{"id":8040,"date":"2020-03-02T13:38:45","date_gmt":"2020-03-02T18:38:45","guid":{"rendered":"https:\/\/www.saintjoachim.qc.ca\/?page_id=8040"},"modified":"2023-02-06T11:03:18","modified_gmt":"2023-02-06T16:03:18","slug":"formulaire-enregistrement-chiens","status":"publish","type":"page","link":"https:\/\/agenceconceptsk.com\/dev\/saintjoachim\/formulaire-enregistrement-chiens\/","title":{"rendered":"Formulaire d&rsquo;enregistrement &#8211; M\u00e9daille pour chiens"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"8040\" class=\"elementor elementor-8040\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-cb6c408 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"cb6c408\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-2711fbd\" data-id=\"2711fbd\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-dc9288c elementor-widget elementor-widget-image\" data-id=\"dc9288c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/agenceconceptsk.com\/dev\/saintjoachim\" target=\"_blank\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"112\" height=\"114\" src=\"https:\/\/agenceconceptsk.com\/dev\/saintjoachim\/wp-content\/uploads\/logo-muni.png\" class=\"attachment-large size-large wp-image-8043\" alt=\"\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-1cc855e\" data-id=\"1cc855e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8e5ff8a elementor-widget elementor-widget-text-editor\" data-id=\"8e5ff8a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><span style=\"font-size: 14pt;\">M<\/span><span style=\"font-size: 14pt;\">unicipalit\u00e9 de Saint-Joachim<\/span><\/strong><br \/>172, de l\u2019\u00c9glise\u00a0<br \/>Saint-Joachim <br \/>(Qc) G0A 3X0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-cbfc47e\" data-id=\"cbfc47e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d557c02 elementor-widget elementor-widget-text-editor\" data-id=\"d557c02\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p style=\"text-align: right;\"><span style=\"font-size: 14pt;\"><br \/><span style=\"font-size: 12pt;\">T\u00e9l. : (418) 827-3755<\/span><\/span><br \/><br \/><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3ac09d9 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3ac09d9\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ee76903\" data-id=\"ee76903\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e2ea0c9 elementor-button-align-center elementor-widget elementor-widget-form\" data-id=\"e2ea0c9\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Suivant&quot;,&quot;step_previous_label&quot;:&quot;Pr\\u00e9c\\u00e9dent&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"Enregistrement - chiens\" aria-label=\"Enregistrement - chiens\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"8040\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"e2ea0c9\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Formulaire d&rsquo;enregistrement &#8211; M\u00e9daille pour chiens\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"8040\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_16 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_16\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate du jour\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_16]\" id=\"form-field-field_16\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" placeholder=\"aaaa\/mm\/jj\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_15 elementor-col-100\">\n\t\t\t\t\t<div\nstyle=\"text-align: center; background-color: rgb(0, 153, 204); color: white;\"><big\nstyle=\"font-weight: bold; color: rgb(255, 255, 255);\"><big>Section 1 :\nIdentification du propri\u00e9taire du chien <\/big><\/big><br>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_3 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNom du propri\u00e9taire\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_3]\" id=\"form-field-field_3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Nom complet\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_2 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAdresse du propri\u00e9taire\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_2]\" id=\"form-field-field_2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Adresse compl\u00e8te\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_4 elementor-col-40\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tT\u00e9l\u00e9phone du propri\u00e9taire\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_4]\" id=\"form-field-field_4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"111-123-4567\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Seuls les caract\u00e8res de num\u00e9ros de t\u00e9l\u00e9phone (#, -, *, etc.) sont accept\u00e9s.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_5 elementor-col-60\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCourriel du propri\u00e9taire\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_5]\" id=\"form-field-field_5\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_14 elementor-col-100\">\n\t\t\t\t\t<div\nstyle=\"text-align: center; background-color: rgb(0, 153, 204); color: white;\"><big\nstyle=\"font-weight: bold; color: rgb(255, 255, 255);\"><big>Section 2 :\nIdentification du chien <\/big><\/big><br>\n<\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_6 elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNom du chien\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_6]\" id=\"form-field-field_6\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_10 elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_10\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSexe\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"M\u00e2le\" id=\"form-field-field_10-0\" name=\"form_fields[field_10]\"> <label for=\"form-field-field_10-0\">M\u00e2le<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Femelle\" id=\"form-field-field_10-1\" name=\"form_fields[field_10]\"> <label for=\"form-field-field_10-1\">Femelle<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_8 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCouleur du chien\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_8]\" id=\"form-field-field_8\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_7 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_7\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tRace de chien   \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_7]\" id=\"form-field-field_7\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_11 elementor-col-66\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_11\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSigne distinctif\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_11]\" id=\"form-field-field_11\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Signe distinctif\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_9 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAnn\u00e9e de naissance\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_9]\" id=\"form-field-field_9\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"(AAAA)\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_13 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_13\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tLa provenance du