{"id":85279,"date":"2023-06-19T08:47:20","date_gmt":"2023-06-19T12:47:20","guid":{"rendered":"https:\/\/www.cachc.ca\/adhesion\/demande-et-cotisations\/"},"modified":"2023-06-19T08:56:25","modified_gmt":"2023-06-19T12:56:25","slug":"demande-et-cotisations","status":"publish","type":"page","link":"https:\/\/www.cachc.ca\/fr\/adhesion\/demande-et-cotisations\/","title":{"rendered":"Demande et cotisations"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column width=\u00a0\u00bb1\/6&Prime;][\/vc_column][vc_column width=\u00a0\u00bb2\/3&Prime;][vc_custom_heading text=\u00a0\u00bbAdh\u00e9sion \u00e0 l&rsquo;ACCSC\u00a0\u00bb font_container=\u00a0\u00bbtag:h1|text_align:center|color:%23000000&Prime; use_theme_fonts=\u00a0\u00bbyes\u00a0\u00bb][vc_column_text]<\/p>\n<p style=\"text-align: justify;\"><span style=\"color: #ffffff;\"><span style=\"color: #000000;\">Les cotisations annuelles d&rsquo;adh\u00e9sion \u00e0 l&rsquo;ACCSC sont li\u00e9es au budget de fonctionnement annuel de votre centre de sant\u00e9, d\u00e9fini comme votre budget de fonctionnement total de toutes les sources de revenus. Les montants sp\u00e9cifiques des cotisations sont indiqu\u00e9s ci-dessous dans le formulaire d&rsquo;adh\u00e9sion. La p\u00e9riode d&rsquo;adh\u00e9sion annuelle s&rsquo;\u00e9tend du 1er avril au 31 mars. <\/span><span style=\"color: #000000;\">Devenez membre ou renouvelez votre adh\u00e9sion via notre formulaire de paiement en ligne s\u00e9curis\u00e9. Si vous pr\u00e9f\u00e9rez payer par ch\u00e8que, veuillez remplir <a href=\"https:\/\/www.cachc.ca\/wp-content\/uploads\/2023\/06\/Adhesion-2023-24-Association-canadienne-des-centres-de-sante-communautaire.pdf\" target=\"_blank\" rel=\"noopener\">cette copie papier<\/a>.<\/span><\/span><span style=\"color: #ffffff;\"><strong>d submit to us along with your cheque. <\/strong><\/span><\/p>\n<p>[\/vc_column_text]<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_17' ><form method='post' enctype='multipart\/form-data'  id='gform_17'  action='\/fr\/wp-json\/wp\/v2\/pages\/85279' data-formid='17' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_17' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_17_1\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_1'>Organization 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_1' id='input_17_1' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_17_6\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Organization Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_17_6' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_17_6_1_container' >\n                                        <input type='text' name='input_6.1' id='input_17_6_1' value=''    aria-required='true'    \/>\n                                        <label for='input_17_6_1' id='input_17_6_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_17_6_2_container' >\n                                        <input type='text' name='input_6.2' id='input_17_6_2' value=''     aria-required='false'   \/>\n                                        <label for='input_17_6_2' id='input_17_6_2_label' class='gform-field-label gform-field-label--type-sub '>Adresse ligne 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_17_6_3_container' >\n                                    <input type='text' name='input_6.3' id='input_17_6_3' value=''    aria-required='true'    \/>\n                                    <label for='input_17_6_3' id='input_17_6_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_17_6_4_container' >\n                                        <select name='input_6.4' id='input_17_6_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alberta' >Alberta<\/option><option value='Colombie-Britannique' >Colombie-Britannique<\/option><option value='Manitoba' >Manitoba<\/option><option value='Nouveau-Brunswick' >Nouveau-Brunswick<\/option><option value='Terre-Neuve-et-Labrador' >Terre-Neuve-et-Labrador<\/option><option value='Territoires du Nord-Ouest' >Territoires du Nord-Ouest<\/option><option value='Nouvelle-\u00c9cosse' >Nouvelle-\u00c9cosse<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='\u00cele du Prince-\u00c9douard' >\u00cele du Prince-\u00c9douard<\/option><option value='Qu\u00e9bec' >Qu\u00e9bec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                        <label for='input_17_6_4' id='input_17_6_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_17_6_5_container' >\n                                    <input type='text' name='input_6.5' id='input_17_6_5' value=''    aria-required='true'    \/>\n                                    <label for='input_17_6_5' id='input_17_6_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_6.6' id='input_17_6_6' value='Canada' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_17_4\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_4'>Please enter the name of the primary contact at your centre for membership.