{"id":9488,"date":"2025-02-06T14:23:58","date_gmt":"2025-02-06T19:23:58","guid":{"rendered":"https:\/\/mitocanada.org\/?page_id=9488"},"modified":"2025-02-06T14:23:58","modified_gmt":"2025-02-06T19:23:58","slug":"formulaire-dinscription","status":"publish","type":"page","link":"https:\/\/mitocanada.org\/fr\/formulaire-dinscription\/","title":{"rendered":"Formulaire d&rsquo;inscription"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1456px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_3_4 3_4 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:75%;--awb-margin-top-large:0px;--awb-spacing-right-large:3.84%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.56%;--awb-width-medium:75%;--awb-spacing-right-medium:3.84%;--awb-spacing-left-medium:2.56%;--awb-width-small:100%;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p>Nous vous remercions de l&rsquo;int\u00e9r\u00eat que vous portez \u00e0 MitoCanada et aux nouvelles dans le monde de l&rsquo;\u00e9ducation, de la sensibilisation et de la recherche sur les mitochondries. Dites-nous comment nous pouvons vous soutenir !<\/p>\n<\/div><div class=\"accordian fusion-accordian\" style=\"--awb-border-size:1px;--awb-icon-size:16px;--awb-content-font-size:var(--awb-typography4-font-size);--awb-icon-alignment:left;--awb-hover-color:var(--awb-color2);--awb-border-color:var(--awb-color3);--awb-background-color:var(--awb-color1);--awb-divider-color:var(--awb-color3);--awb-divider-hover-color:var(--awb-color3);--awb-icon-color:#ffffff;--awb-title-color:#000000;--awb-content-color:#000000;--awb-icon-box-color:#119bb5;--awb-toggle-hover-accent-color:#119bb5;--awb-title-font-family:var(--awb-typography1-font-family);--awb-title-font-weight:var(--awb-typography1-font-weight);--awb-title-font-style:var(--awb-typography1-font-style);--awb-title-font-size:20px;--awb-title-letter-spacing:-0.015em;--awb-title-line-height:1.2;--awb-content-font-family:&quot;Montserrat&quot;;--awb-content-font-style:normal;--awb-content-font-weight:400;\"><div class=\"panel-group fusion-toggle-icon-boxed\" id=\"accordion-9488-1\"><div class=\"fusion-panel panel-default panel-51048f40f3bde81c2 fusion-toggle-has-divider\" style=\"--awb-title-color:#000000;\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_51048f40f3bde81c2\"><a class=\"active\" aria-expanded=\"true\" aria-controls=\"51048f40f3bde81c2\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-9488-1\" data-target=\"#51048f40f3bde81c2\" href=\"#51048f40f3bde81c2\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Formulaire d'information et d'abonnement \u00e0 MitoCanada<\/span><\/a><\/h4><\/div><div id=\"51048f40f3bde81c2\" class=\"panel-collapse collapse in\" aria-labelledby=\"toggle_51048f40f3bde81c2\"><div class=\"panel-body toggle-content 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style=\"--awb-title-color:#000000;\"><div class=\"panel-heading\"><h4 class=\"panel-title toggle\" id=\"toggle_fddaf29aa42aa6145\"><a aria-expanded=\"false\" aria-controls=\"fddaf29aa42aa6145\" role=\"button\" data-toggle=\"collapse\" data-parent=\"#accordion-9488-1\" data-target=\"#fddaf29aa42aa6145\" href=\"#fddaf29aa42aa6145\"><span class=\"fusion-toggle-icon-wrapper\" aria-hidden=\"true\"><i class=\"fa-fusion-box active-icon awb-icon-minus\" aria-hidden=\"true\"><\/i><i class=\"fa-fusion-box inactive-icon awb-icon-plus\" aria-hidden=\"true\"><\/i><\/span><span class=\"fusion-toggle-heading\">Information sur MitoCanada et formulaire d'inscription<\/span><\/a><\/h4><\/div><div id=\"fddaf29aa42aa6145\" class=\"panel-collapse collapse \" aria-labelledby=\"toggle_fddaf29aa42aa6145\"><div class=\"panel-body toggle-content fusion-clearfix\">\r\n<div class=\"wpforms-container wpforms-container-full wpforms-block\" id=\"wpforms-7796\"><form id=\"wpforms-form-7796\" class=\"wpforms-validate 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for=\"wpforms-7796-field_3\" >if is learn<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-7796-field_3\" class=\"wpforms-field-medium\" name=\"wpforms&#091;fields&#093;&#091;3&#093;\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-7796-field_15-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-7796-field_15\">Town and Province<\/label><input type=\"text\" id=\"wpforms-7796-field_15\" class=\"wpforms-field-medium\" name=\"wpforms&#091;fields&#093;&#091;15&#093;\" ><\/div><div id=\"wpforms-7796-field_4-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"4\"><label class=\"wpforms-field-label\">Please tell us if you would like to (check all that apply): <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-7796-field_4\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-7796-field_4_1\" name=\"wpforms&#091;fields&#093;&#091;4&#093;&#091;&#093;\" value=\"Subscribe to MitoCanada&#039;s quarterly mitoNews eNewsletter\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7796-field_4_1\">Subscribe to MitoCanada&rsquo;s quarterly mitoNews eNewsletter<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-7796-field_4_3\" name=\"wpforms&#091;fields&#093;&#091;4&#093;&#091;&#093;\" value=\"Submit a short article for our mitoNews Community Corner section\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7796-field_4_3\">Submit a short article for our mitoNews Community Corner section<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-7796-field_4_7\" name=\"wpforms&#091;fields&#093;&#091;4&#093;&#091;&#093;\" value=\"Be featured as one of our Faces of