{"id":205,"date":"2016-08-17T08:07:11","date_gmt":"2016-08-17T12:07:11","guid":{"rendered":"http:\/\/paicmember.com\/?page_id=205"},"modified":"2024-03-26T17:29:37","modified_gmt":"2024-03-26T21:29:37","slug":"membership-application","status":"publish","type":"page","link":"https:\/\/paicmember.com\/membership-application\/","title":{"rendered":"Membership Application"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; next_background_color=&#8221;#ffffff&#8221; _builder_version=&#8221;4.18.0&#8243; background_image=&#8221;https:\/\/paicmember.com\/wp-content\/uploads\/2022\/10\/47381804_m.jpg&#8221; min_height_tablet=&#8221;638px&#8221; min_height_phone=&#8221;&#8221; min_height_last_edited=&#8221;on|phone&#8221; height=&#8221;636px&#8221; height_tablet=&#8221;1000px&#8221; height_phone=&#8221;720px&#8221; height_last_edited=&#8221;on|phone&#8221; custom_margin=&#8221;||1px|||&#8221; custom_padding=&#8221;16px||136px|||&#8221; top_divider_arrangement_tablet=&#8221;&#8221; top_divider_arrangement_phone=&#8221;&#8221; top_divider_arrangement_last_edited=&#8221;on|desktop&#8221; bottom_divider_style=&#8221;asymmetric2&#8243; bottom_divider_height=&#8221;110px&#8221; background_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row custom_padding_last_edited=&#8221;on|phone&#8221; module_class=&#8221; et_pb_row_fullwidth&#8221; _builder_version=&#8221;4.16&#8243; width=&#8221;89%&#8221; width_tablet=&#8221;80%&#8221; width_phone=&#8221;&#8221; width_last_edited=&#8221;on|desktop&#8221; max_width=&#8221;89%&#8221; max_width_tablet=&#8221;80%&#8221; max_width_phone=&#8221;&#8221; max_width_last_edited=&#8221;on|desktop&#8221; min_height=&#8221;89px&#8221; custom_padding=&#8221;27px|0px|0px|0px|false|false&#8221; custom_padding_tablet=&#8221;27px|0px|0px|0px|false|false&#8221; custom_padding_phone=&#8221;27px|0px|25px|0px|false|false&#8221; animation_direction=&#8221;bottom&#8221; make_fullwidth=&#8221;on&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text _builder_version=&#8221;4.17.6&#8243; text_font=&#8221;|800|||||||&#8221; text_text_color=&#8221;#FFFFFF&#8221; text_font_size=&#8221;33px&#8221; text_line_height=&#8221;1em&#8221; custom_margin=&#8221;11px||12px|||&#8221; custom_padding=&#8221;2px|||||&#8221; animation_direction=&#8221;bottom&#8221; text_font_size_tablet=&#8221;32px&#8221; text_font_size_phone=&#8221;19px&#8221; text_font_size_last_edited=&#8221;on|desktop&#8221; text_text_shadow_style=&#8221;preset3&#8243; text_text_shadow_color=&#8221;#000000&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>professional association of independent contractors<\/p>\n<p>[\/et_pb_text][et_pb_image src=&#8221;https:\/\/paicmember.com\/wp-content\/uploads\/2022\/11\/PAIC-LOGO-Transparent-Bkgrnd-500-500.png&#8221; title_text=&#8221;PAIC LOGO Transparent Bkgrnd 500-500&#8243; src_tablet=&#8221;https:\/\/paicmember.com\/wp-content\/uploads\/2022\/08\/PAIC-LOGO-DESIGN-format-PNG-BLACK.png&#8221; src_phone=&#8221;https:\/\/paicmember.com\/wp-content\/uploads\/2022\/08\/PAIC-LOGO-DESIGN-format-PNG-BLACK.png&#8221; src_last_edited=&#8221;on|tablet&#8221; _builder_version=&#8221;4.19.0&#8243; _module_preset=&#8221;default&#8221; width=&#8221;30%&#8221; width_tablet=&#8221;50%&#8221; width_phone=&#8221;65%&#8221; width_last_edited=&#8221;on|phone&#8221; max_width_tablet=&#8221;&#8221; max_width_phone=&#8221;&#8221; max_width_last_edited=&#8221;on|tablet&#8221; max_height=&#8221;498px&#8221; animation_style=&#8221;zoom&#8221; scroll_horizontal_motion=&#8221;0|43|43|43|4|0|-4&#8243; global_colors_info=&#8221;{}&#8221;][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;section&#8221; _builder_version=&#8221;4.16&#8243; global_colors_info=&#8221;{}&#8221;][et_pb_row