{"id":1353,"date":"2025-10-15T17:52:03","date_gmt":"2025-10-15T17:52:03","guid":{"rendered":"https:\/\/healthonstage.be\/?page_id=1353"},"modified":"2026-01-07T08:50:47","modified_gmt":"2026-01-07T08:50:47","slug":"apply","status":"publish","type":"page","link":"https:\/\/healthonstage.be\/fr\/apply\/","title":{"rendered":"Formulaire d&#039;inscription au terrain"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1353\" class=\"elementor elementor-1353\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b971008 e-flex e-con-boxed e-con e-parent\" data-id=\"b971008\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-a757305 e-con-full e-flex e-con e-child\" data-id=\"a757305\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t<div class=\"elementor-element elementor-element-a93c4b6 e-con-full e-flex e-con e-child\" data-id=\"a93c4b6\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t<div class=\"elementor-element elementor-element-9cfb7f2 e-con-full e-flex e-con e-child\" data-id=\"9cfb7f2\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b2d8150 elementor-widget elementor-widget-elementskit-heading\" data-id=\"b2d8150\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"elementskit-heading.default\">\n\t\t\t\t\t<div class=\"ekit-wid-con\" ><div class=\"ekit-heading elementskit-section-title-wraper text_left   ekit_heading_tablet-   ekit_heading_mobile-\"><h3 class=\"ekit-heading--title elementskit-section-title \">Thank you for applying to pitch at Health on Stage 2026! <\/h3><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-74a482b e-con-full e-flex e-con e-child\" data-id=\"74a482b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bc0cc6f elementor-widget elementor-widget-text-editor\" data-id=\"bc0cc6f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span class=\"TextRun SCXW226850385 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SpellingErrorV2Themed SCXW226850385 BCX0\">Please fill in al<\/span><span class=\"NormalTextRun SCXW226850385 BCX0\">l fields on the application fo<\/span><span class=\"NormalTextRun SCXW226850385 BCX0\">rm and click submit. <\/span><\/span><strong><span class=\"TextRun SCXW226850385 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW226850385 BCX0\">Applications are due by 08 December <\/span><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW226850385 BCX0\">2025 (deadline has passed)<\/span><\/span><\/strong><span class=\"TextRun SCXW226850385 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW226850385 BCX0\"><strong>.<\/strong><\/span><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-02c37b9 e-con-full e-flex e-con e-child\" data-id=\"02c37b9\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t<div class=\"elementor-element elementor-element-0b8ca56 e-con-full e-flex e-con e-child\" data-id=\"0b8ca56\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7862c4e elementor-widget elementor-widget-spacer\" data-id=\"7862c4e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-da43415 elementor-hidden-desktop elementor-hidden-tablet elementor-hidden-mobile elementor-widget elementor-widget-elementskit-video\" data-id=\"da43415\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_video_popup_close_icon&quot;:{&quot;value&quot;:&quot;icon icon-cancel&quot;,&quot;library&quot;:&quot;ekiticons&quot;}}\" data-widget_type=\"elementskit-video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"ekit-wid-con\" >\t\t<div class=\"video-content\" data-video-player=\"[]\" data-video-setting=\"{&quot;videoVolume&quot;:&quot;horizontal&quot;,&quot;startVolume&quot;:0.8,&quot;videoType&quot;:&quot;iframe&quot;,&quot;videoClass&quot;:&quot;mfp-fade&quot;,&quot;popupIcon&quot;:{&quot;value&quot;:&quot;icon icon-cancel&quot;,&quot;library&quot;:&quot;ekiticons&quot;},&quot;videoStyle&quot;:&quot;popup&quot;,&quot;videoTypeName&quot;:&quot;youtube&quot;,&quot;autoplay&quot;:false,&quot;muted&quot;:false,&quot;loop&quot;:false,&quot;bg_color&quot;:&quot;&quot;}\">\n\t\t\t\t\t<div class=\"ekit-hidden-icons\" style=\"display: none;\">\n\t\t\t<div class=\"ekit-popup-close-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"icon icon-cancel\"><\/i>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\n<a class=\"ekit_icon_button glow-ripple ekit-video-popup ekit-video-popup-btn\" href=\"https:\/\/www.youtube.com\/embed\/VhBl3dHT5SY?feature=oembed?playlist=VhBl3dHT5SY&amp;mute=0&amp;autoplay=0&amp;loop=no&amp;controls=0&amp;start=0&amp;end=\" aria-label=\"video-popup\">\n    <i aria-hidden=\"true\" class=\"icon icon-play-button\"><\/i><\/a>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d6209ee elementor-widget elementor-widget-spacer\" data-id=\"d6209ee\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7c1336e e-con-full e-flex e-con e-child\" data-id=\"7c1336e\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1043bd7 elementor-widget