Mito\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7796-field_4_7\">Be featured as one of our Faces of 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name=\"wpforms&#091;fields&#093;&#091;4&#093;&#091;&#093;\" value=\"Participate in patient engagement in research opportunities (like the NFRF-T grant)\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7796-field_4_10\">Participate in patient engagement in research opportunities (like the NFRF-T grant)<\/label><\/li><\/ul><\/div><div id=\"wpforms-7796-field_17-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"17\"><label class=\"wpforms-field-label\">What is your connection to MitoCanada or mitochondrial disease? <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-7796-field_17\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-7796-field_17_1\" name=\"wpforms&#091;fields&#093;&#091;17&#093;&#091;&#093;\" value=\"I am living with mitochondrial disease\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7796-field_17_1\">I am living with mitochondrial 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class=\"wpforms-field-label-inline\" for=\"wpforms-7796-field_17_4\">I am a caregiver to someone with mitochondrial disease<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"checkbox\" id=\"wpforms-7796-field_17_8\" name=\"wpforms&#091;fields&#093;&#091;17&#093;&#091;&#093;\" value=\"I am a healthcare, researcher or scientist in the field\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7796-field_17_8\">I am a healthcare, researcher or scientist in the field<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"checkbox\" id=\"wpforms-7796-field_17_9\" name=\"wpforms&#091;fields&#093;&#091;17&#093;&#091;&#093;\" value=\"I have no personal connection, just interested in learning more\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-7796-field_17_9\">I have no personal connection, just interested in learning more<\/label><\/li><\/ul><\/div><div id=\"wpforms-7796-field_16-container\" class=\"wpforms-field wpforms-field-checkbox\" 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data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-2\"><h3>Explorer<\/h3>\n<\/div><div class=\"fusion-text fusion-text-3\"><p><a href=\"https:\/\/mitocanada.org\/fr\/nouvelles-et-recherche\/bulletins-dinformation-sur-les-vies-energisantes\/\"><span style=\"color: #000000;\">Bulletin d&rsquo;information \u00e9lectronique MitoNews<\/span><\/a><\/p>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;border-color:var(--awb-color3);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:10px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-4\"><p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/mitocanada.org\/fr\/comprendre-mito\/le-coin-des-communautes\/\">Articles du coin des communaut\u00e9s<\/a><\/span><\/p>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;border-color:var(--awb-color3);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:10px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-5\"><p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/mitocanada.org\/fr\/comprendre-mito\/le-coin-des-communautes\/\">Visages de la communaut\u00e9 de Mito<\/a><\/span><\/p>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;border-color:var(--awb-color3);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:10px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-6\"><p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/mitocanada.org\/fr\/comprendre-mito\/le-coin-des-communautes\/\">Ev\u00e9nements dans le domaine de l&rsquo;\u00e9ducation<\/a><\/span><\/p>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;border-color:var(--awb-color3);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:10px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-7\"><p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/mitocanada.org\/fr\/2025-evenements-communautaires-de-collecte-de-fonds\/\">Manifestations communautaires de collecte de fonds<\/a><\/span><\/p>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;border-color:var(--awb-color3);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:10px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-8\"><p><span style=\"color: #000000;\"><a style=\"color: #000000;\" href=\"https:\/\/mitocanada.org\/fr\/registre-des-contacts-avec-les-patients-de-mitocanada\/\">Registre des contacts avec les patients<\/a><\/span><\/p>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;border-color:var(--awb-color3);border-top-width:1px;\"><\/div><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-bottom:10px;width:100%;\"><\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"class_list":["post-9488","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/mitocanada.org\/fr\/wp-json\/wp\/v2\/pages\/9488","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mitocanada.org\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mitocanada.org\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mitocanada.org\/fr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/mitocanada.org\/fr\/wp-json\/wp\/v2\/comments?post=9488"}],"version-history":[{"count":2,"href":"https:\/\/mitocanada.org\/fr\/wp-json\/wp\/v2\/pages\/9488\/revisions"}],"predecessor-version":[{"id":9490,"href":"https:\/\/mitocanada.org\/fr\/wp-json\/wp\/v2\/pages\/9488\/revisions\/9490"}],"wp:attachment":[{"href":"https:\/\/mitocanada.org\/fr\/wp-json\/wp\/v2\/media?parent=9488"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}