gfield gf_left_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_132\"><label class='gfield_label' for='input_1_132' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_132' id='input_1_132' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_134\"  class=\"gfield gf_left_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_134\"><label class='gfield_label' for='input_1_134' >ID Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_134' id='input_1_134' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_139\"  class=\"gfield gf_right_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_139\"><label class='gfield_label' for='input_1_139' >Cell Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_139' id='input_1_139' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_1_90\"  class=\"gfield gf_right_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_90\"><label class='gfield_label' for='input_1_90' >Email Address<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_90' id='input_1_90' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_1_140\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_140\"><legend class='gfield_label gfield_label_before_complex'  >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 ginput_container_address' id='input_1_140' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1' id='input_1_140_1_container' >\n                                        <input type='text' name='input_140.1' id='input_1_140_1' value=''    aria-required='true'    \/>\n                                        <label for='input_1_140_1' id='input_1_140_1_label' >Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_1_140_2_container' >\n                                        <input type='text' name='input_140.2' id='input_1_140_2' value=''     aria-required='false'   \/>\n                                        <label for='input_1_140_2' id='input_1_140_2_label' >Address Line 2<\/label>\n                                    <\/span><input type='hidden' class='gform_hidden' name='input_140.4' id='input_1_140_4' value=''\/><input type='hidden' class='gform_hidden' name='input_140.6' id='input_1_140_6' value='South Africa' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_1_123\"  class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_123\"><h3 class=\"gsection_title\">Bank Account Details<\/h3><div class='gsection_description' id='gfield_description_1_123'>Please provide your bank account information.<\/div><\/div><div id=\"field_1_136\"  class=\"gfield gf_left_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_136\"><label class='gfield_label' for='input_1_136' >Account Holder<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_136' id='input_1_136' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_137\"  class=\"gfield gf_left_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_137\"><label class='gfield_label' for='input_1_137' >Bank Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_137' id='input_1_137' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_138\"  class=\"gfield gf_left_half gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_138\"><label class='gfield_label' for='input_1_138' >Account Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_138' id='input_1_138' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_1_142\"  class=\"gfield field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_142\"><label class='gfield_label' for='input_1_142' >Account Type<\/label><div class='ginput_container ginput_container_select'><select name='input_142' id='input_1_142' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Current (Cheque)' >Current (Cheque)<\/option><option value='Savings' >Savings<\/option><option value='Transmission' >Transmission<\/option><\/select><\/div><\/div><div id=\"field_1_156\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_156\"><label class='gfield_label' for='input_1_156' >Choose an option of cover<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_156' id='input_1_156' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select your option<\/option><option value='Firearms Guardian - Option 1 : R135.00 p\/m' >Firearms Guardian - Option 1 : R135.00 p\/m<\/option><option value='Firearms Guardian - Option 2 : R245.00 p\/m' >Firearms Guardian - Option 2 : R245.00 p\/m<\/option><\/select><\/div><\/div><div id=\"field_1_147\"  class=\"gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_147\"><label class='gfield_label' for='input_1_147' >Debit Date (Your 1st debit order will be your policy inception)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_147' id='input_1_147' class='medium gfield_select'  aria-describedby=\"gfield_description_1_147\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='1st' >1st<\/option><option value='7th' >7th<\/option><option value='15th' >15th<\/option><option value='25th' >25th<\/option><option value='Last day' >Last day<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_1_147'>Your Firearms Guardian policy will only become active once the first debit premium order is received by the insurer.<\/div><\/div><div id=\"field_1_184\"  class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_184\"><h3 class=\"gsection_title\">Debit Order Authorisation<\/h3><\/div><fieldset id=\"field_1_158\"  class=\"gfield field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_158\"><legend class='gfield_label gfield_label_before_complex'  >I hereby request and authorise the Administrator, Firearms Guardian (Pty) Ltd, or its agent\/s, to draw against my bank account as indicated herein each month and to debit my account with the amount equivalent to the premium due by me to in respect of the Firearms Guardian policy, until cancelled by me in writing. In the event of an increase of the premium, Firearms Guardian, or its agent\/s, have my authority to deduct from my account the increased premium. All such debits against my account shall be treated as though I have signed and done them personally. If, in the event of payment from my bank account, such payment day falls on a Sunday or public holiday, the payment day will automatically be the following ordinary business day.<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_1_158'><div class='gchoice gchoice_1_158_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.1' type='checkbox'  value='Agree'  id='choice_1_158_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_158_1' id='label_1_158_1'>Agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_185\"  class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_185\"><h3 class=\"gsection_title\">Declaration<\/h3><\/div><fieldset id=\"field_1_159\"  class=\"gfield field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_159\"><legend class='gfield_label gfield_label_before_complex'  >I hereby apply for a Firearms Guardian policy in accordance with all applicable terms and conditions. I personally completed this application. I acknowledge that payment of premiums on the due dates is my responsibility. I warrant that all information given in this application form is true and complete. I understand and accept the implications of this application and I accept that this application, together with the applicable terms and conditions, represent the agreement between myself and the underwriter of the Firearms Guardian policy, GENRIC Insurance Company Limited (GENRIC). I further understand that the acceptance of my application is in the sole discretion of Firearms Guardian and GENRIC.