chien\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_13]\" id=\"form-field-field_13\" rows=\"4\" placeholder=\" \"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_12 elementor-col-100\">\n\t\t\t\t\t<p>S\u2019il y a lieu, le nom des municipalit\u00e9s o\u00f9 le chien a d\u00e9j\u00e0 \u00e9t\u00e9 enregistr\u00e9 ainsi que toute d\u00e9cision ou jugement \u00e0 l\u2019\u00e9gard du\nchien ou \u00e0 l\u2019\u00e9gard du propri\u00e9taire ou gardien du chien rendue par une municipalit\u00e9 locale en vertu d\u2019un r\u00e8glement\nd\u00e9coulant de la Loi visant \u00e0 favoriser la protecti on des personnes par la mise en place d\u2019un encadrement concernant les\nchiens (chapitre P-38.002) ou d\u2019un r\u00e8glement municipal concernant les chiens. <\/p>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_1 elementor-col-100\">\n\t\t\t\t\t<div\nstyle=\"text-align: center; background-color: rgb(0, 153, 204); color: white;\"><big\nstyle=\"font-weight: bold; color: rgb(255, 255, 255);\"><big>Section 3 :\nInformations m\u00e9dicales du chien <\/big><\/big><br>\n<\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_17 elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_17\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tVaccin contre la rage \u00e0 jour :\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Oui\" id=\"form-field-field_17-0\" name=\"form_fields[field_17]\" required=\"required\"> <label for=\"form-field-field_17-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_17-1\" name=\"form_fields[field_17]\" required=\"required\"> <label for=\"form-field-field_17-1\">Non<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_18 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_18\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSi oui, la date de vaccination\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_18]\" id=\"form-field-field_18\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_19 elementor-col-25 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_19\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSt\u00e9rilisation\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Oui\" id=\"form-field-field_19-0\" name=\"form_fields[field_19]\" required=\"required\"> <label for=\"form-field-field_19-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_19-1\" name=\"form_fields[field_19]\" required=\"required\"> <label for=\"form-field-field_19-1\">Non<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_20 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_20\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNom du v\u00e9t\u00e9rinaire\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_20]\" id=\"form-field-field_20\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-field_22 elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_22\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tT\u00e9l\u00e9phone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[field_22]\" id=\"form-field-field_22\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"111-123-4567\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Seuls les caract\u00e8res de num\u00e9ros de t\u00e9l\u00e9phone (#, -, *, etc.) sont accept\u00e9s.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_21 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_21\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPoids du chien\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_21]\" id=\"form-field-field_21\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Poids en Kg\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_23 elementor-col-33 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_23\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMicropuce\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Oui\" id=\"form-field-field_23-0\" name=\"form_fields[field_23]\" required=\"required\"> <label for=\"form-field-field_23-0\">Oui<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Non\" id=\"form-field-field_23-1\" name=\"form_fields[field_23]\" required=\"required\"> <label for=\"form-field-field_23-1\">Non<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_24 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_24\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\t# de la puce\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_24]\" id=\"form-field-field_24\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" min=\"\" max=\"\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_25 elementor-col-100\">\n\t\t\t\t\t<p>*Le cas \u00e9ch\u00e9ant, un avis \u00e9crit du m\u00e9decin v\u00e9t\u00e9rinaire indiquant que la vaccination, la st\u00e9rilisation ou le micropu\u00e7age est\ncontre-indiqu\u00e9 pour le chien.<\/p> \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_27 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_27\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDans le cas d\u2019un non-renouvellement, veuillez nous retourner le formulaire en prenant soin de nous indiquer l\u2019une des  raisons applicables : \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Chien d\u00e9c\u00e9d\u00e9, vendu ou donn\u00e9\" id=\"form-field-field_27-0\" name=\"form_fields[field_27]\"> <label for=\"form-field-field_27-0\">Chien d\u00e9c\u00e9d\u00e9, vendu ou donn\u00e9<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Chien guide ou d&#039;assistance\" id=\"form-field-field_27-1\" name=\"form_fields[field_27]\"> <label for=\"form-field-field_27-1\">Chien guide ou d'assistance<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-md\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Soumettre<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f319884 elementor-widget elementor-widget-text-editor\" data-id=\"f319884\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p style=\"text-align: center;\">Merci d&rsquo;avoir compl\u00e9t\u00e9 ce formulaire. Nous vous contacterons bient\u00f4t.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Municipalit\u00e9 de Saint-Joachim172, de l\u2019\u00c9glise\u00a0Saint-Joachim (Qc) G0A 3X0 T\u00e9l. : (418) 827-3755 Merci d&rsquo;avoir compl\u00e9t\u00e9 ce formulaire. Nous vous contacterons bient\u00f4t.<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8040","page","type-page","status-publish","hentry","","dev","saintjoachim","wp-json","wp","v2","pages","8040"],"publishpress_future_action":{"enabled":false,"date":"2026-10-08 23:40:12","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/agenceconceptsk.com\/dev\/saintjoachim\/wp-json\/wp\/v2\/pages\/8040","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/agenceconceptsk.com\/dev\/saintjoachim\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/agenceconceptsk.com\/dev\/saintjoachim\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/agenceconceptsk.com\/dev\/saintjoachim\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/agenceconceptsk.com\/dev\/saintjoachim\/wp-json\/wp\/v2\/comments?post=8040"}],"version-history":[{"count":13,"href":"https:\/\/agenceconceptsk.com\/dev\/saintjoachim\/wp-json\/wp\/v2\/pages\/8040\/revisions"}],"predecessor-version":[{"id":12275,"href":"https:\/\/agenceconceptsk.com\/dev\/saintjoachim\/wp-json\/wp\/v2\/pages\/8040\/revisions\/12275"}],"wp:attachment":[{"href":"https:\/\/agenceconceptsk.com\/dev\/saintjoachim\/wp-json\/wp\/v2\/media?parent=8040"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}