{"id":3389,"date":"2022-04-19T14:34:20","date_gmt":"2022-04-19T12:34:20","guid":{"rendered":"https:\/\/bobmartin.co.za\/bobsure\/?page_id=3389"},"modified":"2025-12-14T23:10:05","modified_gmt":"2025-12-14T21:10:05","slug":"join","status":"publish","type":"page","link":"https:\/\/bobmartin.co.za\/bobsure\/join\/","title":{"rendered":"Join"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Section&#8221; _builder_version=&#8221;4.27.5&#8243; background_color=&#8221;#ffffff&#8221; background_enable_image=&#8221;off&#8221; background_size=&#8221;initial&#8221; background_position=&#8221;top_center&#8221; background_repeat=&#8221;repeat&#8221; vertical_offset_tablet=&#8221;0&#8243; horizontal_offset_tablet=&#8221;0&#8243; custom_padding=&#8221;0px||5px||false|false&#8221; hover_enabled=&#8221;0&#8243; box_shadow_horizontal_tablet=&#8221;0px&#8221; box_shadow_vertical_tablet=&#8221;0px&#8221; box_shadow_blur_tablet=&#8221;40px&#8221; box_shadow_spread_tablet=&#8221;0px&#8221; global_colors_info=&#8221;{}&#8221; module_alignment=&#8221;center&#8221; sticky_enabled=&#8221;0&#8243;][et_pb_row disabled_on=&#8221;off|off|off&#8221; module_class=&#8221; et_pb_row_fullwidth et_pb_row_fullwidth et_pb_row_fullwidth&#8221; _builder_version=&#8221;4.27.5&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; width_tablet=&#8221;80%&#8221; width_phone=&#8221;&#8221; width_last_edited=&#8221;on|desktop&#8221; max_width=&#8221;80%&#8221; max_width_tablet=&#8221;80%&#8221; max_width_phone=&#8221;&#8221; max_width_last_edited=&#8221;on|desktop&#8221; custom_margin=&#8221;27px|auto|27px|auto|true|false&#8221; custom_padding=&#8221;0px||||false|false&#8221; hover_enabled=&#8221;0&#8243; make_fullwidth=&#8221;on&#8221; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; background_position=&#8221;top_left&#8221; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text admin_label=&#8221;INTRO TEXT&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; header_2_font=&#8221;Varela Round|700|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#e2211c&#8221; header_2_font_size=&#8221;24px&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||6px||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2>PAW-SOME!<\/h2>\n<p>[\/et_pb_text][et_pb_text admin_label=&#8221;INTRO TEXT 2&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; header_2_font=&#8221;Varela Round|700|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#e2211c&#8221; header_2_font_size=&#8221;18px&#8221; custom_margin=&#8221;0px||||false|false&#8221; custom_padding=&#8221;0px||||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2>You are one step closer to becoming part of the BobSure pet family!<\/h2>\n<p>[\/et_pb_text][et_pb_text admin_label=&#8221;What to expect next&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; header_2_font=&#8221;Varela Round|700|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#3c3c3b&#8221; header_2_font_size=&#8221;22px&#8221; custom_margin=&#8221;0px||||false|false&#8221; custom_padding=&#8221;0px||||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h2>What to expect next:<\/h2>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.27.0&#8243; text_font=&#8221;PT Sans||||||||&#8221; vertical_offset_tablet=&#8221;0&#8243; horizontal_offset_tablet=&#8221;0&#8243; custom_padding=&#8221;30px|30px|30px|30px&#8221; z_index_tablet=&#8221;0&#8243; text_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; text_text_shadow_vertical_length_tablet=&#8221;0px&#8221; text_text_shadow_blur_strength_tablet=&#8221;1px&#8221; link_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; link_text_shadow_vertical_length_tablet=&#8221;0px&#8221; link_text_shadow_blur_strength_tablet=&#8221;1px&#8221; ul_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; ul_text_shadow_vertical_length_tablet=&#8221;0px&#8221; ul_text_shadow_blur_strength_tablet=&#8221;1px&#8221; ol_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; ol_text_shadow_vertical_length_tablet=&#8221;0px&#8221; ol_text_shadow_blur_strength_tablet=&#8221;1px&#8221; quote_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; quote_text_shadow_vertical_length_tablet=&#8221;0px&#8221; quote_text_shadow_blur_strength_tablet=&#8221;1px&#8221; header_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; header_text_shadow_vertical_length_tablet=&#8221;0px&#8221; header_text_shadow_blur_strength_tablet=&#8221;1px&#8221; header_2_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; header_2_text_shadow_vertical_length_tablet=&#8221;0px&#8221; header_2_text_shadow_blur_strength_tablet=&#8221;1px&#8221; header_3_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; header_3_text_shadow_vertical_length_tablet=&#8221;0px&#8221; header_3_text_shadow_blur_strength_tablet=&#8221;1px&#8221; header_4_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; header_4_text_shadow_vertical_length_tablet=&#8221;0px&#8221; header_4_text_shadow_blur_strength_tablet=&#8221;1px&#8221; header_5_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; header_5_text_shadow_vertical_length_tablet=&#8221;0px&#8221; header_5_text_shadow_blur_strength_tablet=&#8221;1px&#8221; header_6_text_shadow_horizontal_length_tablet=&#8221;0px&#8221; header_6_text_shadow_vertical_length_tablet=&#8221;0px&#8221; header_6_text_shadow_blur_strength_tablet=&#8221;1px&#8221; border_radii=&#8221;on|25px|25px|25px|25px&#8221; border_width_all=&#8221;1px&#8221; border_color_all=&#8221;#a5a5a5&#8243; box_shadow_horizontal_tablet=&#8221;0px&#8221; box_shadow_vertical_tablet=&#8221;0px&#8221; box_shadow_blur_tablet=&#8221;40px&#8221; box_shadow_spread_tablet=&#8221;0px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_11' style='display:none'><div id='gf_11' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11'  action='\/bobsure\/wp-json\/wp\/v2\/pages\/3389#gf_11' data-formid='11' novalidate><input id=\"gpnf_session_hash_11\" type=\"hidden\" name=\"gpnf_session_hash\" value=\"8a0612451603\"><div id='gf_page_steps_11' class='gf_page_steps'><div id='gf_step_11_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Application<\/span><\/div><div id='gf_step_11_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Policyholder Details<\/span><\/div><div id='gf_step_11_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>Pets Details<\/span><\/div><div id='gf_step_11_4' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>Policy And Premiums Payable<\/span><\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_11_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_41\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_41'>URL<\/label><div class='ginput_container'><input name='input_41' id='input_11_41' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_11_41'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_11_33\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_33' id='input_11_33' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_11_35\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_35' id='input_11_35' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_11_34\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_34' id='input_11_34' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_11_4\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><ul>\n<li>This is an application for your pet to join Bobsure Pet Insurance.