<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_1_159'><div class='gchoice gchoice_1_159_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.1' type='checkbox'  value='Agree'  id='choice_1_159_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_159_1' id='label_1_159_1'>Agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_186\"  class=\"gfield gsection field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_186\"><h3 class=\"gsection_title\">Declaration and informed consent in terms of the Protection of Personal Information Act 4, of 2013 (POPIA)<\/h3><\/div><fieldset id=\"field_1_180\"  class=\"gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_180\"><legend class='gfield_label gfield_label_before_complex'  >We at GENRIC Insurance Company Limited (GENRIC) and Firearms Guardian (Pty) Ltd respect your right to privacy. We need to collect and process some of your personal information in terms of various Privacy and Data Management laws and are bound by the terms and provisions of the Protection of Personal Information Act, regarding the acquisition, usage, retention, transmission and deletion of your personal information. All information obtained or acquired from \/about you shall remain confidential unless you provide written consent, or unless we are required by law to disclose such information. Your personal information collected is for the primary purpose of providing you with insurance cover and for all other activities and processes incidental to and relevant to this purpose. As this information forms the basis of our assessment and terms, we offer you, it must be correct, complete, and up to date. We will always comply with all relevant regulations in dealing with your information and keep it secure and confidential at all times. Your information shall be kept confidential; however, we shall disclose it to certain third parties as required and other insurers for the specific purpose of insurance and to reduce and prevent any form of fraudulent activity. We may disclose your personal information to our service providers who are involved in the delivery of products or services to you. We have agreements in place to ensure that they comply with the privacy requirements as required by the Protection of Personal Information Act. When we contract with third parties, we impose appropriate security, privacy and confidentiality obligations on them to ensure that personal information that we remain responsible for, is kept secure. We will ensure that anyone to whom we pass your personal information agrees to treat your information with the same level of protection as we are obliged to do. We may also disclose your information: 1. Where we have a duty or a right to disclose in terms of law or industry codes; and 2. Where we believe it is necessary to protect our rights. You have the right to ask us to update, correct or delete your personal information. Should you decide not to accept the proposal, the information collected, will be de-identified and only used for statistical and research purposes. Should you decide to cancel this insurance contract you further consent to GENRIC and Firearms Guardian, in retaining the information in line with the legally permitted retention period, for statistical and reporting purposes only. Our Privacy Notice and POPIA Policy provides the details of how we deal with the personal information of our clients, and it is available on our website at the following address: https:\/\/www.genric.co.za. I hereby voluntary consent to GENRIC processing my Personal Information. I understand the purposes for which my Personal Information is required and for which it will be used. I give GENRIC permission to process my Personal Information as provided above.<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_1_180'><div class='gchoice gchoice_1_180_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_180.1' type='checkbox'  value='Agree'  id='choice_1_180_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_1_180_1' id='label_1_180_1'>Agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_1_157\"  class=\"gfield field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_157\"><label class='gfield_label' for='input_1_157' >CAPTCHA<\/label><div class='gfield_captcha_container'><img class='gfield_captcha' src='https:\/\/firearmsguardian.co.za\/wp-content\/uploads\/gravity_forms\/0-417a4a8d83e9a15a2cf7d2195b00d4f6\/2054210121.png' alt='' width='150' height='42' \/><div class='gfield_captcha_input_container simple_captcha_medium'><input type='text' autocomplete='off' name='input_157' id='input_1_157' \/><input type='hidden' name='input_captcha_prefix_157' value='2054210121' \/><\/div><\/div><\/div><div id=\"field_1_189\"  class=\"gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible\"  data-js-reload=\"field_1_189\"><label class='gfield_label' for='input_1_189' >Comments<\/label><div class='ginput_container'><input name='input_189' id='input_1_189' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_1_189'>This field is for validation purposes and should be left unchanged.<\/div><\/div><\/div><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_1' class='gform_button button' value='SUBMIT'  onclick='if(window[\"gf_submitting_1\"]){return false;}  if( !jQuery(\"#gform_1\")[0].checkValidity || jQuery(\"#gform_1\")[0].checkValidity()){window[\"gf_submitting_1\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_1\"]){return false;} if( !jQuery(\"#gform_1\")[0].checkValidity || jQuery(\"#gform_1\")[0].checkValidity()){window[\"gf_submitting_1\"]=true;}  jQuery(\"#gform_1\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_1' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='1' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_1' value='WyJbXSIsIjBhMzQ1ZDU0NWIwNjBiZGM1ZGZlNTA3MWEzMDlmOWIxIl0=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_target_page_number_1' id='gform_target_page_number_1' value='0' \/>\n            <input type='hidden' class='gform_hidden' name='gform_source_page_number_1' id='gform_source_page_number_1' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><\/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<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Join Today We understand how busy you are, so we have made it as simple as possible to join Firearms Guardian. *Policyholders are registered immediately after the application form is completed and submitted. The policyholder will get confirmation via email.<\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"elementor_header_footer","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"class_list":["post-2","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/firearmsguardian.co.za\/af\/wp-json\/wp\/v2\/pages\/2","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/firearmsguardian.co.za\/af\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/firearmsguardian.co.za\/af\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/firearmsguardian.co.za\/af\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/firearmsguardian.co.za\/af\/wp-json\/wp\/v2\/comments?post=2"}],"version-history":[{"count":282,"href":"https:\/\/firearmsguardian.co.za\/af\/wp-json\/wp\/v2\/pages\/2\/revisions"}],"predecessor-version":[{"id":8993,"href":"https:\/\/firearmsguardian.co.za\/af\/wp-json\/wp\/v2\/pages\/2\/revisions\/8993"}],"wp:attachment":[{"href":"https:\/\/firearmsguardian.co.za\/af\/wp-json\/wp\/v2\/media?parent=2"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}