{"id":12314,"date":"2021-02-07T11:42:41","date_gmt":"2021-02-07T15:42:41","guid":{"rendered":"https:\/\/jss.ca\/?page_id=12314"},"modified":"2021-05-09T14:44:13","modified_gmt":"2021-05-09T18:44:13","slug":"payment","status":"publish","type":"page","link":"https:\/\/jss.ca\/en\/services\/payment\/","title":{"rendered":"Service Fee Payment"},"content":{"rendered":"\n<p>Please make a payment through the form below using credit card via PayPal or E-Transfer. You can find the information on <a href=\"https:\/\/jss.ca\/en\/services\/counselling\/\">the service fees and insurance<\/a> in the Counselling page. If you don&#8217;t know how much you are paying, please contact your servicing counsellor. <\/p>\n\n\n\n<p>If you make a payment through PayPal, you will be redirected to the payment page after clicking the Submit button. If you are paying through E-Transfer, please submit form and make a payment to <strong>info@jss.ca<\/strong> through your financial institution.<\/p>\n\n\n<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_5_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_payment\" >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Payment \/ \u30b5\u30fc\u30d3\u30b9\u6599\u91d1\u652f\u6255\u3044<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"5\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_5\" id=\"frm_hide_fields_5\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"payment\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_5\" name=\"frm_submit_entry_5\" value=\"71109d867b\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/pages\/12314\" \/><div id=\"frm_field_33_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_yngg\" id=\"field_yngg_label\" class=\"frm_primary_label\">Prefix \/ \u656c\u79f0\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[33]\" id=\"field_yngg\"  data-reqmsg=\"Prefix \/ \u656c\u79f0 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Prefix \/ \u656c\u79f0 is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Please select\">Please select<\/option><option  value=\"Mr.\">Mr.<\/option><option  value=\"Mrs.\">Mrs.<\/option><option  value=\"Miss\">Miss<\/option><option  value=\"Ms.\">Ms.<\/option><option  value=\"Dr.\">Dr.<\/option><option  value=\"Prof.\">Prof.<\/option><option  value=\"Rev.\">Rev.<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_34_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_skp9x\" id=\"field_skp9x_label\" class=\"frm_primary_label\">First\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_skp9x\" name=\"item_meta[34]\" value=\"\"  data-reqmsg=\"First cannot be blank.\" aria-required=\"true\" data-invmsg=\"First is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_skp9x\" \/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_skp9x\">First<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_35_container\" class=\"frm_form_field form-field  frm_hidden_container frm_half\">\r\n    <label for=\"field_bk04x\" id=\"field_bk04x_label\" class=\"frm_primary_label\">Last\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_bk04x\" name=\"item_meta[35]\" value=\"\"  data-invmsg=\"Last is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_bk04x\" \/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_bk04x\">Last<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_36_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_lirq1\" id=\"field_lirq1_label\" class=\"frm_primary_label\">Email \/ E\u30e1\u30fc\u30eb\u30a2\u30c9\u30ec\u30b9\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_lirq1\" name=\"item_meta[36]\" value=\"\"  data-reqmsg=\"Email \/ E\u30e1\u30fc\u30eb\u30a2\u30c9\u30ec\u30b9 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email \/ E\u30e1\u30fc\u30eb\u30a2\u30c9\u30ec\u30b9 is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_37_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_y59s\" id=\"field_y59s_label\" class=\"frm_primary_label\">Phone \/ \u96fb\u8a71\u756a\u53f7\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_y59s\" name=\"item_meta[37]\" value=\"\"  data-frmmask=\"(000) 000-0000\" data-reqmsg=\"Phone \/ \u96fb\u8a71\u756a\u53f7 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Phone \/ \u96fb\u8a71\u756a\u53f7 is