<\/li>\n<li>Your personal details as policyholder will be required, as well as that of your pet, and your veterinary provider of choice.<\/li>\n<li>Bobsure Pet Insurance is a product distributed through SWIFT Insurance Brokers, who will represent you at <strong>no extra cost<\/strong>.<\/li>\n<li>Once the form is completed, you will receive notification confirming your request for pet insurance.<\/li>\n<li>Completing the banking details is one step closer to becoming a <strong>BobSure pet parent. Should you prefer to only receive a detailed quote from our team, you may simply skip this step and allow us to help you complete your journey to becoming a responsible pet parent.<\/strong><\/li>\n<\/ul><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_11_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_2' class='gform_page' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_11_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_11_7\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-five-twelfths gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name has_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_11_7'>\n                            <span id='input_11_7_2_container' class='name_prefix name_prefix_select gform-grid-col gform-grid-col--size-auto' >\n                                                    <select name='input_7.2' id='input_11_7_2'    aria-required='false'   >\n                          <option value=''><\/option><option value='Dr.' >Dr.<\/option><option value='Miss' >Miss<\/option><option value='Mr.' >Mr.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Ms.' >Ms.<\/option><option value='Prof.' >Prof.<\/option><option value='Rev.' >Rev.<\/option>\n                      <\/select>\n                                                    <label for='input_11_7_2' class='gform-field-label gform-field-label--type-sub '>Title<\/label>\n                                                  <\/span>\n                            <span id='input_11_7_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_7.3' id='input_11_7_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_7_3' class='gform-field-label gform-field-label--type-sub '>First Name<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_7_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_7.6' id='input_11_7_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_7_6' class='gform-field-label gform-field-label--type-sub '>Last Name<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_11_8\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_8'>Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_8' id='input_11_8' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_11_9\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_9'>Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_9' id='input_11_9' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_11_11' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_11_11' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_3' class='gform_page' data-js='page-field-id-11' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_11_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_11_5\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_11_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_11_5_1_container' >\n                                        <label for='input_11_5_1' id='input_11_5_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_5.1' id='input_11_5_1' value=''    aria-required='false'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_11_5_3_container' >\n                                    <label for='input_11_5_3' id='input_11_5_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_5.3' id='input_11_5_3' value=''    aria-required='false'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_11_5_4_container' >\n                                        <label for='input_11_5_4' id='input_11_5_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                        <input type='text' name='input_5.4' id='input_11_5_4' value=''      aria-required='false'    \/>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_11_5_5_container' >\n                                    <label for='input_11_5_5' id='input_11_5_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_5.5' maxlength='4' placeholder='____' id='input_11_5_5' value=''    aria-required='false'    \/>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_11_5_6_container' >\n                                        <label for='input_11_5_6' id='input_11_5_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                        <select name='input_5.6' id='input_11_5_6'   aria-required='false'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' selected='selected'>South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_11_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_6'>ID Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_11_6' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_12\" class=\"gfield gfield--type-form gfield--input-type-form gform-theme__no-reset--children gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_12'>Pets Details<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-1\">\n\t\t\t\t\tPet type\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-2\">\n\t\t\t\t\tPet Name\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-46\">\n\t\t\t\t\tCat breed\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-47\">\n\t\t\t\t\tDog breed\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-3\">\n\t\t\t\t\tDOB\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-8\">\n\t\t\t\t\tGender\t\t\t\t<\/th>\n\t\t\t\t\t\t<th class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actions<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f1.label, attr: { 'data-value': f1.label }\"\n\t\t\t\t\tdata-heading=\"Pet type\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f2.label, attr: { 'data-value': f2.label }\"\n\t\t\t\t\tdata-heading=\"Pet Name\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f46.label, attr: { 'data-value': f46.label }\"\n\t\t\t\t\tdata-heading=\"Cat breed\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f47.label, attr: { 'data-value': f47.label }\"\n\t\t\t\t\tdata-heading=\"Dog breed\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f3.label, attr: { 'data-value': f3.label }\"\n\t\t\t\t\tdata-heading=\"DOB\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f8.label, attr: { 'data-value': f8.label }\"\n\t\t\t\t\tdata-heading=\"Gender\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Pet {0} where Pet type is {1}.'.gformFormat( $index() + 1, f1.label ) }\">Edit<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Pet {0} where Pet type is {1}.'.gformFormat( $index() + 1, f1.label ) }\">Delete<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"7\">\n\t\t\t\tThere are no <span>Pets.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"11\"\n\t\t        data-nestedformid=\"3\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Pet\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of pets reached.