svi.2aeventos.net
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Submitted URL: https://www.svi.2aeventos.net/
Effective URL: https://svi.2aeventos.net/
Submission: On June 12 via api from US — Scanned from DE
Effective URL: https://svi.2aeventos.net/
Submission: On June 12 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST https://svi.2aeventos.net/?jet_form_builder_submit=submit&method=reload
<form class="jet-form-builder layout-column submit-type-ajax" action="https://svi.2aeventos.net/?jet_form_builder_submit=submit&method=reload" method="POST" data-form-id="12" data-layout="column" enctype="multipart/form-data" data-clear="1"
novalidate="null">
<div style="transform: scale(0); position: absolute;">
<div class="jet-form-builder__field-wrap">
<input name="_jfb_email_hp_" id="_jfb_email_hp_" type="email" data-field-name="_jfb_email_hp_" class="jet-form-builder__field text-field" data-jfb-sync="null" autocomplete="nope">
</div>
</div><input type="hidden" id="_wpnonce" name="_wpnonce" value="176c7cbdc2"><input type="hidden" name="_wp_http_referer" value="/">
<!--_jfb_current_render_states--><input type="hidden" name="_jfb_current_render_states[]" value="DEFAULT.STATE" data-jfb-sync=""><input type="hidden" class="jet-form-builder__field hidden-field" name="_jet_engine_booking_form_id"
data-field-name="_jet_engine_booking_form_id" value="12">
<input type="hidden" class="jet-form-builder__field hidden-field" name="_jet_engine_refer" data-field-name="_jet_engine_refer" value="https://svi.2aeventos.net/">
<input type="hidden" class="jet-form-builder__field hidden-field" name="__queried_post_id" data-field-name="__queried_post_id" value="14">
<div class="jet-form-builder-progress-pages jfb-progress-type--default jet-form-builder-progress-pages--global" data-type="default">
<div class="jet-form-builder-progress-pages__item--wrapper active-page" data-page="1">
<div class="jet-form-builder-progress-pages__item">
<div class="jet-form-builder-progress-pages__item--circle">1</div>
<div class="jet-form-builder-progress-pages__item--label">Paso 1</div>
</div>
<div class="jet-form-builder-progress-pages__separator"></div>
</div>
<div class="jet-form-builder-progress-pages__item--wrapper" data-page="2">
<div class="jet-form-builder-progress-pages__item">
<div class="jet-form-builder-progress-pages__item--circle">2</div>
<div class="jet-form-builder-progress-pages__item--label">Paso 2</div>
</div>
<div class="jet-form-builder-progress-pages__separator"></div>
</div>
<div class="jet-form-builder-progress-pages__item--wrapper" data-page="3">
<div class="jet-form-builder-progress-pages__item">
<div class="jet-form-builder-progress-pages__item--circle">3</div>
<div class="jet-form-builder-progress-pages__item--label">Enviar</div>
</div>
</div>
</div>
<div class="jet-form-builder-page " data-page="1" data-page-offset="75">
<input type="hidden" class="jet-form-builder__field hidden-field" name="post_id" data-field-name="post_id" data-jfb-sync="null" value="14">
<p><strong>Información para su proceso de inscripción</strong></p>
<p><strong>Transferencia en Bs.:</strong><br>Cuenta corriente del Banco Nacional de Crédito BNC Nro. 0191 0154 182100228915<br>a nombre de Organización 2A Eventos, C.A.<br>Rif J-41225945-8<br>Indicar en el concepto nombre del participante</p>
<p><strong>Deposito en dls en efectivo:</strong><br>Cuenta corriente del Banco Nacional de Crédito BNC Nro. 0191 0098 71 2398012857<br>a nombre de Organización 2A Eventos, C.A. Rif J-41225945-8</p>
<p><strong>Costos de inscripción:</strong><br>Médicos Miembros solventes de la SVI: 50USdls<br>Médicos Miembros no solventes de la SVI y otras especialidades: 60USdls<br>Residentes de postgrado: 20dls<br>Estudiantes: 10dls</p>
<p>Tasa BCV del día del pago</p>
<div class="jet-form-builder__next-page-wrap">
<button class="jet-form-builder__next-page" type="button">Siguiente</button>
</div>
</div>
<div class="jet-form-builder-page jet-form-builder-page--hidden" data-page="2" data-page-offset="75">
<div class="jet-form-builder-row field-type-text-field">
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Nombres <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__field-wrap">
<input required="required" name="nombres" id="nombres" type="text" data-field-name="nombres" class="jet-form-builder__field text-field" data-jfb-sync="null">
</div>
</div>
<div class="jet-form-builder-row field-type-text-field">
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Apellidos <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__field-wrap">
<input required="required" name="apellidos" id="apellidos" type="text" data-field-name="apellidos" class="jet-form-builder__field text-field" data-jfb-sync="null">
</div>
</div>
<div class="jet-form-builder-row field-type-text-field">
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Cédula de identidad <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__field-wrap">
