{"id":26252,"date":"2022-01-24T07:19:42","date_gmt":"2022-01-24T13:19:42","guid":{"rendered":"https:\/\/www.nfu.ca\/adhesion-des-jeunes-mensuelle\/"},"modified":"2025-11-06T11:55:24","modified_gmt":"2025-11-06T17:55:24","slug":"adhesion-des-jeunes-mensuelle","status":"publish","type":"page","link":"https:\/\/www.nfu.ca\/fr\/adherez\/adhesion-des-jeunes-mensuelle\/","title":{"rendered":"Devenez un jeune membre (mensuel)"},"content":{"rendered":"\n<header class=\"wp-block-cover alignfull is-light has-custom-content-position is-position-bottom-center banner-top\" id=\"banner-top\"><span aria-hidden=\"true\" class=\"wp-block-cover__background has-background-dim has-background-gradient\" style=\"background-color:#98826f;background:linear-gradient(180deg,rgba(0,0,0,0.97) 0%,rgba(0,0,0,0.05) 69%)\"><\/span><img loading=\"lazy\" decoding=\"async\" width=\"1200\" height=\"600\" src=\"https:\/\/www.nfu.ca\/wp-content\/uploads\/2018\/07\/nfu-youth-membership-thumb.jpg\" class=\"wp-block-cover__image-background wp-post-image\" alt=\"UNF - Adh\u00e9sion des jeunes - Pouce\" data-object-fit=\"cover\" srcset=\"https:\/\/www.nfu.ca\/wp-content\/uploads\/2018\/07\/nfu-youth-membership-thumb.jpg 1200w, https:\/\/www.nfu.ca\/wp-content\/uploads\/2018\/07\/nfu-youth-membership-thumb-300x150.jpg 300w, https:\/\/www.nfu.ca\/wp-content\/uploads\/2018\/07\/nfu-youth-membership-thumb-768x384.jpg 768w, https:\/\/www.nfu.ca\/wp-content\/uploads\/2018\/07\/nfu-youth-membership-thumb-1024x512.jpg 1024w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><div class=\"wp-block-cover__inner-container is-layout-flow wp-block-cover-is-layout-flow\">\n<p class=\"has-text-align-left has-large-font-size\"><\/p>\n<\/div><\/header>\n\n<div class=\"wp-block-stackable-hero alignwide stk-block-hero stk-block stk-08fda9e is-style-default mb\" data-v=\"2\" id=\"content-first\" data-block-id=\"08fda9e\"><style>.stk-08fda9e .stk-block-hero__content{min-height:500px !important;align-items:center !important;display:flex !important;}<\/style><div class=\"stk-block-hero__content stk-content-align stk-08fda9e-column alignwide stk-container stk-08fda9e-container stk--no-background stk--no-padding\"><div class=\"stk-block-content stk-inner-blocks has-text-align-left stk-08fda9e-inner-blocks\"><ol class=\"breadcrumb\"><li><a href=\"https:\/\/www.nfu.ca\/fr\/\">National Farmers Union<\/a><\/li><\/ol>\n\n\n\n<div class=\"wp-block-stackable-heading stk-block-heading stk-block-heading--v2 stk-block stk-6c2c9d1 page-title\" id=\"become-a-youth-member-monthly\" data-block-id=\"6c2c9d1\"><h1 class=\"stk-block-heading__text\">Devenez un jeune membre (mensuel)<\/h1><\/div>\n\n\n\n<div class=\"wp-block-stackable-columns stk-block-columns stk-block stk-54b76e7 form-columns\" id=\"form-columns\" data-block-id=\"54b76e7\"><div class=\"stk-row stk-inner-blocks has-text-align-left stk-block-content stk-content-align stk-54b76e7-column\">\n<div class=\"wp-block-stackable-column stk-block-column stk-column stk-block stk-ef63229 about-membership\" data-v=\"4\" id=\"about-membership\" data-block-id=\"ef63229\"><div class=\"stk-column-wrapper stk-block-column__content stk-container stk-ef63229-container stk--no-background stk--no-padding\"><div class=\"has-text-align-left stk-block-content stk-inner-blocks stk-ef63229-inner-blocks\">\n<div class=\"wp-block-stackable-heading stk-block-heading stk-block-heading--v2 stk-block stk-04c752d\" id=\"about-nfu-membership\" data-block-id=\"04c752d\"><h3 class=\"stk-block-heading__text\">\u00c0 propos de l&rsquo;adh\u00e9sion \u00e0 l&rsquo;UNF<\/h3><\/div>\n\n\n\n<div class=\"wp-block-stackable-text stk-block-text stk-block stk-3cea961\" data-block-id=\"3cea961\"><p class=\"stk-block-text__text\">Tous les jeunes, y compris les jeunes non agricoles, \u00e2g\u00e9s de 14 \u00e0 35 ans peuvent adh\u00e9rer \u00e0 l&rsquo;UNF. Les jeunes agriculteurs, \u00e2g\u00e9s de 14 \u00e0 21 ans, sont automatiquement membres de l&rsquo;association de leur famille.<\/p><\/div>\n\n\n\n<div class=\"wp-block-stackable-text stk-block-text stk--hide-desktop stk--hide-tablet stk-block stk-784396a\" data-block-id=\"784396a\"><p class=\"stk-block-text__text\"><a href=\"#member-form\">Aller au formulaire<\/a> <\/p><\/div>\n\n\n\n<div class=\"wp-block-stackable-text stk-block-text stk-block stk-72921b9\" data-block-id=\"72921b9\"><p class=\"stk-block-text__text\">Les jeunes agriculteurs \u00e2g\u00e9s de 21 \u00e0 25 ans peuvent acqu\u00e9rir une adh\u00e9sion annuelle au prix de 113 dollars. Les jeunes agriculteurs \u00e2g\u00e9s de 26 \u00e0 35 ans doivent acheter une carte de membre de l&rsquo;exploitation familiale. Les jeunes non agriculteurs peuvent devenir membres associ\u00e9s pour 75 dollars, avec tous les privil\u00e8ges li\u00e9s \u00e0 l&rsquo;adh\u00e9sion, \u00e0 l&rsquo;exception du droit de vote et du droit d&rsquo;occuper une fonction \u00e9lective.