\n\t\t\t<\/p>\n<\/div>\n<input type=\"hidden\"\n                name=\"input_12\"\n                id=\"input_11_12\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><div class='gfield_description' id='gfield_description_11_12'>Please enter details of the pets to be insured<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_11_13' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_11_13' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_4' class='gform_page' data-js='page-field-id-13' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_11_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_14\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><span style=\"font-size: 12pt; font-family: arial, helvetica, sans-serif;\"><strong><span style=\"color: #ff0000;\">PLEASE NOTE:<\/span> you have the option to pay your premium annually. If you select this option, one of our friendly consultants will be in touch with you to set that up.<\/strong><\/span><\/p><\/div><div id=\"field_11_15\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Final Calculation<\/h3><\/div><div id=\"field_11_16\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p class=\"total-monthly-premium\">\nTotal monthly premium: <strong><\/strong>\n<\/p><\/div><div id=\"field_11_17\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p class=\"total-annual-premium\">\nTotal annual premium: <strong><\/strong>\n<\/p><\/div><div id=\"field_11_36\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_36' id='input_11_36' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_11_37\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_37' id='input_11_37' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_11_18\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Payment option<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_18'>\n\t\t\t<div class='gchoice gchoice_11_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Monthly'  id='choice_11_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_18_0' id='label_11_18_0' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Annually'  id='choice_11_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_18_1' id='label_11_18_1' class='gform-field-label gform-field-label--type-inline'>Annually<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_11_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Signup channel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_38'>\n\t\t\t<div class='gchoice gchoice_11_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Swift Underwriting Managers Pty Ltd' checked='checked' id='choice_11_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_38_0' id='label_11_38_0' class='gform-field-label gform-field-label--type-inline'>Swift Underwriting Managers Pty Ltd<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_19\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field-brokers field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_19'>Broker selection<\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_11_19' class='large gfield_select'     aria-invalid=\"false\" ><option value='' >Please select<\/option><optgroup label='NATIONAL BROKERS'><option value='7020' selected='selected'>SWIFT Insurance Brokers (Pty) Ltd \u2013 FSP \u2013 492285<\/option><\/optgroup><\/select><\/div><\/div><div id=\"field_11_39\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field-agents gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_39'>Agent name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_39' id='input_11_39' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select<\/option><option value='3629' >Andrina Fong<\/option><option value='3630' >Angelo Graham<\/option><option value='3659' >Cameron View Integrisure<\/option><option value='3631' >Colyn Erasmus<\/option><option value='3652' >Dawie Pieterse<\/option><option value='3632' >Dion Naicker<\/option><option value='3648' >Elias Monere<\/option><option value='3649' >Elzonia Riekert<\/option><option value='3650' >Erica Swart<\/option><option value='3658' >Gaamangwe Kneane<\/option><option value='3633' >Gustav Lewis<\/option><option value='3651' >Gwendolyn Lombard<\/option><option value='3634' >Hendry Madzinhandela<\/option><option value='3635' >Hloni Hlapolosa<\/option><option value='3685' >Janine Alexander<\/option><option value='3655' >Keenan Ogle<\/option><option value='3696' >Kutlwano<\/option><option value='3656' >Kyle Snyman<\/option><option value='3654' >Lance Apie<\/option><option value='3653' >Lauren Franks<\/option><option value='3686' >Magda van der Merwe<\/option><option value='3636' >Marco Rozyn<\/option><option value='3637' >Mohamed Soobrayan<\/option><option value='3704' >Mohamed Soobrayan<\/option><option value='3697' >Nazeem<\/option><option value='3638' >Nazir Wajah<\/option><option value='3639' >Nduduzo Sibiya<\/option><option value='3640' >Netina Morgan<\/option><option value='3641' >Nosipho Olori<\/option><option value='3657' >Philly Nkeane<\/option><option value='3698' >Phindile Nkomo \r\n<\/option><option value='3642' >Pierre Blom<\/option><option value='3643' >Quinton Elias<\/option><option value='3644' >Renier Barnard<\/option><option value='3687' >Rhyno Steyn<\/option><option value='3705' >Scott Mclaren<\/option><option value='3645' >Simone Fember<\/option><option value='3646' >Siya Ndlovu<\/option><option value='3647' >Zelna Swanepoel<\/option><\/select><\/div><\/div><div id=\"field_11_40\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_40'>Call reference number<\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_11_40' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_20\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Authority to debit account<\/h3><div class='gsection_description' id='gfield_description_11_20'><strong style=\"color:#e2211c\">Completing the banking details is one step closer to becoming a <strong>BobSure pet parent. Should you prefer to only receive a detailed quote from our team, you may simply skip this step and allow us to help you complete your journey to becoming a responsible pet parent.