<\/div><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_17_4'>\n                            <span id='input_17_4_3_container' class='name_first gform-grid-col' >\n                                                    <input type='text' name='input_4.3' id='input_17_4_3' value=''   aria-required='true'    \/>\n                                                    <label for='input_17_4_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                               <\/span>\n                            <span id='input_17_4_6_container' class='name_last gform-grid-col' >\n                                                    <input type='text' name='input_4.6' id='input_17_4_6' value=''   aria-required='true'    \/>\n                                                    <label for='input_17_4_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                <\/span>\n                            <div class='gf_clear gf_clear_complex'><\/div>\n                        <\/div><\/li><li id=\"field_17_5\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_17_5'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_5'>Email address of primary contact<\/div><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_17_5' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_17_5\" \/>\n                        <\/div><\/li><li id=\"field_17_2\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield_price gfield_price_17_2 gfield_product_17_2 gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Membership fee for 2025-26<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_17_2'><p>CACHC&rsquo;s annual membership dues for the period beginning April 1, 2025 to March 31, 2026 are tied to your organization&#39;s Annual Operating Budget*. Please check off the budget and annual dues rate that applies to your organization: NOTE: Membership takes effect immediately upon receipt of payment.<\/p><\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_17_2'>\n\t\t\t<li class='gchoice gchoice_17_2_0'>\n\t\t\t\t<input name='input_2' type='radio' value='Budget under $1,000,000|500'  id='choice_17_2_0'    \/>\n\t\t\t\t<label for='choice_17_2_0' id='label_17_2_0' class='gform-field-label gform-field-label--type-inline'>Budget under $1,000,000 : $500\/year<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_2_1'>\n\t\t\t\t<input name='input_2' type='radio' value='Budget $1,000,000 - $1,500,000|750'  id='choice_17_2_1'    \/>\n\t\t\t\t<label for='choice_17_2_1' id='label_17_2_1' class='gform-field-label gform-field-label--type-inline'>Budget $1,000,000 - $1,500,000 : $750\/year<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_2_2'>\n\t\t\t\t<input name='input_2' type='radio' value='Budget $1,500,000 - $2,000,000|1000'  id='choice_17_2_2'    \/>\n\t\t\t\t<label for='choice_17_2_2' id='label_17_2_2' class='gform-field-label gform-field-label--type-inline'>Budget $1,500,000 - $2,000,000 : $1,000\/year<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_2_3'>\n\t\t\t\t<input name='input_2' type='radio' value='Budget  $2,000,000 - $3,000,000|1250'  id='choice_17_2_3'    \/>\n\t\t\t\t<label for='choice_17_2_3' id='label_17_2_3' class='gform-field-label gform-field-label--type-inline'>Budget $2,000,000 - $3,000,000 : $1,250\/year<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_2_4'>\n\t\t\t\t<input name='input_2' type='radio' value='Budget $3,000,000 \u2013 $4,000,000|1500'  id='choice_17_2_4'    \/>\n\t\t\t\t<label for='choice_17_2_4' id='label_17_2_4' class='gform-field-label gform-field-label--type-inline'>Budget $3,000,000 \u2013 $4,000,000 : $1,500\/year<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_2_5'>\n\t\t\t\t<input name='input_2' type='radio' value='Budget $4,000,000 \u2013 $5,000,000|2000'  id='choice_17_2_5'    \/>\n\t\t\t\t<label for='choice_17_2_5' id='label_17_2_5' class='gform-field-label gform-field-label--type-inline'>Budget $4,000,000 \u2013 $5,000,000 : $2,000\/year<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_2_6'>\n\t\t\t\t<input name='input_2' type='radio' value='Budget $5,000,000 \u2013 $6,000,000|2500'  id='choice_17_2_6'    \/>\n\t\t\t\t<label for='choice_17_2_6' id='label_17_2_6' class='gform-field-label gform-field-label--type-inline'>Budget $5,000,000 \u2013 $6,000,000: $2,500\/year<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_2_7'>\n\t\t\t\t<input name='input_2' type='radio' value='Budget $6,000,000 \u2013 $8,000,000|3000'  id='choice_17_2_7'    \/>\n\t\t\t\t<label for='choice_17_2_7' id='label_17_2_7' class='gform-field-label gform-field-label--type-inline'>Budget $6,000,000 \u2013 $8,000,000 : $3,000\/year<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_2_8'>\n\t\t\t\t<input name='input_2' type='radio' value='Budget $8,000,000 \u2013 $10,000,000|3500'  id='choice_17_2_8'    \/>\n\t\t\t\t<label for='choice_17_2_8' id='label_17_2_8' class='gform-field-label gform-field-label--type-inline'>Budget $8,000,000 \u2013 $10,000,000 : $3,500\/year<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_17_2_9'>\n\t\t\t\t<input name='input_2' type='radio' value='Budget over $10,000,000|4000'  id='choice_17_2_9'    \/>\n\t\t\t\t<label for='choice_17_2_9' id='label_17_2_9' class='gform-field-label gform-field-label--type-inline'>Budget over $10,000,000 : $4,000\/year<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_17_7\" class=\"gfield gfield--type-total gfield--input-type-total gfield_price gfield_price_17_ gfield_total gfield_total_17_ field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  aria-atomic=\"true\" aria-live=\"polite\" ><label class='gfield_label gform-field-label' for='input_17_7'>Dues Amount<\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<span class='ginput_total ginput_total_17'>$ 0.00 CAD<\/span>\n\t\t\t\t\t\t\t<input type='hidden' name='input_7' id='input_17_7' class='gform_hidden'\/>\n\t\t\t\t\t\t<\/div><\/li><li id=\"field_17_3\" class=\"gfield gfield--type-creditcard gfield--input-type-creditcard field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_17_3_1'>Credit Card<\/label><div class='ginput_complex ginput_container ginput_container_creditcard gform-grid-row' id='input_17_3'><span class='ginput_full gform-grid-col' id='input_17_3_1_container' >\n                                    <div class='gform_card_icon_container'><div class='gform_card_icon gform_card_icon_amex' >American Express<\/div><div class='gform_card_icon gform_card_icon_discover' >Discover<\/div><div class='gform_card_icon gform_card_icon_mastercard' >MasterCard<\/div><div class='gform_card_icon gform_card_icon_visa' >Visa<\/div><span class='screen-reader-text' id='field_17_3_supported_creditcards'>Cartes bancaires prises en charge\u00a0: American Express, Discover, MasterCard, Visa<\/span><\/div>\n                                    <input type='text' name='input_3.1' id='input_17_3_1' value=''   onchange='gformMatchCard(\"input_17_3_1\");' onkeyup='gformMatchCard(\"input_17_3_1\");' autocomplete='off' pattern='[0-9]*' title='Seuls les chiffres sont autoris\u00e9s'  aria-required='false'  \/>\n                                    <label for='input_17_3_1' id='input_17_3_1_label' class='gform-field-label gform-field-label--type-sub '>Num\u00e9ro de carte<\/label>\n                                 <\/span><span class='ginput_full ginput_cardextras gform-grid-col gform-grid-row' id='input_17_3_2_container'>\n                                            <span class='ginput_cardinfo_left' id='input_17_3_2_cardinfo_left'>\n                                                <span class='ginput_card_expiration_container ginput_card_field'>\n                                                    \n                                                       <select name='input_3.2[]' id='input_17_3_2_month'   class='ginput_card_expiration ginput_card_expiration_month' aria-required='false'  >\n                                                           <option value=''>Mois<\/option><option value='1' >01<\/option><option value='2' >02<\/option><option value='3' >03<\/option><option value='4' >04<\/option><option value='5' >05<\/option><option value='6' >06<\/option><option value='7' >07<\/option><option value='8' >08<\/option><option value='9' >09<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option>\n                                                       <\/select>\n                                                       \n                                                   \n                                                   \n                                                       <select name='input_3.2[]' id='input_17_3_2_year'   class='ginput_card_expiration ginput_card_expiration_year' aria-required='false'  >\n                                                           <option value=''>Ann\u00e9e<\/option><option value='2026' >2026<\/option><option value='2027' >2027<\/option><option value='2028' >2028<\/option><option value='2029' >2029<\/option><option value='2030' >2030<\/option><option value='2031' >2031<\/option><option value='2032' >2032<\/option><option value='2033' >2033<\/option><option value='2034' >2034<\/option><option value='2035' >2035<\/option><option value='2036' >2036<\/option><option value='2037' >2037<\/option><option value='2038' >2038<\/option><option value='2039' >2039<\/option><option value='2040' 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