<\/p><\/div>\n\n\n\n<div class=\"wp-block-stackable-text stk-block-text stk-block stk-522ee71\" data-block-id=\"522ee71\"><p class=\"stk-block-text__text\">Pour plus d&rsquo;informations ou pour entrer en contact avec les jeunes de l&rsquo;UNF, veuillez contacter <a href=\"mailto:nfuyouth@nfu.ca\">nfuyouth@nfu.ca<\/a>.<\/p><\/div>\n<\/div><\/div><\/div>\n\n\n\n<div class=\"wp-block-stackable-column stk-block-column stk-column stk-block stk-30bd8ff member-form\" data-v=\"4\" id=\"member-form\" data-block-id=\"30bd8ff\"><div class=\"stk-column-wrapper stk-block-column__content stk-container stk-30bd8ff-container stk--no-background stk--no-padding\"><div class=\"stk-block-content stk-inner-blocks stk-30bd8ff-inner-blocks\">\n<div class=\"wp-block-stackable-text stk-block-text stk--hide-desktop stk--hide-tablet stk-block stk-c0f791c\" data-block-id=\"c0f791c\"><p class=\"stk-block-text__text\"><a href=\"#about-membership\">\u00c0 propos de l&rsquo;adh\u00e9sion \u00e0 l&rsquo;UNF<\/a><\/p><\/div>\n\n\n\n<legend class=\"gfield_label gform-field-label\">Choisissez un intervalle d&rsquo;adh\u00e9sion :<\/legend>\n<div class=\"btn-group\" role=\"group\" id=\"interval-choices\" aria-label=\"Membership Intervals\">\n  <a role=\"button\" href=\"https:\/\/www.nfu.ca\/fr\/adherez\/adhesion-des-jeunes\/\" class=\"btn btn-yearly\">Adh\u00e9sion d&rsquo;un an<\/a>\n  <a role=\"button\" href=\"#\" class=\"btn btn-monthly active\">Mensuelle<\/a>\n<\/div>\n\n\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar 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class='gform_required_legend'>\u00ab\u00a0<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\u00a0\u00bb indique les champs n\u00e9cessaires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_13' id='gform_13'  action='\/fr\/wp-json\/wp\/v2\/pages\/26252#gf_13' data-formid='13' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6Lc38X4sAAAAAO6byCBm-Nw4Tv1RgJWQ4cskx_t7' data-tabindex='0'><input id=\"input_2581bcd571aec2f3f1c41c4964174506\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_2581bcd571aec2f3f1c41c4964174506\" value=\"\"\/><\/div><input type='hidden' class='gform_hidden' name='gnd_token' id='gnd_token' autocomplete='off' value='20260416204754-932f2c716d9db2d8adaabaa1d6b95381cf613a67' \/>\n                        <div class='gform-body gform_body'><div id='gform_fields_13' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_13_58\" 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_13_58'>Comments<\/label><div class='ginput_container'><input name='input_58' id='input_13_58' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_13_58'>Ce champ n\u2019est utilis\u00e9 qu\u2019\u00e0 des fins de validation et devrait rester inchang\u00e9.<\/div><\/div><div id=\"field_13_50\" 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_50' id='input_13_50' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='Adh\u00e9sion des jeunes \u00e0 l&#039;UNF' \/><\/div><\/div><div id=\"field_13_49\" 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_49' id='input_13_49' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='https:\/\/www.nfu.ca\/fr\/wp-json\/wp\/v2\/pages\/26252' \/><\/div><\/div><div id=\"field_13_55\" 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_55' id='input_13_55' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_13_53\" 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\"  ><legend class=\"gfield_label gform-field-label\">Acheter une adh\u00e9sion mensuelle \u00e0 l&rsquo;UNF pour les jeunes<\/legend>\n<div class=\"h4 price-display\">10,00 $ <span>par mois<\/span><\/div><\/div><div id=\"field_13_54\" class=\"gfield gfield--type-product gfield--input-type-hiddenproduct gfield--width-full gform_hidden gfield_price gfield_price_13_54 gfield_product_13_54 gfield_hidden_product field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_13_54_1'>Prix de l&#039;adh\u00e9sion mensuelle des jeunes \u00e0 l&#039;UNF (produit r\u00e9el)<\/label><div class='ginput_container ginput_container_product_price_hidden'><input type='hidden' name='input_54.3' value='1' id='ginput_quantity_13_54' class='gform_hidden' \/><input type='hidden' name='input_54.1' value='Prix de l&#039;adh\u00e9sion mensuelle des jeunes \u00e0 l&#039;UNF (produit r\u00e9el)' class='gform_hidden' \/><input name='input_54.2' id='ginput_base_price_13_54' type='hidden' value='$ 10.00 CAD' class='gform_hidden ginput_amount' \/><\/div><\/div><fieldset id=\"field_13_56\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full 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' >Vous \u00eates membre de l&#039;UNF pour la premi\u00e8re fois ?