<\/strong><\/div><\/div><div id=\"field_11_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_21'>Account holder<\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_11_21' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_22'>Branch code<\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_11_22' type='text' value='' class='large' maxlength='6'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_23'>Bank and branch name<\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_11_23' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_24\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_24'>Account number<\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_11_24' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Account type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_25'>\n\t\t\t<div class='gchoice gchoice_11_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Cheque'  id='choice_11_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_25_0' id='label_11_25_0' class='gform-field-label gform-field-label--type-inline'>Cheque<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Savings'  id='choice_11_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_25_1' id='label_11_25_1' class='gform-field-label gform-field-label--type-inline'>Savings<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_11_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Debit Day<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_26'>\n\t\t\t<div class='gchoice gchoice_11_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='1'  id='choice_11_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_26_0' id='label_11_26_0' class='gform-field-label gform-field-label--type-inline'>1st<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='7'  id='choice_11_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_26_1' id='label_11_26_1' class='gform-field-label gform-field-label--type-inline'>7th<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_26_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='15'  id='choice_11_26_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_26_2' id='label_11_26_2' class='gform-field-label gform-field-label--type-inline'>15th<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_27\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><span style=\"font-size: 10pt;\">I request and authorise Renasa Insurance Co Ltd to draw against the above mentioned account, the amount necessary for<\/span><br><span style=\"font-size: 10pt;\">payment of the monthly premium, as and when, required. This amount will debit every month until this arrangement is<\/span><br><span style=\"font-size: 10pt;\">cancelled in writing by either party.<\/span><br><span style=\"font-size: 10pt;\">I accept that, if the debit date falls on a weekend, I will be debited on the subsequent working day. If no debit date is selected<\/span><br><span style=\"font-size: 10pt;\">P.UMA reserves the right to select the last working day of each month.<\/span><\/p>\n<p><span style=\"font-size: small;\"><strong>DECLARATION<\/strong><br>I hereby confirm that all details supplied above are true and correct to the best of my knowledge. NB: Any false disclosure could result in the policy being made void. This policy will be renewed on 1 December each year. You will be informed of any&nbsp;changes 30 days prior to renewal.<\/span><\/p>\n<p><span style=\"font-size: small;\">By signing below,&nbsp;I hereby accept all <a title=\"T&amp;Cs\" href=\"https:\/\/bobmartin.co.za\/bobsure\/faq\/#wording\" target=\"_blank\" rel=\"nofollow\">terms and conditions (available by clicking here)<\/a> related to this policy and authorise the premium to be debited off my account.&nbsp;<\/span><\/p>\n<p><span style=\"font-size: small;\">By completing this application form you consent to us obtaining any veterinary histories required from your treating vets in order for us to underwrite this risk. All your information will be treated in the strictest confidence at all times.<\/span><\/p><\/div><div id=\"field_11_28\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_28'>Client signature<\/label><div ><div id='input_11_28_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><input type='hidden' class='gform_hidden' name='input_11_28_valid' id='input_11_28_valid' \/><canvas id='input_11_28' width='300' height='180'><\/canvas><\/div><\/div><\/div><div id=\"field_11_29\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Client validation by electronic signature<\/h3><\/div><div id=\"field_11_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_30'>Type your RSA ID no<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_11_30' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_31\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_31'>Type your full name\/s + surname<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_11_31' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_32\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><strong style=\"font-family: Arial; font-size: small;\">These are important documents &amp; should be kept for reference purposes. A copy of the details entered will be sent to us for processing, and a reference copy will be emailed to you (at the email address you've entered) for your records.<\/strong><\/p><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_11' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='submit' id='gform_submit_button_11' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Finish &amp; Submit Application'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_11' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_11' id='gform_theme_11' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_11' id='gform_style_settings_11' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_11' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='11' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='ZAR' value='Pzy4H\/\/HUgcTtkBxQp878ZdyV\/+qS4k06RttBGvIhoYJ0zVxq8fPUx+ktdw6\/c22dQVtfQF7j7OY+\/x7jSEY8FKFRKB2\/6Y1s1rLzhNB4FafWmo=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_11' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_11' id='gform_target_page_number_11' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_11' id='gform_source_page_number_11' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <\/form>\n                        <\/div><script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 11, 'https:\/\/bobmartin.co.za\/bobsure\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_11').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_11');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_11').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_11').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_11').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_11').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_11').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_11').val();gformInitSpinner( 11, 'https:\/\/bobmartin.co.za\/bobsure\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [11, current_page]);window['gf_submitting_11'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_11').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_11').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [11]);window['gf_submitting_11'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_11').text());}else{jQuery('#gform_11').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"11\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_11\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_11\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_11\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 11, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );\n<\/script>\n\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221; admin_label=&#8221;Row&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p style=\"text-align: center;\">By submitting this application you confirm that we may contact you for any pet related offerings through P-uma, Renasa or associated companies.