{"id":1982,"date":"2026-04-01T09:59:49","date_gmt":"2026-04-01T14:59:49","guid":{"rendered":"https:\/\/staging5.nsd.tech\/?page_id=1982"},"modified":"2026-04-01T10:00:46","modified_gmt":"2026-04-01T15:00:46","slug":"hsde-client-intake-form","status":"publish","type":"page","link":"https:\/\/staging5.nsd.tech\/fr\/hsde-client-intake-form\/","title":{"rendered":"HSDE Client Intake Form"},"content":{"rendered":"<div id=\"cs-content\" class=\"cs-content\"><div class=\"x-section e1982-e1 m1j2-0\"><div class=\"x-row x-container max width e1982-e2 m1j2-1 m1j2-2\"><div class=\"x-row-inner\"><div class=\"x-col e1982-e3 m1j2-3 NsdSpacerSmallAll\"><script>\nvar 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class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_437' id='gform_437'  action='\/fr\/wp-json\/wp\/v2\/pages\/1982' data-formid='437' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_437' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><div id=\"field_437_154\" 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\" data-group-id=\"6ba0610e\" data-field-span=\"12\"><h2>Intake Request Form<\/h2><\/div><div id=\"field_437_106\" 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\" data-group-id=\"263a56ad\" data-field-span=\"12\"><h3 class=\"gsection_title\">Your Personal Details<\/h3><\/div><div id=\"field_437_1\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter FIRST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"c8e873a6\" data-field-span=\"3\"><label id='gfield_label_437_1' class='gfield_label gform-field-label' for='input_437_1'><span class='gform-field-label__text'>First Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='50' data-text-counter-template='{current} of {max} max characters'><input name='input_1' id='input_437_1' type='text' value='' class='large' maxlength='50'  tabindex='1'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MIDDLE_NAME gf_hide_charleft field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"c8e873a6\" data-field-span=\"3\"><label id='gfield_label_437_3' class='gfield_label gform-field-label' for='input_437_3'><span class='gform-field-label__text'>Middle Name<\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='50' data-text-counter-template='{current} of {max} max characters'><input name='input_3' id='input_437_3' type='text' value='' class='large' maxlength='50'  tabindex='2'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_110\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter LAST_NAME gf_hide_charleft field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"c8e873a6\" data-field-span=\"3\"><label id='gfield_label_437_110' class='gfield_label gform-field-label' for='input_437_110'><span class='gform-field-label__text'>Last Name<\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='50' data-text-counter-template='{current} of {max} max characters'><input name='input_110' id='input_437_110' type='text' value='' class='large' maxlength='50'  tabindex='3'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_111\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter NICK_NAME gf_hide_charleft field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"c8e873a6\" data-field-span=\"3\"><label id='gfield_label_437_111' class='gfield_label gform-field-label' for='input_437_111'><span class='gform-field-label__text'>Preferred\/Other Name<\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='50' data-text-counter-template='{current} of {max} max characters'><input name='input_111' id='input_437_111' type='text' value='' class='large' maxlength='50'  tabindex='4' placeholder='(Optional)'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_16\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-quarter DATE_BIRTH gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"1e286acf\" data-field-span=\"3\"><label id='gfield_label_437_16' class='gfield_label gform-field-label' for='input_437_16'><span class='gform-field-label__text'>Date of Birth<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_437_16'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_16'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\ttabindex='5' \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_437_16' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_437_16' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_437_16' aria-label='Date of