{"id":60,"date":"2026-05-05T08:50:49","date_gmt":"2026-05-05T05:20:49","guid":{"rendered":"https:\/\/iranianpainsociety.org\/register\/?page_id=60"},"modified":"2026-05-05T08:52:04","modified_gmt":"2026-05-05T05:22:04","slug":"application-membership","status":"publish","type":"page","link":"https:\/\/iranianpainsociety.org\/register\/application-membership\/","title":{"rendered":"Application Membership"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f62-o1\" lang=\"fa-IR\" dir=\"rtl\" data-wpcf7-id=\"62\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/register\/wp-json\/wp\/v2\/pages\/60#wpcf7-f62-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"\u0641\u0631\u0645 \u062a\u0645\u0627\u0633\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"62\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.2\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"fa_IR\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f62-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<style>\n\/* === \u0641\u0631\u0645 \u0639\u0636\u0648\u06cc\u062a IASP | \u0637\u0631\u0627\u062d\u06cc \u062f\u0627\u062e\u0644\u06cc === *\/\n.iasp-form {\n direction: ltr;\n text-align: left;\n font-family: \"Vazir\", \"IRANSans\", sans-serif;\n background: #fff;\n padding: 30px 40px;\n border-radius: 16px;\n box-shadow: 0 4px 16px rgba(0,0,0,0.1);\n max-width: 800px;\n margin: 40px auto;\n}\n.iasp-form h3, \n.iasp-form h4 {\n color: #333;\n border-right: 4px solid #4CAF50;\n padding-right: 10px;\n margin-bottom: 15px;\n}\n.iasp-form label {\n display: block;\n margin-top: 15px;\n font-weight: bold;\n color: #333;\n}\n.iasp-form input[type=\"text\"],\n.iasp-form input[type=\"email\"],\n.iasp-form input[type=\"tel\"],\n.iasp-form input[type=\"date\"],\n.iasp-form textarea,\n.iasp-form select {\n width: 100%;\n padding: 10px;\n border-radius: 8px;\n border: 1px solid #ccc;\n margin-top: 6px;\n font-family: inherit;\n box-sizing: border-box;\n}\n.iasp-form textarea {\n height: 80px;\n resize: vertical;\n}\n.iasp-form hr {\n border: none;\n border-top: 1px solid #ddd;\n margin: 25px 0;\n}\n.iasp-form input[type=\"submit\"] {\n display: block;\n width: 100%;\n background-color: #4CAF50;\n color: white;\n padding: 12px;\n font-size: 16px;\n border: none;\n border-radius: 8px;\n cursor: pointer;\n transition: background 0.3s;\n margin-top: 20px;\n}\n.iasp-form input[type=\"submit\"]:hover {\n background-color: #43a047;\n}\n.iasp-form .wpcf7-checkbox {\n display: grid;\n grid-template-columns: repeat(auto-fit, minmax(220px, 1fr));\n gap: 8px 16px;\n margin-top: 10px;\n}\n.iasp-form .wpcf7-checkbox label {\n background: #f9f9f9;\n border: 1px solid #ddd;\n border-radius: 6px;\n padding: 6px 10px;\n cursor: pointer;\n transition: background 0.2s, border-color 0.2s;\n}\n.iasp-form .wpcf7-checkbox label:hover {\n background: #eef7ee;\n border-color: #4CAF50;\n}\n.iasp-form input[type=\"checkbox\"] {\n margin-left: 6px;\n transform: scale(1.1);\n}\n@media (max-width: 600px) {\n .iasp-form {\n padding: 20px;\n }\n .iasp-form .wpcf7-checkbox {\n grid-template-columns: repeat(auto-fit, minmax(160px, 1fr));\n }\n}\n<\/style>\n<div class=\"iasp-form\">\n\t<h3>Iranian Association for the Study of Pain (I.P.S)<br \/>\nApplication Membership\n\t<\/h3>\n\t<p><label>First Name:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"First Name\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span>\n\t<\/p>\n\t<p><label>Last Name:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Last Name\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span>\n\t<\/p>\n\t<p><label>Phone:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"\" value=\"\" type=\"tel\" name=\"phone\" \/><\/span>\n\t<\/p>\n\t<p><label>Email:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"example@email.com\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n\t<\/p>\n\t<p><label>Residential Address:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"address-home\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"\" name=\"address-home\"><\/textarea><\/span>\n\t<\/p>\n\t<p><label>city:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"city-home\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city-home\" \/><\/span><br \/>\n<label>Province:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"state-home\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"state-home\" \/><\/span><br \/>\n<label>country:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"country-home\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"country-home\" \/><\/span><br \/>\n<label>Postal Code:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"postal-home\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"postal-home\" \/><\/span>\n\t<\/p>\n<hr \/>\n\t<h4>Place of Employment\n\t<\/h4>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"address-work\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Place of Employment\" name=\"address-work\"><\/textarea><\/span><br \/>\n<label>city:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"city-work\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city-work\" \/><\/span><br \/>\n<label>Hospital:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"state-work\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"state-work\" \/><\/span><br \/>\n<label>Clinic::<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"country-work\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"country-work\" \/><\/span><br \/>\n<label>University:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"postal-work\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"postal-work\" \/><\/span>\n\t<\/p>\n<hr \/>\n\t<h4>Academic \/Professional Degree(s)\n\t<\/h4>\n\t<p><label>Academic \/Professional Degree(s):<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"education\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"education\" \/><\/span><br \/>\n<label>Year of Graduation:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"graduation-year\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"graduation-year\" \/><\/span><br \/>\n<label>Last Discipline:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"degree\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"degree\" \/><\/span><br \/>\n<label>Occupation:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"university\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"university\" \/><\/span><br \/>\n<label>Professional Title:<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"university-city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"university-city\" \/><\/span>\n\t<\/p>\n\t<h4>Specialty \/Discipline\n\t<\/h4>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"specialty\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Anesthesiology\" \/><span class=\"wpcf7-list-item-label\">Anesthesiology<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Oncology\" \/><span class=\"wpcf7-list-item-label\">Oncology<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Complementary &amp; Alternative Medicines\" \/><span class=\"wpcf7-list-item-label\">Complementary &amp; Alternative Medicines<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Orthopedics\/Rheumatology\" \/><span class=\"wpcf7-list-item-label\">Orthopedics\/Rheumatology<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Dentistry\/Oral Medicine\" \/><span class=\"wpcf7-list-item-label\">Dentistry\/Oral Medicine<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Pain Medicine\" \/><span class=\"wpcf7-list-item-label\">Pain Medicine<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Family Medicine\/Primary Care\" \/><span class=\"wpcf7-list-item-label\">Family Medicine\/Primary Care<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Palliative Medicine\" \/><span class=\"wpcf7-list-item-label\">Palliative Medicine<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Health Care\/Research Administration\" \/><span class=\"wpcf7-list-item-label\">Health Care\/Research Administration<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Pediatrics\" \/><span class=\"wpcf7-list-item-label\">Pediatrics<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Internal Medicine\" \/><span class=\"wpcf7-list-item-label\">Internal Medicine<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Physical Medicine and Rehabilitation\" \/><span class=\"wpcf7-list-item-label\">Physical Medicine and Rehabilitation<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Neurology\" \/><span class=\"wpcf7-list-item-label\">Neurology<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Psychiatry\" \/><span class=\"wpcf7-list-item-label\">Psychiatry<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Neuroscience\/Pharmacology\/Physiology\" \/><span class=\"wpcf7-list-item-label\">Neuroscience\/Pharmacology\/Physiology<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Psychology\/Social Science\" \/><span class=\"wpcf7-list-item-label\">Psychology\/Social Science<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Neurosurgery\/Surgery\" \/><span class=\"wpcf7-list-item-label\">Neurosurgery\/Surgery<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Physical Therapy\" \/><span class=\"wpcf7-list-item-label\">Physical Therapy<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Nursing\" \/><span class=\"wpcf7-list-item-label\">Nursing<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"specialty[]\" value=\"Other\" \/><span class=\"wpcf7-list-item-label\">Other<\/span><\/label><\/span><\/span><\/span>\n\t<\/p>\n<hr \/>\n\t<h4>Do you have a background in pain research and analysis?\n\t<\/h4>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"pain-experience\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"pain-experience\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"pain-experience\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<h4>Are you a member of the Local Association for the Study of Pain chapter in your country?\n\t<\/h4>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cooperation\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cooperation\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cooperation\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<h4>Are you a member of the IASP chapter in your country?\n\t<\/h4>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cooperation\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cooperation\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cooperation\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<h4>Would you be interested in establishing a collaboration with the Iranian Pain Society?\n\t<\/h4>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cooperation\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"cooperation\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"cooperation\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t<\/p>\n\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"send\" \/>\n\t<\/p>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\n\n\n<p><\/p>\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":""},"class_list":["post-60","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/iranianpainsociety.org\/register\/wp-json\/wp\/v2\/pages\/60","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/iranianpainsociety.org\/register\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/iranianpainsociety.org\/register\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/iranianpainsociety.org\/register\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/iranianpainsociety.org\/register\/wp-json\/wp\/v2\/comments?post=60"}],"version-history":[{"count":4,"href":"https:\/\/iranianpainsociety.org\/register\/wp-json\/wp\/v2\/pages\/60\/revisions"}],"predecessor-version":[{"id":65,"href":"https:\/\/iranianpainsociety.org\/register\/wp-json\/wp\/v2\/pages\/60\/revisions\/65"}],"wp:attachment":[{"href":"https:\/\/iranianpainsociety.org\/register\/wp-json\/wp\/v2\/media?parent=60"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}