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>PAW-SOME!You are one step closer to becoming part of the BobSure pet family!What to expect next:\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_11' style='display:none'><div id='gf_11' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11'  action='\/bobsure\/wp-json\/wp\/v2\/pages\/3389#gf_11' data-formid='11' novalidate><input id=\"gpnf_session_hash_11\" type=\"hidden\" name=\"gpnf_session_hash\" value=\"2d8cfd6d76c2\"><div id='gf_page_steps_11' class='gf_page_steps'><div id='gf_step_11_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Application<\/span><\/div><div id='gf_step_11_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Policyholder Details<\/span><\/div><div id='gf_step_11_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>Pets Details<\/span><\/div><div id='gf_step_11_4' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>Policy And Premiums Payable<\/span><\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_11_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_41\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_41'>Name<\/label><div class='ginput_container'><input name='input_41' id='input_11_41' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_11_41'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_11_33\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_33' id='input_11_33' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_11_35\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_35' id='input_11_35' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_11_34\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_34' id='input_11_34' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_11_4\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><ul>\n<li>This is an application for your pet to join Bobsure Pet Insurance.<\/li>\n<li>Your personal details as policyholder will be required, as well as that of your pet, and your veterinary provider of choice.<\/li>\n<li>Bobsure Pet Insurance is a product distributed through SWIFT Insurance Brokers, who will represent you at <strong>no extra cost<\/strong>.<\/li>\n<li>Once the form is completed, you will receive notification confirming your request for pet insurance.<\/li>\n<li>Completing the banking details is one step closer to becoming a <strong>BobSure pet parent. Should you prefer to only receive a detailed quote from our team, you may simply skip this step and allow us to help you complete your journey to becoming a responsible pet parent.<\/strong><\/li>\n<\/ul><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_11_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_2' class='gform_page' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_11_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_11_7\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-five-twelfths gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name has_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_11_7'>\n                            <span id='input_11_7_2_container' class='name_prefix name_prefix_select gform-grid-col gform-grid-col--size-auto' >\n                                                    <select name='input_7.2' id='input_11_7_2'    aria-required='false'   >\n                          <option value=''><\/option><option value='Dr.' >Dr.<\/option><option value='Miss' >Miss<\/option><option value='Mr.' >Mr.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Ms.' >Ms.<\/option><option value='Prof.' >Prof.<\/option><option value='Rev.' >Rev.<\/option>\n                      <\/select>\n                                                    <label for='input_11_7_2' class='gform-field-label gform-field-label--type-sub '>Title<\/label>\n                                                  <\/span>\n                            <span id='input_11_7_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_7.3' id='input_11_7_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_7_3' class='gform-field-label gform-field-label--type-sub '>First Name<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_7_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_7.6' id='input_11_7_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_7_6' class='gform-field-label gform-field-label--type-sub '>Last Name<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_11_8\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_8'>Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_8' id='input_11_8' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_11_9\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_9'>Phone Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_9' id='input_11_9' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_11_11' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_11_11' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_3' class='gform_page' data-js='page-field-id-11' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_11_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_11_5\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_11_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_11_5_1_container' >\n                                        <label for='input_11_5_1' id='input_11_5_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_5.1' id='input_11_5_1' value=''    aria-required='false'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_11_5_3_container' >\n                                    <label for='input_11_5_3' id='input_11_5_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_5.3' id='input_11_5_3' value=''    aria-required='false'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_11_5_4_container' >\n                                        <label for='input_11_5_4' id='input_11_5_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                        <input type='text' name='input_5.4' id='input_11_5_4' value=''      aria-required='false'    \/>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_11_5_5_container' >\n                                    <label for='input_11_5_5' id='input_11_5_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_5.5' maxlength='4' placeholder='____' id='input_11_5_5' value=''    aria-required='false'    \/>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_11_5_6_container' >\n                                        <label for='input_11_5_6' id='input_11_5_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                        <select name='input_5.6' id='input_11_5_6'   aria-required='false'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' selected='selected'>South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_11_6\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_6'>ID Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_11_6' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_12\" class=\"gfield gfield--type-form gfield--input-type-form gform-theme__no-reset--children gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_12'>Pets Details<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-1\">\n\t\t\t\t\tPet type\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-2\">\n\t\t\t\t\tPet Name\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-46\">\n\t\t\t\t\tCat