<input required="required" name="cedula" id="cedula" type="text" data-field-name="cedula" class="jet-form-builder__field text-field" data-jfb-sync="null">
</div>
</div>
<div class="jet-form-builder-row field-type-text-field">
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Telf móvil <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__field-wrap">
<input required="required" name="telefono_de_contacto" id="telefono_de_contacto" type="tel" data-field-name="telefono_de_contacto" class="jet-form-builder__field text-field" data-jfb-sync="null">
</div>
</div>
<div class="jet-form-builder-row field-type-text-field">
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Correo electrónico <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__field-wrap">
<input required="required" name="Correoelectrnico" id="Correoelectrnico" type="email" data-field-name="Correoelectrnico" class="jet-form-builder__field text-field" data-jfb-sync="null">
</div>
</div>
<div class="jet-form-builder-row field-type-text-field">
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Especialidad <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__field-wrap">
<input required="required" name="Especialidad" id="Especialidad" type="text" data-field-name="Especialidad" class="jet-form-builder__field text-field" data-jfb-sync="null">
</div>
</div>
<div class="jet-form-builder-row field-type-radio-field wp-block-jet-forms-radio-field">
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Miembro de la SVI <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__fields-group checkradio-wrap" data-jfb-sync="">
<div class="jet-form-builder__field-wrap radio-wrap checkradio-wrap"><label class="jet-form-builder__field-label for-radio">
<input type="radio" name="miembro_de_la_svi" value="Sí " data-field-name="miembro_de_la_svi" class="jet-form-builder__field radio-field checkradio-field" required="required"><span>Sí </span></label></div>
<div class="jet-form-builder__field-wrap radio-wrap checkradio-wrap"><label class="jet-form-builder__field-label for-radio">
<input type="radio" name="miembro_de_la_svi" value="No" data-field-name="miembro_de_la_svi" class="jet-form-builder__field radio-field checkradio-field" required="required"><span>No</span></label></div>
</div>
</div>
<div class="jet-form-builder-row field-type-text-field">
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Ciudad donde trabaja <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__field-wrap">
<input required="required" name="ciudad" id="ciudad" type="text" data-field-name="ciudad" class="jet-form-builder__field text-field" data-jfb-sync="null">
</div>
</div>
<div class="jet-form-builder-row field-type-text-field">
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Estado donde trabaja <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__field-wrap">
<input required="required" name="estado" id="estado" type="text" data-field-name="estado" class="jet-form-builder__field text-field" data-jfb-sync="null">
</div>
</div>
<div class="jet-form-builder__next-page-wrap">
<div class="jet-form-builder__next-page-msg">Por favor rellene los campos con información válida.</div><!----> <button type="button" class="jet-form-builder__prev-page" data-to-page="1">Atrás </button> <button
class="jet-form-builder__next-page" type="button" disabled="">Siguiente</button>
</div>
</div>
<div class="jet-form-builder-page jet-form-builder-page--hidden" data-page="3" data-page-offset="75">
<div class="wp-block-group">
<div class="wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained">
<div class="jet-form-builder-row field-type-text-field">
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Monto pagado <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__field-wrap">
<input required="required" name="monto_del_pago" id="monto_del_pago" type="text" data-field-name="monto_del_pago" class="jet-form-builder__field text-field" data-jfb-sync="null">
</div>
</div>
<div class="jet-form-builder-row field-type-media-field">
<template class="jet-form-builder__preview-template">
<div class="jet-form-builder-file-upload__file" data-file="%file_url%">
<!-- preview -->
<!-- field -->
<div class="jet-form-builder-file-upload__file-remove" data-file-name="%file_name%">
<svg width="22" height="22" viewBox="0 0 14 15" fill="none" xmlns="http://www.w3.org/2000/svg">
<path
d="M4.375 7H6.125V12.25H4.375V7ZM7.875 7H9.625V12.25H7.875V7ZM10.5 1.75C10.5 1.51302 10.4134 1.30794 10.2402 1.13477C10.0762 0.961589 9.87109 0.875 9.625 0.875H4.375C4.12891 0.875 3.91927 0.961589 3.74609 1.13477C3.58203 1.30794 3.5 1.51302 3.5 1.75V3.5H0V5.25H0.875V14C0.875 14.237 0.957031 14.4421 1.12109 14.6152C1.29427 14.7884 1.50391 14.875 1.75 14.875H12.25C12.4961 14.875 12.7012 14.7884 12.8652 14.6152C13.0384 14.4421 13.125 14.237 13.125 14V5.25H14V3.5H10.5V1.75ZM5.25 2.625H8.75V3.5H5.25V2.625ZM11.375 5.25V13.125H2.625V5.25H11.375Z">