Birth: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_437_120\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter GENDER gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"1e286acf\" data-field-span=\"3\"><label id='gfield_label_437_120' class='gfield_label gform-field-label' for='input_437_120'><span class='gform-field-label__text'>Gender<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_120' id='input_437_120' class='large gfield_select' tabindex='6'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='F' >Female<\/option><option value='M' >Male<\/option><option value='U' >Unknown<\/option><option value='X' >Non-Binary<\/option><option value='P' >Prefer not to say<\/option><\/select><\/div><\/div><div id=\"field_437_5\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-quarter EMAIL gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gpev-field\" data-field-class=\"gpev-field\" data-group-id=\"1e286acf\" data-field-span=\"3\"><label id='gfield_label_437_5' class='gfield_label gform-field-label' for='input_437_5'><span class='gform-field-label__text'>Email Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_437_5' type='email' value='' class='large' tabindex='7'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_437_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter TELE1 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"1e286acf\" data-field-span=\"3\"><label id='gfield_label_437_4' class='gfield_label gform-field-label' for='input_437_4'><span class='gform-field-label__text'>Phone Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_437_4' type='text' value='' class='large'   tabindex='8' placeholder='___-___-____' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"999-999-9999\"\/><\/div><\/div><div id=\"field_437_119\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third PHONENUMBERS field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"3a888741\" data-field-span=\"4\"><label id='gfield_label_437_119' class='gfield_label gform-field-label' for='input_437_119'><span class='gform-field-label__text'>Secondary Phone<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_119' id='input_437_119' type='text' value='' class='large'   tabindex='9' placeholder='___-___-____'  aria-invalid=\"false\"   data-mask=\"999-999-9999\"\/><\/div><\/div><div id=\"field_437_14\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third PRIMARYLANG notranslate gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"3a888741\" data-field-span=\"4\"><label id='gfield_label_437_14' class='gfield_label gform-field-label' for='input_437_14'><span class='gform-field-label__text'>Preferred Language<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_437_14' class='large gfield_select' tabindex='10'   aria-required=\"true\" aria-invalid=\"false\" ><option value='058' >English<\/option><option value='069' >French<\/option><option value='005' >Afrikaans<\/option><option value='009' >Albanian<\/option><option value='010' >Amharic<\/option><option value='013' >Arabic<\/option><option value='014' >Armenian<\/option><option value='024' >Bengali<\/option><option value='029' >Bisaya<\/option><option value='033' >Burmese<\/option><option value='036' >Cantonese<\/option><option value='037' >Catalan<\/option><option value='038' >Cebuano<\/option><option value='044' >Chinese<\/option><option value='226' >Chinese - Simplified<\/option><option value='227' >Chinese - Traditional<\/option><option value='047' >Creole<\/option><option value='048' >Croatian<\/option><option value='049' >Czech<\/option><option value='050' >Danish<\/option><option value='055' >Dutch<\/option><option value='064' >Farsi (Persian)<\/option><option value='316' >Filipino<\/option><option value='074' >German<\/option><option value='077' >Gujarati<\/option><option value='237' >Hiligaynon<\/option><option value='083' >Hindi<\/option><option value='086' >Hungarian<\/option><option value='244' >Ilican<\/option><option value='245' >Ilocano<\/option><option value='246' >Indonesian<\/option><option value='090' >Italian<\/option><option value='247' >Itsekiri<\/option><option value='092' >Japanese<\/option><option value='099' >Karen<\/option><option value='104' >Kinyarwanda<\/option><option value='108' >Korean<\/option><option value='121' >Malagasy<\/option><option value='123' >Malayalam<\/option><option value='127' >Mandarin<\/option><option value='129' >Marathi<\/option><option