breed\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-47\">\n\t\t\t\t\tDog breed\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-3\">\n\t\t\t\t\tDOB\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th class=\"gpnf-field-8\">\n\t\t\t\t\tGender\t\t\t\t<\/th>\n\t\t\t\t\t\t<th class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actions<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f1.label, attr: { 'data-value': f1.label }\"\n\t\t\t\t\tdata-heading=\"Pet type\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f2.label, attr: { 'data-value': f2.label }\"\n\t\t\t\t\tdata-heading=\"Pet Name\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f46.label, attr: { 'data-value': f46.label }\"\n\t\t\t\t\tdata-heading=\"Cat breed\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f47.label, attr: { 'data-value': f47.label }\"\n\t\t\t\t\tdata-heading=\"Dog breed\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f3.label, attr: { 'data-value': f3.label }\"\n\t\t\t\t\tdata-heading=\"DOB\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f8.label, attr: { 'data-value': f8.label }\"\n\t\t\t\t\tdata-heading=\"Gender\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Pet {0} where Pet type is {1}.'.gformFormat( $index() + 1, f1.label ) }\">Edit<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Pet {0} where Pet type is {1}.'.gformFormat( $index() + 1, f1.label ) }\">Delete<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"7\">\n\t\t\t\tThere are no <span>Pets.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"11\"\n\t\t        data-nestedformid=\"3\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Pet\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of pets reached.\n\t\t\t<\/p>\n<\/div>\n<input type=\"hidden\"\n                name=\"input_12\"\n                id=\"input_11_12\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><div class='gfield_description' id='gfield_description_11_12'>Please enter details of the pets to be insured<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_11_13' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_11_13' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_11_4' class='gform_page' data-js='page-field-id-13' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_11_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_11_14\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><span style=\"font-size: 12pt; font-family: arial, helvetica, sans-serif;\"><strong><span style=\"color: #ff0000;\">PLEASE NOTE:<\/span> you have the option to pay your premium annually. If you select this option, one of our friendly consultants will be in touch with you to set that up.<\/strong><\/span><\/p><\/div><div id=\"field_11_15\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Final Calculation<\/h3><\/div><div id=\"field_11_16\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p class=\"total-monthly-premium\">\nTotal monthly premium: <strong><\/strong>\n<\/p><\/div><div id=\"field_11_17\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p class=\"total-annual-premium\">\nTotal annual premium: <strong><\/strong>\n<\/p><\/div><div id=\"field_11_36\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_36' id='input_11_36' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_11_37\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_37' id='input_11_37' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><fieldset id=\"field_11_18\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Payment option<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_18'>\n\t\t\t<div class='gchoice gchoice_11_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Monthly'  id='choice_11_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_18_0' id='label_11_18_0' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Annually'  id='choice_11_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_18_1' id='label_11_18_1' class='gform-field-label gform-field-label--type-inline'>Annually<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_11_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Signup channel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_38'>\n\t\t\t<div class='gchoice gchoice_11_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Swift Underwriting Managers Pty Ltd' checked='checked' id='choice_11_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_38_0' id='label_11_38_0' class='gform-field-label gform-field-label--type-inline'>Swift Underwriting Managers Pty Ltd<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_19\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field-brokers field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_19'>Broker selection<\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_11_19' class='large gfield_select'     aria-invalid=\"false\" ><option value='' >Please select<\/option><optgroup label='NATIONAL BROKERS'><option value='7020' selected='selected'>SWIFT Insurance Brokers (Pty) Ltd \u2013 FSP \u2013 492285<\/option><\/optgroup><\/select><\/div><\/div><div id=\"field_11_39\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field-agents gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_39'>Agent name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_39' id='input_11_39' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Please select<\/option><option value='3629' >Andrina Fong<\/option><option value='3630' >Angelo Graham<\/option><option value='3659' >Cameron View Integrisure<\/option><option value='3631' >Colyn Erasmus<\/option><option value='3652' >Dawie Pieterse<\/option><option value='3632' >Dion Naicker<\/option><option value='3648' >Elias Monere<\/option><option value='3649' >Elzonia Riekert<\/option><option value='3650' >Erica Swart<\/option><option value='3658' >Gaamangwe Kneane<\/option><option value='3633' >Gustav Lewis<\/option><option value='3651' >Gwendolyn Lombard<\/option><option value='3634' >Hendry Madzinhandela<\/option><option value='3635' >Hloni Hlapolosa<\/option><option value='3685' >Janine Alexander<\/option><option value='3655' >Keenan Ogle<\/option><option value='3696' >Kutlwano<\/option><option value='3656' >Kyle Snyman<\/option><option value='3654' >Lance Apie<\/option><option value='3653' >Lauren Franks<\/option><option value='3686' >Magda van der Merwe<\/option><option value='3636' >Marco Rozyn<\/option><option value='3637' >Mohamed Soobrayan<\/option><option value='3704' >Mohamed Soobrayan<\/option><option value='3697' >Nazeem<\/option><option value='3638' >Nazir Wajah<\/option><option value='3639' >Nduduzo Sibiya<\/option><option value='3640' >Netina Morgan<\/option><option value='3641' >Nosipho Olori<\/option><option value='3657' >Philly Nkeane<\/option><option value='3698' >Phindile Nkomo \r\n<\/option><option value='3642' >Pierre Blom<\/option><option value='3643' >Quinton Elias<\/option><option value='3644' >Renier Barnard<\/option><option value='3687' >Rhyno Steyn<\/option><option value='3705' >Scott Mclaren<\/option><option value='3645' >Simone Fember<\/option><option value='3646' >Siya Ndlovu<\/option><option value='3647' >Zelna Swanepoel<\/option><\/select><\/div><\/div><div id=\"field_11_40\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_40'>Call reference number<\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_11_40' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_20\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Authority to debit account<\/h3><div class='gsection_description' id='gfield_description_11_20'><strong style=\"color:#e2211c\">Completing the banking details is one step closer to becoming a <strong>BobSure pet parent. Should you prefer to only receive a detailed quote from our team, you may simply skip this step and allow us to help you complete your journey to becoming a responsible pet parent.