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_56'><div class='gchoice gchoice_13_56_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.1' type='checkbox'  value='oui'  id='choice_13_56_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_56_1' id='label_13_56_1' class='gform-field-label gform-field-label--type-inline'>oui, je suis membre de l&rsquo;UNF pour la premi\u00e8re fois<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_41\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Don suppl\u00e9mentaire<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_41'><div class='gchoice gchoice_13_41_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_41.1' type='checkbox'  value='oui'  id='choice_13_41_1'   aria-describedby=\"gfield_description_13_41\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_41_1' id='label_13_41_1' class='gform-field-label gform-field-label--type-inline'>Oui, ajoutez un don \u00e0 ma cotisation<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_13_41'>Lorsque vous achetez votre adh\u00e9sion, vous pouvez choisir de faire un don unique \u00e0 l&rsquo;UNF en m\u00eame temps que vous payez votre cotisation. Votre carte de cr\u00e9dit ne sera d\u00e9bit\u00e9e qu&rsquo;une seule fois.<\/div><\/fieldset><div id=\"field_13_38\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_13_38 gfield_product_13_38 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_38'>Montant du don<\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_38' id='input_13_38' type='text' value='' class='small ginput_amount'    aria-invalid=\"false\" aria-describedby=\"gfield_description_13_38\" \/>\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_13_38'>Merci de votre attention ! Veuillez saisir le montant de votre don suppl\u00e9mentaire.<\/div><\/div><div id=\"field_13_32\" class=\"gfield gfield--type-total gfield--input-type-total gfield--width-full donation_total gfield_price gfield_price_13_ gfield_total gfield_total_13_ field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  aria-atomic=\"true\" aria-live=\"polite\" ><label class='gfield_label gform-field-label' for='input_13_32'>D\u00e9biter votre carte de cr\u00e9dit au moment du paiement<\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_32' id='input_13_32' value='$ 0.00 CAD' class='gform-text-input-reset ginput_total ginput_total_13' \/>\n\t\t\t\t\t\t<\/div><\/div><div id=\"field_13_3\" 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\">Informations personnelles<\/h3><\/div><fieldset id=\"field_13_4\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full 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' >Nom<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_13_4'>\n                            \n                            <span id='input_13_4_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.3' id='input_13_4_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_13_4_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_13_4_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.6' id='input_13_4_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_13_4_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_13_5\" class=\"gfield gfield--type-email gfield--input-type-email 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_13_5'>Courriel<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_5' id='input_13_5' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_13_10\" class=\"gfield gfield--type-phone gfield--input-type-phone 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_13_10'>Num\u00e9ro de t\u00e9l\u00e9phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_10' id='input_13_10' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_48\" 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_13_48'>Num\u00e9ro de membre de l&#039;UNF<\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_13_48' type='text' value='' class='medium' maxlength='16'     aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_13_21\" 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\">Adresse postale<\/h3><\/div><fieldset id=\"field_13_15\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full 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' >Votre adresse postale<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_13_15' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_13_15_1_container' >\n                                        <input type='text' name='input_15.1' id='input_13_15_1' value=''    aria-required='true'    \/>\n                                        <label for='input_13_15_1' id='input_13_15_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_13_15_2_container' >\n                                        <input type='text' name='input_15.2' id='input_13_15_2' value=''     aria-required='false'   \/>\n                                        <label for='input_13_15_2' id='input_13_15_2_label' class='gform-field-label gform-field-label--type-sub '>Adresse ligne 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_13_15_3_container' >\n                                    <input type='text' name='input_15.3' id='input_13_15_3' value=''    aria-required='true'    \/>\n                                    <label for='input_13_15_3' id='input_13_15_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_13_15_4_container' >\n                                        <select name='input_15.4' id='input_13_15_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alberta' >Alberta<\/option><option value='Colombie-Britannique' >Colombie-Britannique<\/option><option value='Manitoba' >Manitoba<\/option><option value='Nouveau-Brunswick' >Nouveau-Brunswick<\/option><option value='Terre-Neuve-et-Labrador' >Terre-Neuve-et-Labrador<\/option><option value='Territoires du Nord-Ouest' >Territoires du Nord-Ouest<\/option><option value='Nouvelle-\u00c9cosse' >Nouvelle-\u00c9cosse<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='\u00cele du Prince-\u00c9douard' >\u00cele du Prince-\u00c9douard<\/option><option value='Qu\u00e9bec' >Qu\u00e9bec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                        <label for='input_13_15_4' id='input_13_15_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_13_15_5_container' >\n                                    <input type='text' name='input_15.5' id='input_13_15_5' value=''    aria-required='true'    \/>\n                                    <label for='input_13_15_5' id='input_13_15_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_15.6' id='input_13_15_6' value='Canada' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_13_11\" 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\">Options d&#039;achat<\/h3><\/div><fieldset id=\"field_13_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full 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' >Options d&#039;achat<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_13_12'>\n\t\t\t<div class='gchoice gchoice_13_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='m\u00eame adresse physique' checked='checked' id='choice_13_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_12_0' id='label_13_12_0' class='gform-field-label gform-field-label--type-inline'>J&rsquo;ach\u00e8te cette adh\u00e9sion pour moi-m\u00eame.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_13_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='\u00e0 l&#039;abri des regards'  id='choice_13_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_13_12_1' id='label_13_12_1' class='gform-field-label gform-field-label--type-inline'>J&rsquo;ach\u00e8te une adh\u00e9sion au nom de quelqu&rsquo;un d&rsquo;autre.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_13_17\" 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\">Informations sur le b\u00e9n\u00e9ficiaire<\/h3><\/div><fieldset id=\"field_13_16\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full 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' >Nom du b\u00e9n\u00e9ficiaire<\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_13_16'>\n                            \n                            <span id='input_13_16_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_16.3' id='input_13_16_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_13_16_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_13_16_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_16.6' id='input_13_16_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_13_16_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_13_18\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_18'>Courriel