invalid\" aria-invalid=\"false\" pattern=\"\\(\\d\\d\\d\\) \\d\\d\\d-\\d\\d\\d\\d$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_78_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <div  id=\"field_54xha_label\" class=\"frm_primary_label\">Address \/ \u4f4f\u6240\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <fieldset aria-labelledby=\"field_54xha_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\tAddress \/ \u4f4f\u6240<\/legend>\n<div class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_78-line1_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_54xha_line1\" class=\"frm_screen_reader frm_hidden\">\n\t\tAddress \/ \u4f4f\u6240\t<\/label>\n\t\t<input type=\"text\" id=\"field_54xha_line1\" value=\"\" name=\"item_meta[78][line1]\"  data-reqmsg=\"Address \/ \u4f4f\u6240 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address \/ \u4f4f\u6240 is invalid\" aria-invalid=\"false\"   autocomplete=\"address-line1\" \/>\n\t<\/div>\n<div id=\"frm_field_78-line2_container\" class=\"frm_form_field form-field \">\n\t<label for=\"field_54xha_line2\" class=\"frm_screen_reader frm_hidden\">\n\t\tAddress \/ \u4f4f\u6240\t<\/label>\n\t\t<input type=\"text\" id=\"field_54xha_line2\" value=\"\" name=\"item_meta[78][line2]\"  data-reqmsg=\"Address \/ \u4f4f\u6240 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address \/ \u4f4f\u6240 is invalid\" class=\"frm_optional\" aria-invalid=\"false\"   autocomplete=\"address-line2\" \/>\n\t<\/div>\n<div id=\"frm_field_78-city_container\" class=\"frm_form_field form-field frm_third frm_first\">\n\t<label for=\"field_54xha_city\" class=\"frm_screen_reader frm_hidden\">\n\t\tCity\t<\/label>\n\t\t<input type=\"text\" id=\"field_54xha_city\" value=\"\" name=\"item_meta[78][city]\"  data-reqmsg=\"Address \/ \u4f4f\u6240 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address \/ \u4f4f\u6240 is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level2\" \/>\n\t<div class=\"frm_description\">City<\/div><\/div>\n<div id=\"frm_field_78-state_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_54xha_state\" class=\"frm_screen_reader frm_hidden\">\n\t\tState\/Province\t<\/label>\n\t\t<input type=\"text\" id=\"field_54xha_state\" value=\"\" name=\"item_meta[78][state]\"  data-reqmsg=\"Address \/ \u4f4f\u6240 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address \/ \u4f4f\u6240 is invalid\" aria-invalid=\"false\"   autocomplete=\"address-level1\" \/>\n\t<div class=\"frm_description\">State\/Province<\/div><\/div>\n<div id=\"frm_field_78-zip_container\" class=\"frm_form_field form-field frm_third\">\n\t<label for=\"field_54xha_zip\" class=\"frm_screen_reader frm_hidden\">\n\t\tZip\/Postal\t<\/label>\n\t\t<input type=\"text\" id=\"field_54xha_zip\" value=\"\" name=\"item_meta[78][zip]\"  data-reqmsg=\"Address \/ \u4f4f\u6240 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Address \/ \u4f4f\u6240 is invalid\" aria-invalid=\"false\"   autocomplete=\"postal-code\" \/>\n\t<div class=\"frm_description\">Zip\/Postal<\/div><\/div>\n<\/div>\n<\/fieldset>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_38_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_feaae\" id=\"field_feaae_label\" class=\"frm_primary_label\">Payment Purpose \/ \u652f\u6255\u3044\u76ee\u7684\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[38]\" id=\"field_feaae\"  data-reqmsg=\"Payment Purpose \/ \u652f\u6255\u3044\u76ee\u7684 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Payment Purpose \/ \u652f\u6255\u3044\u76ee\u7684 is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Counselling Fee \/ \u30ab\u30a6\u30f3\u30bb\u30ea\u30f3\u30b0\u6599\">Counselling Fee \/ \u30ab\u30a6\u30f3\u30bb\u30ea\u30f3\u30b0\u6599<\/option><option  value=\"Program Fee \/ \u30d7\u30ed\u30b0\u30e9\u30e0\u6599\">Program Fee \/ \u30d7\u30ed\u30b0\u30e9\u30e0\u6599<\/option><option  value=\"Other \/ \u305d\u306e\u4ed6\">Other \/ \u305d\u306e\u4ed6<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_39_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_1ogrm\" id=\"field_1ogrm_label\" class=\"frm_primary_label\">Program Name \/ \u30d7\u30ed\u30b0\u30e9\u30e0\u540d\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_1ogrm\" name=\"item_meta[39]\" value=\"\"  data-reqmsg=\"Program Name \/ \u30d7\u30ed\u30b0\u30e9\u30e0\u540d cannot be blank.