<\/strong><\/div><\/div><div id=\"field_11_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_21'>Account holder<\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_11_21' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_22'>Branch code<\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_11_22' type='text' value='' class='large' maxlength='6'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_23'>Bank and branch name<\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_11_23' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_24\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_24'>Account number<\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_11_24' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Account type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_25'>\n\t\t\t<div class='gchoice gchoice_11_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Cheque'  id='choice_11_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_25_0' id='label_11_25_0' class='gform-field-label gform-field-label--type-inline'>Cheque<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Savings'  id='choice_11_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_25_1' id='label_11_25_1' class='gform-field-label gform-field-label--type-inline'>Savings<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_11_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Debit Day<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_26'>\n\t\t\t<div class='gchoice gchoice_11_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='1'  id='choice_11_26_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_26_0' id='label_11_26_0' class='gform-field-label gform-field-label--type-inline'>1st<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='7'  id='choice_11_26_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_26_1' id='label_11_26_1' class='gform-field-label gform-field-label--type-inline'>7th<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_26_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='15'  id='choice_11_26_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_11_26_2' id='label_11_26_2' class='gform-field-label gform-field-label--type-inline'>15th<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_27\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><span style=\"font-size: 10pt;\">I request and authorise Renasa Insurance Co Ltd to draw against the above mentioned account, the amount necessary for<\/span><br><span style=\"font-size: 10pt;\">payment of the monthly premium, as and when, required. This amount will debit every month until this arrangement is<\/span><br><span style=\"font-size: 10pt;\">cancelled in writing by either party.<\/span><br><span style=\"font-size: 10pt;\">I accept that, if the debit date falls on a weekend, I will be debited on the subsequent working day. If no debit date is selected<\/span><br><span style=\"font-size: 10pt;\">P.UMA reserves the right to select the last working day of each month.<\/span><\/p>\n<p><span style=\"font-size: small;\"><strong>DECLARATION<\/strong><br>I hereby confirm that all details supplied above are true and correct to the best of my knowledge. NB: Any false disclosure could result in the policy being made void. This policy will be renewed on 1 December each year. You will be informed of any&nbsp;changes 30 days prior to renewal.<\/span><\/p>\n<p><span style=\"font-size: small;\">By signing below,&nbsp;I hereby accept all <a title=\"T&amp;Cs\" href=\"https:\/\/bobmartin.co.za\/bobsure\/faq\/#wording\" target=\"_blank\" rel=\"nofollow\">terms and conditions (available by clicking here)<\/a> related to this policy and authorise the premium to be debited off my account.&nbsp;<\/span><\/p>\n<p><span style=\"font-size: small;\">By completing this application form you consent to us obtaining any veterinary histories required from your treating vets in order for us to underwrite this risk. All your information will be treated in the strictest confidence at all times.<\/span><\/p><\/div><div id=\"field_11_28\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_28'>Client signature<\/label><div ><div id='input_11_28_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><input type='hidden' class='gform_hidden' name='input_11_28_valid' id='input_11_28_valid' \/><canvas id='input_11_28' width='300' height='180'><\/canvas><\/div><\/div><\/div><div id=\"field_11_29\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Client validation by electronic signature<\/h3><\/div><div id=\"field_11_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_30'>Type your RSA ID no<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_11_30' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_31\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_11_31'>Type your full name\/s + surname<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_11_31' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_32\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><strong style=\"font-family: Arial; font-size: small;\">These are important documents &amp; should be kept for reference purposes. A copy of the details entered will be sent to us for processing, and a reference copy will be emailed to you (at the email address you've entered) for your records.<\/strong><\/p><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_11' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='submit' id='gform_submit_button_11' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Finish &amp; Submit Application'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_11' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_11' id='gform_theme_11' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_11' id='gform_style_settings_11' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_11' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='11' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='ZAR' value='2vGL0C31Soc64QGLOQl9PYYhxKHdiV4c1SVEC0GdIcfEjtYASbSLAh+5+23gGTNiPFMHgCCwOyjA8FjVzdW+qCbzxk0IspYpk7ilXZBv\/HjsrjY=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_11' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_11' id='gform_target_page_number_11' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_11' id='gform_source_page_number_11' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <\/form>\n                        <\/div><script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 11, 'https:\/\/bobmartin.co.za\/bobsure\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_11').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_11');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_11').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){form_content.find('form').css('opacity', 0);jQuery('#gform_wrapper_11').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_11').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_11').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_11').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_11').val();gformInitSpinner( 11, 'https:\/\/bobmartin.co.za\/bobsure\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [11, current_page]);window['gf_submitting_11'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_11').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_11').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [11]);window['gf_submitting_11'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_11').text());}else{jQuery('#gform_11').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"11\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_11\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_11\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_11\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 11, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} );\n<\/script>\nBy submitting this application you confirm that we may contact you for any pet related offerings through P-uma, Renasa or associated companies.<\/p>\n","protected":false},"author":7,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","inline_featured_image":false,"footnotes":""},"class_list":["post-3389","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Join &#8902; Bobsure Pet Insurance<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Join &#8902; Bobsure Pet Insurance\" \/>\n<meta property=\"og:description\" content=\"PAW-SOME!You are one step closer to becoming part of the BobSure pet family!What to expect next:By submitting this application you confirm that we may contact you for any pet related offerings through P-uma, Renasa or associated companies.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/bobmartin.co.za\/bobsure\/join\/\" \/>\n<meta property=\"og:site_name\" content=\"Bobsure Pet Insurance\" \/>\n<meta property=\"article:modified_time\" content=\"2025-12-14T21:10:05+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/bobmartin.co.za\/bobsure\/wp-content\/uploads\/2024\/10\/Bobsure-logo.png\" \/>\n\t<meta property=\"og:image:width\" content=\"407\" \/>\n\t<meta property=\"og:image:height\" content=\"407\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/join\\\/\",\"url\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/join\\\/\",\"name\":\"Join &#8902; Bobsure Pet Insurance\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/#website\"},\"datePublished\":\"2022-04-19T12:34:20+00:00\",\"dateModified\":\"2025-12-14T21:10:05+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/join\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/join\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/join\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Join\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/#website\",\"url\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/\",\"name\":\"Bobsure Pet Insurance\",\"description\":\"Pet Insurance for your best friend.\",\"publisher\":{\"@id\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/#organization\"},\"alternateName\":\"BobSure\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/#organization\",\"name\":\"Bobsure\",\"url\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/wp-content\\\/uploads\\\/2024\\\/08\\\/Full-Logo.png\",\"contentUrl\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/wp-content\\\/uploads\\\/2024\\\/08\\\/Full-Logo.png\",\"width\":337,\"height\":347,\"caption\":\"Bobsure\"},\"image\":{\"@id\":\"https:\\\/\\\/bobmartin.co.za\\\/bobsure\\\/#\\\/schema\\\/logo\\\/image\\\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Join &#8902; Bobsure Pet Insurance","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Join &#8902; Bobsure Pet Insurance","og_description":"PAW-SOME!You are one step closer to becoming part of the BobSure pet family!What to expect next:By submitting this application you confirm that we may contact you for any pet related offerings through P-uma, Renasa or associated companies.","og_url":"https:\/\/bobmartin.co.za\/bobsure\/join\/","og_site_name":"Bobsure Pet Insurance","article_modified_time":"2025-12-14T21:10:05+00:00","og_image":[{"width":407,"height":407,"url":"https:\/\/bobmartin.co.za\/bobsure\/wp-content\/uploads\/2024\/10\/Bobsure-logo.png","type":"image\/png"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/bobmartin.co.za\/bobsure\/join\/","url":"https:\/\/bobmartin.co.za\/bobsure\/join\/","name":"Join &#8902; Bobsure Pet Insurance","isPartOf":{"@id":"https:\/\/bobmartin.co.za\/bobsure\/#website"},"datePublished":"2022-04-19T12:34:20+00:00","dateModified":"2025-12-14T21:10:05+00:00","breadcrumb":{"@id":"https:\/\/bobmartin.co.za\/bobsure\/join\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/bobmartin.co.za\/bobsure\/join\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/bobmartin.co.za\/bobsure\/join\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/bobmartin.co.za\/bobsure\/"},{"@type":"ListItem","position":2,"name":"Join"}]},{"@type":"WebSite","@id":"https:\/\/bobmartin.co.za\/bobsure\/#website","url":"https:\/\/bobmartin.co.za\/bobsure\/","name":"Bobsure Pet Insurance","description":"Pet Insurance for your best friend.","publisher":{"@id":"https:\/\/bobmartin.co.za\/bobsure\/#organization"},"alternateName":"BobSure","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/bobmartin.co.za\/bobsure\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/bobmartin.co.za\/bobsure\/#organization","name":"Bobsure","url":"https:\/\/bobmartin.co.za\/bobsure\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/bobmartin.co.za\/bobsure\/#\/schema\/logo\/image\/","url":"https:\/\/bobmartin.co.za\/bobsure\/wp-content\/uploads\/2024\/08\/Full-Logo.png","contentUrl":"https:\/\/bobmartin.co.za\/bobsure\/wp-content\/uploads\/2024\/08\/Full-Logo.png","width":337,"height":347,"caption":"Bobsure"},"image":{"@id":"https:\/\/bobmartin.co.za\/bobsure\/#\/schema\/logo\/image\/"}}]}},"_links":{"self":[{"href":"https:\/\/bobmartin.co.za\/bobsure\/wp-json\/wp\/v2\/pages\/3389","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bobmartin.co.za\/bobsure\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bobmartin.co.za\/bobsure\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bobmartin.co.za\/bobsure\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/bobmartin.co.za\/bobsure\/wp-json\/wp\/v2\/comments?post=3389"}],"version-history":[{"count":22,"href":"https:\/\/bobmartin.co.za\/bobsure\/wp-json\/wp\/v2\/pages\/3389\/revisions"}],"predecessor-version":[{"id":8375,"href":"https:\/\/bobmartin.co.za\/bobsure\/wp-json\/wp\/v2\/pages\/3389\/revisions\/8375"}],"wp:attachment":[{"href":"https:\/\/bobmartin.co.za\/bobsure\/wp-json\/wp\/v2\/media?parent=3389"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}