elementor-widget-image\" data-id=\"1043bd7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"768\" height=\"617\" src=\"https:\/\/healthonstage.be\/wp-content\/uploads\/2025\/08\/Generic-spotlights-blue-768x617.png\" class=\"attachment-medium_large size-medium_large wp-image-310\" alt=\"\" srcset=\"https:\/\/healthonstage.be\/wp-content\/uploads\/2025\/08\/Generic-spotlights-blue-768x617.png 768w, https:\/\/healthonstage.be\/wp-content\/uploads\/2025\/08\/Generic-spotlights-blue-300x241.png 300w, https:\/\/healthonstage.be\/wp-content\/uploads\/2025\/08\/Generic-spotlights-blue-1024x823.png 1024w, https:\/\/healthonstage.be\/wp-content\/uploads\/2025\/08\/Generic-spotlights-blue-600x482.png 600w, https:\/\/healthonstage.be\/wp-content\/uploads\/2025\/08\/Generic-spotlights-blue.png 1120w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ceda732 e-flex e-con-boxed e-con e-parent\" data-id=\"ceda732\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c324b5c elementor-widget elementor-widget-spacer\" data-id=\"c324b5c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3b9fab2 e-con-full e-flex e-con e-child\" data-id=\"3b9fab2\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6966aac elementor-widget elementor-widget-heading\" data-id=\"6966aac\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Application has been closed.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-130abf9 elementor-widget elementor-widget-spacer\" data-id=\"130abf9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0c97921 elementor-hidden-desktop elementor-hidden-tablet elementor-hidden-mobile e-flex e-con-boxed e-con e-parent\" data-id=\"0c97921\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-17a6fb2 e-con-full e-flex e-con e-child\" data-id=\"17a6fb2\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9d6c9b0 elementor-widget elementor-widget-elementskit-heading\" data-id=\"9d6c9b0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"elementskit-heading.default\">\n\t\t\t\t\t<div class=\"ekit-wid-con\" ><div class=\"ekit-heading elementskit-section-title-wraper text_center   ekit_heading_tablet-   ekit_heading_mobile-\"><h3 class=\"ekit-heading--title elementskit-section-title \">Application Form  <\/h3><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-82d13fd elementor-widget elementor-widget-jet-form-builder-form\" data-id=\"82d13fd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"jet-form-builder-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<link rel='stylesheet' id='wp-block-library-css' href='https:\/\/healthonstage.be\/wp-includes\/css\/dist\/block-library\/common.min.css?ver=7.0' media='all' \/>\n<style id=\"jet-form-builder-1362-inline-css\"><\/style><form  class=\"jet-form-builder layout-column submit-type-reload\" action=\"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/pages\/1353\/?yR1iUB=BxPXb56Uih&amp;method=reload\" method=\"POST\" data-form-id=\"1362\" data-layout=\"column\" enctype=\"multipart\/form-data\" novalidate=\"null\" ssr_validation_method=\"rest\">\r\n<input type=\"hidden\" name=\"_jfb_current_render_states[]\" value=\"DEFAULT.STATE\" data-jfb-sync \/><input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"_jet_engine_booking_form_id\" data-field-name=\"_jet_engine_booking_form_id\" value=\"1362\">\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"_jet_engine_refer\" data-field-name=\"_jet_engine_refer\" value=\"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/pages\/1353\/\">\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"__queried_post_id\" data-field-name=\"__queried_post_id\" value=\"1353\">\n\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"post_id\" data-field-name=\"post_id\" data-jfb-sync=\"null\" value=\"1353\">\n\n\n\n\n<div class=\"wp-block-group is-nowrap is-layout-flex wp-container-core-group-is-layout-7387b849 wp-block-group-is-layout-flex\"><div  class=\"jet-form-builder-row field-type-heading-field\" >\n<div class=\"jet-form-builder__heading\">\r\n<div class=\"jet-form-builder__label-text\">Hospital information <\/div><\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Name of hospital  <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"name_of_hospital\" id=\"name_of_hospital\" type=\"text\" data-field-name=\"name_of_hospital\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_vJa6w8uW\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Contact person name\u00a0 <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"contact_person_name\" id=\"contact_person_name\" type=\"text\" data-field-name=\"contact_person_name\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_zkyWgTmi\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Contact person title\u00a0 <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"contact_person_title\" id=\"contact_person_title\" type=\"text\" data-field-name=\"contact_person_title\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_QBjAaHdw\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Email