\" aria-required=\"true\" data-invmsg=\"Program Name \/ \u30d7\u30ed\u30b0\u30e9\u30e0\u540d is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_1ogrm\" \/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_1ogrm\">Please enter the program name<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_40_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_fh5er\" id=\"field_fh5er_label\" class=\"frm_primary_label\">Details \/ \u305d\u306e\u4ed6\u8a73\u7d30\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_fh5er\" name=\"item_meta[40]\" value=\"\"  data-invmsg=\"Details \/ \u305d\u306e\u4ed6\u8a73\u7d30 is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_fh5er\" \/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_fh5er\">Please enter the detail if you chose Other.<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_41_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_72mer\" id=\"field_72mer_label\" class=\"frm_primary_label\">Your Service Provider \/ \u30b5\u30fc\u30d3\u30b9\u62c5\u5f53\u8005\u540d\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[41]\" id=\"field_72mer\"  data-frmval=\"Please select\" data-reqmsg=\"Your Service Provider \/ \u30b5\u30fc\u30d3\u30b9\u62c5\u5f53\u8005\u540d cannot be blank.\" aria-required=\"true\" data-invmsg=\"Your Service Provider \/ \u30b5\u30fc\u30d3\u30b9\u62c5\u5f53\u8005\u540d is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Please select\" selected='selected'>Please select<\/option><option  value=\"Takanori Kuge\">Takanori Kuge<\/option><option  value=\"Junko Mifune\">Junko Mifune<\/option><option  value=\"Chie Takano Reeves\">Chie Takano Reeves<\/option><option  value=\"Unknown \/ \u4e0d\u660e\">Unknown \/ \u4e0d\u660e<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_42_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <div  id=\"field_drxx6_label\" class=\"frm_primary_label\">Service Fee \/ \u30b5\u30fc\u30d3\u30b9\u6599\u91d1\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_data_container\" aria-labelledby=\"field_drxx6_label\" role=\"group\"><input type=\"text\" name=\"item_meta[42]\" id=\"field_drxx6\" value=\"\" data-frmprice=\"0\"  placeholder=\"$\" data-reqmsg=\"Service Fee \/ \u30b5\u30fc\u30d3\u30b9\u6599\u91d1 cannot be blank.\" aria-required=\"true\" data-invmsg=\"Service Fee \/ \u30b5\u30fc\u30d3\u30b9\u6599\u91d1 is invalid\" aria-invalid=\"false\"   \/>\n<\/div>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_drxx6\">Please enter the service fee amount.\/ \u30b5\u30fc\u30d3\u30b9\u6599\u91d1\u306e\u91d1\u984d\u3092\u3054\u8a18\u5165\u304f\u3060\u3055\u3044\u3002<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_73_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <div  id=\"field_x6bkb_label\" class=\"frm_primary_label\">Payment Method\/\u652f\u6255\u3044\u65b9\u6cd5\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_x6bkb_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_73-0\">\t\t\t<label  for=\"field_x6bkb-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[73]\" id=\"field_x6bkb-0\" value=\"E-Transfer\"\n\t\t data-reqmsg=\"Payment Method\/\u652f\u6255\u3044\u65b9\u6cd5 cannot be blank.\" data-invmsg=\"Payment Method\/\u652f\u6255\u3044\u65b9\u6cd5 is invalid\"   \/> E-Transfer<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_73-1\">\t\t\t<label  for=\"field_x6bkb-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[73]\" id=\"field_x6bkb-1\" value=\"PayPal (Credit card)\"\n\t\t data-reqmsg=\"Payment Method\/\u652f\u6255\u3044\u65b9\u6cd5 cannot be blank.\" data-invmsg=\"Payment Method\/\u652f\u6255\u3044\u65b9\u6cd5 is invalid\"   \/> PayPal (Credit card)<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_43_container\" class=\"frm_form_field form-field  frm_top_container frm_total_big frm12 frm_first\">\r\n    <div id=\"field_986hy_label\" class=\"frm_primary_label\">Total \/ \u5408\u8a08<\/div>\r\n    <p class=\"frm_total_formatted\"><\/p>\r\n    <input  type=\"hidden\" id=\"field_986hy\" name=\"item_meta[43]\" value=\"\"  data-frmtotal  data-invmsg=\"Total \/ \u5408\u8a08 is invalid\" aria-invalid=\"false\" data-frmtotal   \/>\r\n    \r\n    \r\n<\/div>\n\t\t<input  type=\"hidden\" name=\"item_meta[76]\" id=\"field_shxeh\" value=\"Pending\"  data-frmval=\"Pending\"   \/>\n\t\t<div