value='266' >Mizo<\/option><option value='133' >Nepali<\/option><option value='144' >Other Middle Eastern Languages<\/option><option value='154' >Pashto<\/option><option value='150' >Polish<\/option><option value='151' >Portuguese<\/option><option value='153' >Punjabi<\/option><option value='155' >Romanian<\/option><option value='156' >Russian<\/option><option value='160' >Serbian<\/option><option value='293' >Shona<\/option><option value='170' >Sinhalese<\/option><option value='172' >Slovene<\/option><option value='173' >Somali<\/option><option value='176' >Spanish<\/option><option value='178' >Swahili<\/option><option value='181' >Tagalog<\/option><option value='182' >Tamil<\/option><option value='185' >Telugu<\/option><option value='186' >Thai<\/option><option value='189' >Tigrigna<\/option><option value='194' >Turkish<\/option><option value='197' >Ukrainian<\/option><option value='199' >Urdu<\/option><option value='202' >Vietnamese<\/option><option value='209' >Yoruba<\/option><option value='001' >Acholi<\/option><option value='002' >Ada<\/option><option value='003' >Affar<\/option><option value='004' >Afghan<\/option><option value='006' >Aka<\/option><option value='007' >Akan<\/option><option value='212' >Aklanon<\/option><option value='008' >Akra<\/option><option value='213' >American Sign Language (ASL)<\/option><option value='011' >Anuak (Anywa)<\/option><option value='214' >Aran<\/option><option value='015' >Ashanti<\/option><option value='215' >Assamese<\/option><option value='016' >Assyrian<\/option><option value='017' >Azeri<\/option><option value='018' >Bahasa Indonesian<\/option><option value='216' >Balochi<\/option><option value='019' >Bambara<\/option><option value='340' >Bamileke \/ Ghomala<\/option><option value='330' >Banso<\/option><option value='020' >Bantu<\/option><option value='217' >Baule<\/option><option value='218' >Belarusian<\/option><option value='021' >Belen<\/option><option value='022' >Bemba<\/option><option value='023' >Bembe<\/option><option value='025' >Beni<\/option><option value='219' >Benin<\/option><option value='026' >Berber<\/option><option value='320' >Beti<\/option><option value='027' >Bhari<\/option><option value='220' >Bicol\/Bikol\/Bicolano<\/option><option value='221' >Bijaiya<\/option><option value='222' >Bilen<\/option><option value='028' >Bini<\/option><option value='030' >Bissa<\/option><option value='223' >Bontok<\/option><option value='224' >Braille (translation only)<\/option><option value='031' >Breton<\/option><option value='032' >Bulgarian<\/option><option value='341' >Burji \/ Bembala \/ Bambala \/ Daashi<\/option><option value='034' >Busan<\/option><option value='035' >Busango<\/option><option value='039' >Chakma<\/option><option value='040' >Chaldean<\/option><option value='041' >Chaocho<\/option><option value='225' >Chavacano<\/option><option value='042' >Chichewa<\/option><option value='043' >Chin<\/option><option value='228' >Chiuchow<\/option><option value='045' >Chiyao<\/option><option value='046' >Chowchau<\/option><option value='229' >Concani<\/option><option value='325' >Cree<\/option><option value='338' >Dagaare<\/option><option value='051' >Dari<\/option><option value='336' >Daza \/ Dazaga \/ Tebu<\/option><option value='053' >Dinka<\/option><option value='054' >Dioula<\/option><option value='230' >Dzongkha<\/option><option value='056' >Edo<\/option><option value='057' >Efik<\/option><option value='321' >Esan<\/option><option value='059' >Estonian<\/option><option value='060' >Ewe<\/option><option value='062' >Fang<\/option><option value='063' >Fanti<\/option><option value='333' >Fe&#039;fe \/ Fe&#039;efe&#039;e \/ Nufi \/ Bafang<\/option><option value='065' >Finnish<\/option><option value='066' >Flemish<\/option><option value='231' >Foochow<\/option><option value='067' >Fouki<\/option><option value='068' >Foullah<\/option><option value='070' >Fukinese<\/option><option value='071' >Fulani<\/option><option value='072' >Ga<\/option><option value='073' >Gaelic<\/option><option value='232' >Georgian<\/option><option value='323' >Grebo\/Krumen<\/option><option value='075' >Greek<\/option><option value='076' >Guerze<\/option><option value='233' >Hainam<\/option><option value='234' >Hakha Chin<\/option><option value='078' >Hakka<\/option><option value='235' >Harara<\/option><option value='236' >Harary<\/option><option value='079' >Hargar<\/option><option value='080' >Hassanya<\/option><option