</path>
</svg>
</div>
<span class="jet-form-builder-file-upload__file-invalid-marker" style="display: none">
<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 20 20" fill="currentcolor" width="24" height="24" aria-hidden="true" focusable="false">
<path
d="M10 2c4.42 0 8 3.58 8 8s-3.58 8-8 8-8-3.58-8-8 3.58-8 8-8zm1.13 9.38l.35-6.46H8.52l.35 6.46h2.26zm-.09 3.36c.24-.23.37-.55.37-.96 0-.42-.12-.74-.36-.97s-.59-.35-1.06-.35-.82.12-1.07.35-.37.55-.37.97c0 .41.13.73.38.96.26.23.61.34 1.06.34s.8-.11 1.05-.34z">
</path>
</svg>
</span>
<!-- footer -->
</div>
</template>
<div class="jet-form-builder__label">
<div class="jet-form-builder__label-text">Capture de la planilla de pago <span class="jet-form-builder__required">* (obligatorio)</span></div>
</div>
<div class="jet-form-builder__field-wrap jet-form-builder-file-upload">
<div class="jet-form-builder-file-upload__content">
<div class="jet-form-builder-file-upload__loader"><svg xmlns="http://www.w3.org/2000/svg" width="38" height="38" viewBox="0 0 38 38" stroke="#fff">
<g fill="none" fill-rule="evenodd">
<g transform="translate(1 1)" stroke-width="2">
<circle stroke-opacity=".5" cx="18" cy="18" r="18"></circle>
<path d="M36 18c0-9.94-8.06-18-18-18" transform="rotate(137.826 18 18)">
<animateTransform attributeName="transform" type="rotate" from="0 18 18" to="360 18 18" dur="1s" repeatCount="indefinite"></animateTransform>
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</g>
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<div class="jet-form-builder-file-upload__files" data-args="{"max_files":1,"max_size":5242880}">
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</div>
<div class="jet-form-builder-file-upload__fields">
<input class="jet-form-builder__field file-field jet-form-builder-file-upload__input" name="capture_de_la_planilla_de_pago" data-field-name="capture_de_la_planilla_de_pago" type="file" data-form_id="12"
id="capture_de_la_planilla_de_pago" required="required" data-jfb-sync="null" accept="image/jpeg,image/png,application/pdf" data-max_size="5242880">
</div>
<div class="jet-form-builder-file-upload__message"><small>Maximum file size: 5 MB</small></div>
<div class="jet-form-builder-file-upload__errors is-hidden"></div>
</div>
<div class="jet-form-builder__desc"><small>Tipos de archivos admitidos: JPG, PNG o PDF</small></div>
</div>
</div>
</div>
<script>
jQuery(document).ready(function($) {
$(document).on('click', '.jet-form-builder__next-page', function() {
$('html, body').animate({
scrollTop: $(".jet-form-builder").offset().top
}, 500);
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</script>
<div class="jet-form-builder-row field-type-submit-field">
<div data-type="submit" class="jet-form-builder__action-button-wrapper jet-form-builder__submit-wrap has-prev">
<button type="button" class="jet-form-builder__prev-page" data-to-page="2">Atrás </button> <button class="jet-form-builder__action-button jet-form-builder__submit submit-type-ajax" type="submit">Enviar </button>
</div>
</div>
</div>
<div class="jet-form-builder-messages-wrap" data-form-id="12"></div>
</form>Text Content
Skip to content * Formulario de inscripción * Vea el Programa aquí * Sitio web SVI Menu * Formulario de inscripción * Vea el Programa aquí * Sitio web SVI XXIV JORNADAS NACIONALES DE INFECTOLOGÍA SOCIEDAD VENEZOLANA DE INFECTOLOGÍA DEL 27 AL 29 DE JUNIO LUGAR: HOTEL RENAISSANCE CARACAS LA CASTELLANA HASTA PRONTO 1 Paso 1 2 Paso 2 3 Enviar Información para su proceso de inscripción Transferencia en Bs.: Cuenta corriente del Banco Nacional de Crédito BNC Nro. 0191 0154 182100228915 a nombre de Organización 2A Eventos, C.A. Rif J-41225945-8 Indicar en el concepto nombre del participante Deposito en dls en efectivo: Cuenta corriente del Banco Nacional de Crédito BNC Nro. 0191 0098 71 2398012857 a nombre de Organización 2A Eventos, C.A. Rif J-41225945-8 Costos de inscripción: Médicos Miembros solventes de la SVI: 50USdls Médicos Miembros no solventes de la SVI y otras especialidades: 60USdls Residentes de postgrado: 20dls Estudiantes: 10dls Tasa BCV del día del pago Siguiente Nombres * (obligatorio) Apellidos * (obligatorio) Cédula de identidad * (obligatorio) Telf móvil * (obligatorio) Correo electrónico * (obligatorio) Especialidad * (obligatorio) Miembro de la SVI * (obligatorio) Sí No Ciudad donde trabaja * (obligatorio) Estado donde trabaja * (obligatorio) Por favor rellene los campos con información válida. Atrás Siguiente Monto pagado * (obligatorio) Capture de la planilla de pago * (obligatorio) Maximum file size: 5 MB Tipos de archivos admitidos: JPG, PNG o PDF Atrás Enviar Vea el Programa aquí Para más información, otras formas de pago o sugerencias escriba a: 2aeventosccs@gmail.com Si tiene problemas completando el formulario, escriba o comuníquese con: