{"id":206,"date":"2012-07-26T16:25:23","date_gmt":"2012-07-26T16:25:23","guid":{"rendered":"http:\/\/allianceinsurancegrp.com\/?page_id=206"},"modified":"2017-01-20T22:23:20","modified_gmt":"2017-01-21T03:23:20","slug":"motorcycle-insurance-quote","status":"publish","type":"page","link":"https:\/\/allianceinsurancegrp.com\/quotes\/motorcycle-insurance-quote\/","title":{"rendered":"Motorcycle Insurance Quote"},"content":{"rendered":"<p>[vc_row][vc_column width=&#8221;5\/6&#8243;]\n                <div class='gf_browser_chrome gform_wrapper' id='gform_wrapper_1' ><div id='gf_1' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_1' id='gform_1'  action='\/wp-json\/wp\/v2\/pages\/206#gf_1'>\n                        <div class='gform_body'><ul id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below'><li id='field_1_1'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_1' >Closest Store Location<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_1' id='input_1_1' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\"><option value='' ><\/option><option value='Madison, TN' >Madison, TN<\/option><option value='Nashville, TN (Charlotte Pike)' >Nashville, TN (Charlotte Pike)<\/option><option value='Nashville, TN (Nolensville Road)' >Nashville, TN (Nolensville Road)<\/option><option value='Smyrna, TN' >Smyrna, TN<\/option><\/select><\/div><\/li><li id='field_1_10'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>General Information<\/h2><\/li><li id='field_1_2'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Name<span class='gfield_required'>*<\/span><\/label><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_1_2'>\n                            <span id='input_1_2_3_container' class='name_first' >\n                                                    <input type='text' name='input_2.3' id='input_1_2_3' value='' aria-label='First name'   aria-required=\"true\" aria-invalid=\"false\" \/>\n                                                    <label for='input_1_2_3' >First<\/label>\n                                               <\/span>\n                            <span id='input_1_2_6_container' class='name_last' >\n                                                    <input type='text' name='input_2.6' id='input_1_2_6' value='' aria-label='Last name'   aria-required=\"true\" aria-invalid=\"false\" \/>\n                                                    <label for='input_1_2_6' >Last<\/label>\n                                                <\/span>\n                            <div class='gf_clear gf_clear_complex'><\/div>\n                        <\/div><\/li><li id='field_1_3'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_3' >Phone Number<\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_1_3' type='tel' value='' class='medium'    aria-invalid=\"false\"  \/><\/div><\/li><li id='field_1_5'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_5' >Email Address<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_1_5' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/>\n                        <\/div><\/li><li id='field_1_4'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Address<span class='gfield_required'>*<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address' id='input_1_4' >\n                         <span class='ginput_full address_line_1' id='input_1_4_1_container' >\n                                        <input type='text' name='input_4.1' id='input_1_4_1' value=''    aria-required=\"true\"\/>\n                                        <label for='input_1_4_1' id='input_1_4_1_label' >Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2' id='input_1_4_2_container' >\n                                        <input type='text' name='input_4.2' id='input_1_4_2' value=''   \/>\n                                        <label for='input_1_4_2' id='input_1_4_2_label' >Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city' id='input_1_4_3_container' >\n                                    <input type='text' name='input_4.3' id='input_1_4_3' value=''    aria-required=\"true\"\/>\n                                    <label for='input_1_4_3' id='input_1_4_3_label' >City<\/label>\n                                 <\/span><span class='ginput_right address_state' id='input_1_4_4_container' >\n                                        <select name='input_4.4' id='input_1_4_4'     aria-required=\"true\"><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' selected='selected'>Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_1_4_4' id='input_1_4_4_label' >State<\/label>\n                                      <\/span><span class='ginput_left address_zip' id='input_1_4_5_container' >\n                                    <input type='text' name='input_4.5' id='input_1_4_5' value=''    aria-required=\"true\"\/>\n                                    <label for='input_1_4_5' id='input_1_4_5_label' >ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_1_4_6' value='United States'\/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id='field_1_12'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_12' >Marital Status<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_1_12' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\"><option value='' ><\/option><option value='Single' >Single<\/option><option value='Married' >Married<\/option><option value='Divorced' >Divorced<\/option><option value='Separated' >Separated<\/option><option value='Widowed' >Widowed<\/option><\/select><\/div><\/li><li id='field_1_13'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_13' >Gender<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_1_13' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\"><option value='' ><\/option><option value='Male' >Male<\/option><option value='Female' >Female<\/option><\/select><\/div><\/li><li id='field_1_14'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Date of Birth<span class='gfield_required'>*<\/span><\/label><div id='input_1_14' class='ginput_container ginput_container_date'><div class='clear-multi'><div class='gfield_date_month ginput_container ginput_container_date' id='input_1_14_1_container'>\n                                            <input type='number' maxlength='2' name='input_14[]' id='input_1_14_1' value=''    min='1' max='12' step='1'\/>\n                                            <label for='input_1_14_1' >MM<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date' id='input_1_14_2_container'>\n                                            <input type='number' maxlength='2' name='input_14[]' id='input_1_14_2' value=''    min='1' max='31' step='1'\/>\n                                            <label for='input_1_14_2' >DD<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date' id='input_1_14_3_container'>\n                                            <input type='number' maxlength='4' name='input_14[]' id='input_1_14_3' value=''    min='1920' max='2024' step='1'\/>\n                                            <label for='input_1_14_3' >YYYY<\/label>\n                                       <\/div>\n                                   <\/div><\/div><\/li><li id='field_1_16'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_16' >Tickets &amp; Accidents<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_16' id='input_1_16' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_1_9'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>Motorcycle Information<\/h2><\/li><li id='field_1_15'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_15' >Year<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_1_15' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_1_6'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_6' >Make<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_1_6' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_1_7'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_7' >Model<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_1_7' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_1_8'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_8' >CCs<\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_1_8' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><\/li><li id='field_1_11'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_11' >Additional Information<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_11' id='input_1_11' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_1_17'  class='gfield gsection field_sublabel_below field_description_below gfield_visibility_visible' ><h2 class='gsection_title'>Coverage Options<\/h2><\/li><li id='field_1_18'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_1_18' >Coverage<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_18' id='input_1_18' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\"><option value='Liability Only' >Liability 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