address\u00a0 <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"email_address\" id=\"email_address\" type=\"email\" data-field-name=\"email_address\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_HVG8vr2P\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Phone number\u00a0 <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"phone_number\" id=\"phone_number\" type=\"text\" data-field-name=\"phone_number\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_duzXmtNy\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n<div  class=\"jet-form-builder-row field-type-group-break-field\" >\n<div class=\"jet-form-builder__field-wrap\">\n\t<div class=\"jet-form-builder__group-break\"><\/div>\n<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-heading-field\" >\n<div class=\"jet-form-builder__heading\">\r\n<div class=\"jet-form-builder__label-text\">Person who will pitch\u00a0\u00a0<\/div><\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-checkbox-field\" >\n<div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap checkboxes-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-checkbox\">\n\t\t\t<input type=\"checkbox\" name=\"same_as_above\" value=\"same_info\" data-field-name=\"same_as_above\"  class=\"jet-form-builder__field checkboxes-field checkradio-field\"><span>Same as above<\/span><\/label><\/div><\/div><div class=\"jet-form-builder__desc\"><small>(Please skip to Challenge section below)\u00a0<\/small><\/div>\n<\/div>\n\n<div class=\"jet-form-builder__conditional \" data-jfb-conditional=\"[{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;same_info&quot;,&quot;field&quot;:&quot;same_as_above&quot;,&quot;use_preset&quot;:false}]\" data-jfb-func=\"{&quot;hide&quot;:{&quot;dom&quot;:true}}\">\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Pitch presenter name\u00a0 <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"pitch_presenter_name\" id=\"pitch_presenter_name\" type=\"text\" data-field-name=\"pitch_presenter_name\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_vdZijs3E\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Pitch presenter title  <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"presenter_title\" id=\"presenter_title\" type=\"text\" data-field-name=\"presenter_title\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_Y8MdzpqU\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Email address  <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"presenter_email\" id=\"presenter_email\" type=\"email\" data-field-name=\"presenter_email\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_4YxRIC9r\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Phone number\u00a0<\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input name=\"presenter_phone\" id=\"presenter_phone\" type=\"text\" data-field-name=\"presenter_phone\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_qbaFR5sO\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n<\/div>\n\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-heading-field\" >\n<div class=\"jet-form-builder__heading\">\r\n<div class=\"jet-form-builder__label-text\">Challenge information<\/div><\/div>\n<\/div>\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Challenge title <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"challenge_title1\" id=\"challenge_title1\" type=\"text\" data-field-name=\"challenge_title1\" class=\"jet-form-builder__field text-field\" maxlength=\"100\" data-jfb-sync=\"null\" autocomplete=\"off_1SNB3A6R\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-textarea-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Description of challenge <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t<textarea class=\"jet-form-builder__field textarea-field\" required=\"required\" name=\"description_of_challenge1\" data-field-name=\"description_of_challenge1\" id=\"description_of_challenge1\" data-jfb-sync=\"null\" maxlength=\"1500\"><\/textarea>\n\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-radio-field wp-block-jet-forms-radio-field\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Which theme fits your challenge best? <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"which_theme_fits_your_challenge_best1\" value=\"humanless_hospitals \" data-field-name=\"which_theme_fits_your_challenge_best1\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Humanless hospitals <\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"which_theme_fits_your_challenge_best1\" value=\"ai-powered_hospitals\" data-field-name=\"which_theme_fits_your_challenge_best1\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>AI-powered hospitals<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"which_theme_fits_your_challenge_best1\" value=\"brick-less_hospitals\" data-field-name=\"which_theme_fits_your_challenge_best1\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Brick-less hospitals<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"which_theme_fits_your_challenge_best1\" value=\"patient-free_medicine\" data-field-name=\"which_theme_fits_your_challenge_best1\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Patient-free medicine<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"which_theme_fits_your_challenge_best1\" value=\"big_data_little_care\" data-field-name=\"which_theme_fits_your_challenge_best1\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Big data, little care<\/span><\/label><\/div><\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-radio-field wp-block-jet-forms-radio-field\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Your challenge\u2019s stage of engagement <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"your_challenge_s_stage_of_engagement1\" value=\"exploration \" data-field-name=\"your_challenge_s_stage_of_engagement1\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Exploration <\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"your_challenge_s_stage_of_engagement1\" value=\"pilot-ready \" data-field-name=\"your_challenge_s_stage_of_engagement1\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Pilot-ready <\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"your_challenge_s_stage_of_engagement1\" value=\"adoption-ready\" data-field-name=\"your_challenge_s_stage_of_engagement1\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Adoption-ready<\/span><\/label><\/div><\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-7387b849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-textarea-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Additional info or specific needs (optional)<\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t<textarea class=\"jet-form-builder__field textarea-field\" name=\"additional_info_or_specific_needs_optional1\" data-field-name=\"additional_info_or_specific_needs_optional1\" id=\"additional_info_or_specific_needs_optional1\" data-jfb-sync=\"null\" maxlength=\"850\"><\/textarea>\n\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n<div  class=\"jet-form-builder-row field-type-repeater-field\" >\n<div class=\"jet-form-builder__field-wrap\"><div data-repeater=\"1\" data-field-name=\"add_another_challenge\" name=\"add_another_challenge\"  class=\"jet-form-builder-repeater jet-form-builder__field\" data-jfb-sync=\"null\">\n<template class=\"jet-form-builder-repeater__initial\"><div class=\"jet-form-builder-repeater__row\" data-repeater-row=\"1\"><div class=\"jet-form-builder-repeater__row-fields\">\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Challenge title <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"add_another_challenge[__i__][challenge_title]\" id=\"add_another_challenge___i___challenge_title\" type=\"text\" data-field-name=\"challenge_title\" class=\"jet-form-builder__field text-field\" maxlength=\"100\" data-jfb-sync=\"null\" autocomplete=\"off_V1BcH4Ug\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-textarea-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Description of challenge <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t<textarea class=\"jet-form-builder__field textarea-field\" required=\"required\" name=\"add_another_challenge[__i__][description_of_challenge]\" data-field-name=\"description_of_challenge\" id=\"add_another_challenge___i___description_of_challenge\" data-jfb-sync=\"null\" maxlength=\"1500\"><\/textarea>\n\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-radio-field wp-block-jet-forms-radio-field\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Which theme fits your challenge best? <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"add_another_challenge[__i__][which_theme_fits_your_challenge_best]\" value=\"humanless_hospitals \" data-field-name=\"which_theme_fits_your_challenge_best\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Humanless hospitals <\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"add_another_challenge[__i__][which_theme_fits_your_challenge_best]\" value=\"ai-powered_hospitals\" data-field-name=\"which_theme_fits_your_challenge_best\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>AI-powered hospitals<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"add_another_challenge[__i__][which_theme_fits_your_challenge_best]\" value=\"brick-less_hospitals\" data-field-name=\"which_theme_fits_your_challenge_best\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Brick-less hospitals<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"add_another_challenge[__i__][which_theme_fits_your_challenge_best]\" value=\"patient-free_medicine\" data-field-name=\"which_theme_fits_your_challenge_best\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Patient-free medicine<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"add_another_challenge[__i__][which_theme_fits_your_challenge_best]\" value=\"big_data_little_care\" data-field-name=\"which_theme_fits_your_challenge_best\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Big