id=\"frm_field_84_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Submit<\/button>\r\n\r\n<\/div>\r\n<\/div>\n<div id=\"frm_field_85_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n\t<div  id=\"field_lb6o4_label\" class=\"frm_primary_label\">\u652f\u6255\u3044\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/div>\r\n\t<fieldset aria-labelledby=\"field_lb6o4_label\">\n<legend class=\"frm_screen_reader frm_hidden\">\n\t\u652f\u6255\u3044<\/legend>\n<div class=\"frm_combo_inputs_container\">\n<div id=\"frm_field_85-cc_container\" class=\"frm_form_field form-field frm_full frm_cc_number\">\n\t<label for=\"field_lb6o4_cc\" class=\"frm_screen_reader frm_hidden\">\n\t\t\u652f\u6255\u3044\t<\/label>\n\t\t<input type=\"tel\" id=\"field_lb6o4_cc\" value=\"\" name=\"item_meta[85][cc]\"  placeholder=\"\" data-placeholder=\"\" data-invmsg=\"\u652f\u6255\u3044 is invalid\" aria-invalid=\"false\"   autocomplete=\"cc-number\" autocorrect=\"off\" spellcheck=\"off\" autocapitalize=\"off\" data-name=\"85-cc\" placeholder=\"\" \/>\n\t<\/div>\n<div id=\"frm_field_85-month_container\" class=\"frm_form_field form-field frm_third frm_first frm_cc_exp_month\">\n\t<label for=\"field_lb6o4_month\" class=\"frm_screen_reader frm_hidden\">\n\t\t\u652f\u6255\u3044\t<\/label>\n\t\t\t<select name=\"item_meta[85][month]\" id=\"field_lb6o4_month\"  placeholder=\"Month\" data-placeholder=\"Month\" data-invmsg=\"\u652f\u6255\u3044 is invalid\" aria-invalid=\"false\"  >\n\t\t\t<option value=\"\" class=\"frm-select-placeholder\">\n\t\t\t\tMonth\t\t\t<\/option>\n\t\t\t<option  value=\"1\">1<\/option><option  value=\"2\">2<\/option><option  value=\"3\">3<\/option><option  value=\"4\">4<\/option><option  value=\"5\">5<\/option><option  value=\"6\">6<\/option><option  value=\"7\">7<\/option><option  value=\"8\">8<\/option><option  value=\"9\">9<\/option><option  value=\"10\">10<\/option><option  value=\"11\">11<\/option><option  value=\"12\">12<\/option>\t\t<\/select>\n\t<\/div>\n<div id=\"frm_field_85-year_container\" class=\"frm_form_field form-field frm_third frm_cc_exp_year\">\n\t<label for=\"field_lb6o4_year\" class=\"frm_screen_reader frm_hidden\">\n\t\t\u652f\u6255\u3044\t<\/label>\n\t\t\t<select name=\"item_meta[85][year]\" id=\"field_lb6o4_year\"  placeholder=\"Year\" data-placeholder=\"Year\" data-invmsg=\"\u652f\u6255\u3044 is invalid\" aria-invalid=\"false\"  >\n\t\t\t<option value=\"\" class=\"frm-select-placeholder\">\n\t\t\t\tYear\t\t\t<\/option>\n\t\t\t<option  value=\"2026\">2026<\/option><option  value=\"2027\">2027<\/option><option  value=\"2028\">2028<\/option><option  value=\"2029\">2029<\/option><option  value=\"2030\">2030<\/option><option  value=\"2031\">2031<\/option><option  value=\"2032\">2032<\/option><option  value=\"2033\">2033<\/option><option  value=\"2034\">2034<\/option><option  value=\"2035\">2035<\/option><option  value=\"2036\">2036<\/option>\t\t<\/select>\n\t<\/div>\n<div id=\"frm_field_85-cvc_container\" class=\"frm_form_field form-field frm_third frm_cc_cvc\">\n\t<label for=\"field_lb6o4_cvc\" class=\"frm_screen_reader frm_hidden\">\n\t\t\u652f\u6255\u3044\t<\/label>\n\t\t<input type=\"tel\" id=\"field_lb6o4_cvc\" value=\"\" name=\"item_meta[85][cvc]\"  placeholder=\"\" data-placeholder=\"\" data-invmsg=\"\u652f\u6255\u3044 is invalid\" aria-invalid=\"false\"   spellcheck=\"off\" autocapitalize=\"off\" maxlength=\"4\" autocorrect=\"off\" autocomplete=\"off\" data-name=\"85-cvc\" placeholder=\"\" \/>\n\t<\/div>\n<\/div>\n<\/fieldset>\n\r\n\t\r\n\t\r\n<\/div>\n\t\t<input  type=\"hidden\" name=\"item_meta[86]\" id=\"field_1y2vq\" value=\"\"     \/>\n\t\t\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_126_container\">\n\t\t\t<label for=\"field_svf8k\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_svf8k\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[126]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"yFCAxXlXsmD1qQDbGkG\/LzmmsYr3umYsPrNFjt4chpYKIID+5VWZ\/U5Z5q3J4ZfD\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Please make a payment through the form below using credit card via PayPal or E-Transfer. You can find the information on the service fees and insurance in the Counselling page. If you don&#8217;t know how much you are paying, please contact your servicing counsellor. 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