{"id":651,"date":"2019-03-04T10:30:13","date_gmt":"2019-03-04T10:30:13","guid":{"rendered":"http:\/\/kecgajah.demakkab.go.id\/?page_id=651"},"modified":"2019-09-04T06:33:37","modified_gmt":"2019-09-04T06:33:37","slug":"formulir","status":"publish","type":"page","link":"https:\/\/kecgajah.demakkab.go.id\/?page_id=651","title":{"rendered":"Formulir Permohonan Informasi"},"content":{"rendered":"<div id=\"vfb-form-1\" class=\"visual-form-builder-container\"><form id=\"laporan-1\" class=\"visual-form-builder vfb-form-1 \" method=\"post\" enctype=\"multipart\/form-data\">\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"1\" \/><fieldset class=\"vfb-fieldset vfb-fieldset-1 silahkan-isi-form-dibawah-ini \" id=\"item-vfb-14\"><div class=\"vfb-legend\"><h3>Silahkan isi form dibawah ini.<\/h3><\/div><ul class=\"vfb-section vfb-section-1\"><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-5\"><label for=\"vfb-5\" class=\"vfb-desc\">Nama  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-5\" id=\"vfb-5\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-8\"><label for=\"vfb-8\" class=\"vfb-desc\">Alamat  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-8\" id=\"vfb-8\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-9\"><label for=\"vfb-9\" class=\"vfb-desc\">Pekerjaan  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-9\" id=\"vfb-9\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-phone  \" id=\"item-vfb-10\"><label for=\"vfb-10\" class=\"vfb-desc\">No. Handphone  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"tel\" name=\"vfb-10\" id=\"vfb-10\" value=\"\" class=\"vfb-text  vfb-medium  required  phone \" \/><\/li><li class=\"vfb-item vfb-item-email  \" id=\"item-vfb-11\"><label for=\"vfb-11\" class=\"vfb-desc\">Email  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"email\" name=\"vfb-11\" id=\"vfb-11\" value=\"\" class=\"vfb-text  vfb-medium  required  email \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-12\"><label for=\"vfb-12\" class=\"vfb-desc\">No. Identitas KTP\/SIM  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-12\" id=\"vfb-12\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-file-upload  \" id=\"item-vfb-13\"><label for=\"vfb-13\" class=\"vfb-desc\">Upload KTP\/SIM  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"file\" name=\"vfb-13\" id=\"vfb-13\" value=\"\" class=\"vfb-text  vfb-medium  required    {accept:'png|jpe?g|gif'}\" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-15\"><label for=\"vfb-15\" class=\"vfb-desc\">Tujuan Penggunaan Informasi  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-15\" id=\"vfb-15\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><\/ul>&nbsp;<\/fieldset><fieldset class=\"vfb-fieldset vfb-fieldset-2 verifikasi \" id=\"item-vfb-2\" style=\"display:block\"><div class=\"vfb-legend\"><h3>Verifikasi<\/h3><\/div><ul class=\"vfb-section vfb-section-2\"><li class=\"vfb-item vfb-item-secret\"  style=\"display:block\"><label for=\"vfb-3\" class=\"vfb-desc\">Please enter any two digits <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"hidden\" name=\"_vfb-secret\" value=\"vfb-3\" \/><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-3\" id=\"vfb-3\" value=\"\" class=\"vfb-text  vfb-medium  required {digits:true,maxlength:2,minlength:2} \" style=\"display:block\" \/><label>Example: 12<\/label><\/span><li style=\"display:none;\"><label>This box is for spam protection - <strong>please leave it blank<\/strong>:<\/label><div><input name=\"vfb-spam\" \/><\/div><\/li>\n\t\t\t<li class=\"vfb-item vfb-item-submit\" id=\"item-vfb-4\">\n\t\t\t\t\t\t<input type=\"submit\" name=\"vfb-submit\" id=\"vfb-4\" value=\"Kirim\" class=\"vfb-submit \" \/>\n\t\t\t\t\t\t<\/li><\/ul>\n\t\t\t<\/fieldset><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F651\" \/><\/form><\/div> <!-- .visual-form-builder-container -->\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/pages\/651"}],"collection":[{"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=651"}],"version-history":[{"count":8,"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/pages\/651\/revisions"}],"predecessor-version":[{"id":1134,"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/pages\/651\/revisions\/1134"}],"wp:attachment":[{"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=651"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}