data, little care<\/span><\/label><\/div><\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-radio-field wp-block-jet-forms-radio-field\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Your challenge\u2019s stage of engagement <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"add_another_challenge[__i__][your_challenge_s_stage_of_engagement]\" value=\"exploration \" data-field-name=\"your_challenge_s_stage_of_engagement\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Exploration <\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"add_another_challenge[__i__][your_challenge_s_stage_of_engagement]\" value=\"pilot-ready \" data-field-name=\"your_challenge_s_stage_of_engagement\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Pilot-ready <\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"add_another_challenge[__i__][your_challenge_s_stage_of_engagement]\" value=\"adoption-ready\" data-field-name=\"your_challenge_s_stage_of_engagement\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Adoption-ready<\/span><\/label><\/div><\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-textarea-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Additional info or specific needs (optional)<\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t<textarea class=\"jet-form-builder__field textarea-field\" name=\"add_another_challenge[__i__][additional_info_or_specific_needs_optional]\" data-field-name=\"additional_info_or_specific_needs_optional\" id=\"add_another_challenge___i___additional_info_or_specific_needs_optional\" data-jfb-sync=\"null\" maxlength=\"850\"><\/textarea>\n\t<\/div>\n<\/div>\n<\/div><div class=\"jet-form-builder-repeater__row-remove\"><button type=\"button\" class=\"jet-form-builder-repeater__remove\">&times;<\/button><\/div><\/div><\/template>\n<div class=\"jet-form-builder-repeater__items\"><\/div><div class=\"jet-form-builder-repeater__actions\">\n                <button type=\"button\" class=\"jet-form-builder-repeater__new\">Add another challenge<\/button>\n                <\/div><\/div><\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-submit-field\" >\n\t<div data-type=\"submit\" class=\"jet-form-builder__action-button-wrapper jet-form-builder__submit-wrap\">\n\t<button class=\"jet-form-builder__action-button jet-form-builder__submit submit-type-reload\" type=\"submit\">Submit my hospital\u2019s pitch(es)<\/button>\n\t<\/div>\n\t\n<\/div>\n\n\n<input type=\"hidden\" class=\"captcha-token\" name=\"_captcha_token\" value=\"\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\t<div class=\"jet-form-builder-messages-wrap\" data-form-id=\"1362\"><\/div>\n<\/form>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b4c0419 e-flex e-con-boxed e-con e-parent\" data-id=\"b4c0419\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-adfad7b e-con-full e-flex e-con e-child\" data-id=\"adfad7b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5101669 elementor-widget elementor-widget-elementskit-heading\" data-id=\"5101669\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"elementskit-heading.default\">\n\t\t\t\t\t<div class=\"ekit-wid-con\" ><div class=\"ekit-heading elementskit-section-title-wraper text_center   ekit_heading_tablet-   ekit_heading_mobile-\"><h3 class=\"ekit-heading--title elementskit-section-title \">Questions or concerns about your pitch registration? <\/h3><\/div><\/div>\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-51ec1db e-con-full e-flex e-con e-child\" data-id=\"51ec1db\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-94251a3 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"94251a3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"mailto:slienart@hub.brussels\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Contact us<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Thank you for applying to pitch at Health on Stage 2026! Please fill in all fields on the application form and click submit. Applications are due by 08 December 2025 (deadline has passed). Application has been closed. Application Form Hospital information Name of hospital * Contact person name\u00a0 * Contact person title\u00a0 * Email address\u00a0 [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":1342,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1353","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/pages\/1353","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/comments?post=1353"}],"version-history":[{"count":68,"href":"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/pages\/1353\/revisions"}],"predecessor-version":[{"id":2364,"href":"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/pages\/1353\/revisions\/2364"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/media\/1342"}],"wp:attachment":[{"href":"https:\/\/healthonstage.be\/fr\/wp-json\/wp\/v2\/media?parent=1353"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}