du destinataire<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_18' id='input_13_18' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_13_19\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_19'>Num\u00e9ro de t\u00e9l\u00e9phone du destinataire<\/label><div class='ginput_container ginput_container_phone'><input name='input_19' id='input_13_19' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_20\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full 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' >Adresse du destinataire<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_13_20' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_13_20_1_container' >\n                                        <input type='text' name='input_20.1' id='input_13_20_1' value=''    aria-required='false'    \/>\n                                        <label for='input_13_20_1' id='input_13_20_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_13_20_2_container' >\n                                        <input type='text' name='input_20.2' id='input_13_20_2' value=''     aria-required='false'   \/>\n                                        <label for='input_13_20_2' id='input_13_20_2_label' class='gform-field-label gform-field-label--type-sub '>Adresse ligne 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_13_20_3_container' >\n                                    <input type='text' name='input_20.3' id='input_13_20_3' value=''    aria-required='false'    \/>\n                                    <label for='input_13_20_3' id='input_13_20_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_13_20_4_container' >\n                                        <select name='input_20.4' id='input_13_20_4'     aria-required='false'    ><option value='' selected='selected'><\/option><option value='Alberta' >Alberta<\/option><option value='Colombie-Britannique' >Colombie-Britannique<\/option><option value='Manitoba' >Manitoba<\/option><option value='Nouveau-Brunswick' >Nouveau-Brunswick<\/option><option value='Terre-Neuve-et-Labrador' >Terre-Neuve-et-Labrador<\/option><option value='Territoires du Nord-Ouest' >Territoires du Nord-Ouest<\/option><option value='Nouvelle-\u00c9cosse' >Nouvelle-\u00c9cosse<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='\u00cele du Prince-\u00c9douard' >\u00cele du Prince-\u00c9douard<\/option><option value='Qu\u00e9bec' >Qu\u00e9bec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                        <label for='input_13_20_4' id='input_13_20_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_13_20_5_container' >\n                                    <input type='text' name='input_20.5' id='input_13_20_5' value=''    aria-required='false'    \/>\n                                    <label for='input_13_20_5' id='input_13_20_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_20.6' id='input_13_20_6' value='Canada' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_13_46\" 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\"><\/h3><\/div><div id=\"field_13_57\" 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\"  ><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_13' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Achat d&#039;une adh\u00e9sion'  \/> <input type='hidden' name='gform_ajax' value='form_id=13&amp;title=&amp;description=&amp;tabindex=0&amp;theme=orbital&amp;styles={&quot;theme&quot;:&quot;orbital&quot;,&quot;inputPrimaryColor&quot;:&quot;#204ce5&quot;}&amp;hash=8ea88fdbde0fdacf440d7d1ec549592a' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_13' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_13' id='gform_theme_13' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_13' id='gform_style_settings_13' value='{&quot;theme&quot;:&quot;orbital&quot;,&quot;inputPrimaryColor&quot;:&quot;#204ce5&quot;}' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_13' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='13' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='CAD' value='TkvGV5k13QWFdzyx0NPZwGTCLfh9\/rDx7ZKXECAT3KqK3DYbgoryZ27LZ5UHtAti9O1ozREd+fdUWJ8whqH67K8dZqtBwQ2bNKEvcgWaFmibZ8c=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_13' 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