admin_label=&#8221;row&#8221; _builder_version=&#8221;4.18.0&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; width=&#8221;69%&#8221; max_width=&#8221;2050px&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_cta title=&#8221;Membership Application&#8221; button_url=&#8221;http:\/\/paicmember.com\/wp-content\/uploads\/2024\/03\/PAIC-Enrollment-Application_Consent-2.21.24.pdf&#8221; url_new_window=&#8221;on&#8221; button_text=&#8221;Download Application&#8221; admin_label=&#8221;Call To Action&#8221; _builder_version=&#8221;4.24.2&#8243; body_font_size=&#8221;16px&#8221; background_color=&#8221;RGBA(255,255,255,0)&#8221; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; custom_button=&#8221;on&#8221; button_text_color=&#8221;#FFFFFF&#8221; button_bg_color=&#8221;#757575&#8243; button_icon=&#8221;&#xf019;||fa||900&#8243; button_on_hover=&#8221;off&#8221; text_orientation=&#8221;left&#8221; background_layout=&#8221;light&#8221; hover_enabled=&#8221;0&#8243; use_border_color=&#8221;off&#8221; border_color=&#8221;#ffffff&#8221; border_style=&#8221;solid&#8221; button_letter_spacing_hover=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; button_text_size__hover_enabled=&#8221;off&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_text_color__hover_enabled=&#8221;off&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_border_width__hover_enabled=&#8221;off&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; button_border_color__hover_enabled=&#8221;off&#8221; button_one_border_color__hover_enabled=&#8221;off&#8221; button_two_border_color__hover_enabled=&#8221;off&#8221; button_border_radius__hover_enabled=&#8221;off&#8221; button_one_border_radius__hover_enabled=&#8221;off&#8221; 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Simply download the membership application and submit it using the upload form below to get started.<\/p>\n<p>[\/et_pb_cta][et_pb_contact_form email=&#8221;ldeyen@midwesterninsurance.com&#8221; success_message=&#8221;Thank you for submitting your application.&#8221; submit_button_text=&#8221;Submit Application&#8221; _builder_version=&#8221;4.19.0&#8243; _module_preset=&#8221;default&#8221; _unique_id=&#8221;4adb69d7-27d0-4b3f-8051-5beb0829569c&#8221; custom_button=&#8221;on&#8221; button_text_color=&#8221;#FFFFFF&#8221; button_bg_color=&#8221;#7a7a7a&#8221; button_use_icon=&#8221;off&#8221; use_custom_message_richtext=&#8221;on&#8221; custom_message_richtext=&#8221;<\/p>\n<p>This is an email from a contact form on <a href=%22https:\/\/paicmember.com\/membership-application%22>paicmember.com<\/a> and includes a completed application.<\/p>\n<\/p>\n<p><strong>Name:<\/strong> %%Name%%<\/p>\n<\/p>\n<p><strong>Email: <\/strong> %%Email%%<\/p>\n<\/p>\n<p><strong>Phone:<\/strong> %%Phone%%<\/p>\n<\/p>\n<p><strong>Message:<\/strong> %%Message%%<\/p>\n<\/p>\n<p><span style=%22color: #ff0000;%22>See attachment(s)<\/span><\/p>\n<p>&#8221; 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