value='081' >Hausa<\/option><option value='082' >Hebrew<\/option><option value='084' >Hindko<\/option><option value='085' >Hokkin<\/option><option value='238' >Ibibio<\/option><option value='087' >Ibo<\/option><option value='239' >Icelandic<\/option><option value='334' >Idoma<\/option><option value='240' >Igbo<\/option><option value='241' >Igorot<\/option><option value='242' >Ijaw<\/option><option value='243' >Ika<\/option><option value='088' >Ilongo<\/option><option value='089' >Ishan<\/option><option value='248' >Ivbiosakon<\/option><option value='091' >Izi<\/option><option value='249' >Jarai<\/option><option value='093' >Javanese<\/option><option value='324' >Jingpo<\/option><option value='094' >Jolay<\/option><option value='012' >Juba Arabic<\/option><option value='095' >Kacchi<\/option><option value='250' >Kakwa<\/option><option value='096' >Kanarese<\/option><option value='097' >Kandahari<\/option><option value='098' >Kankani<\/option><option value='251' >Kannada<\/option><option value='252' >Kapampangan<\/option><option value='253' >Kashmiri<\/option><option value='254' >Kazakh<\/option><option value='342' >Kenyang \/ Nyang \/ Banyang \/ Manyang<\/option><option value='100' >Khmer<\/option><option value='101' >Kifuliru<\/option><option value='102' >Kihavu<\/option><option value='322' >Kihemba\/Hemba\/Kiluba-Hemba<\/option><option value='326' >Kikamba<\/option><option value='103' >Kikongo<\/option><option value='335' >Kinnauri<\/option><option value='255' >Kinyamulenge<\/option><option value='105' >Kirega<\/option><option value='106' >Kirundi<\/option><option value='107' >Kiswahili<\/option><option value='256' >Kituba<\/option><option value='257' >Konkani<\/option><option value='328' >Kpelle<\/option><option value='109' >Krio<\/option><option value='110' >Kurdish<\/option><option value='313' >Kurmanji<\/option><option value='258' >Kyrgyz<\/option><option value='259' >La langue des signes qu\u00e9b\u00e9coise (LSQ)<\/option><option value='111' >Laotian<\/option><option value='329' >Lari<\/option><option value='112' >Latvian<\/option><option value='113' >Lebanese<\/option><option value='260' >Lengie<\/option><option value='114' >Lingala<\/option><option value='115' >Lithuanian<\/option><option value='116' >Lowma<\/option><option value='261' >Luganda<\/option><option value='262' >Lugishu<\/option><option value='263' >Lutoro<\/option><option value='117' >Maban<\/option><option value='118' >Macedonian<\/option><option value='264' >Macena<\/option><option value='119' >Macua<\/option><option value='120' >Mahou<\/option><option value='265' >Makonde<\/option><option value='122' >Malay<\/option><option value='124' >Maligo<\/option><option value='125' >Malinke<\/option><option value='126' >Maltese<\/option><option value='327' >Mande<\/option><option value='128' >Mandingo<\/option><option value='311' >Masalit<\/option><option value='130' >Mashi<\/option><option value='131' >Mende<\/option><option value='132' >Mina<\/option><option value='267' >Moldovan<\/option><option value='268' >Mongolian<\/option><option value='269' >Moore<\/option><option value='270' >Naandi\/Cemual<\/option><option value='271' >Ndebele<\/option><option value='337' >Ngiemboon<\/option><option value='331' >Ngomba<\/option><option value='134' >Norwegian<\/option><option value='272' >Nubian<\/option><option value='135' >Nuer<\/option><option value='136' >Nzima<\/option><option value='273' >Oko<\/option><option value='137' >Okpe<\/option><option value='138' >Oriya<\/option><option value='139' >Oromo<\/option><option value='274' >Osal<\/option><option value='140' >Other African Languages<\/option><option value='141' >Other Chinese Dialects<\/option><option value='142' >Other European Languages<\/option><option value='143' >Other Languages<\/option><option value='275' >Other Signed Languages<\/option><option value='145' >Other South Asian Languages<\/option><option value='146' >Other South East Asian Lang.<\/option><option value='276' >Otuho<\/option><option value='277' >Pahari<\/option><option value='278' >Pampango<\/option><option value='279' >Pangasinan<\/option><option value='148' >Peul<\/option><option value='280' >Phuockien<\/option><option value='149' >Pidgin<\/option><option value='281' >Plautdietsch<\/option><option value='152' >Poular<\/option><option value='282' >Rohingya<\/option><option value='283' >Romani<\/option><option value='284' >Rukiga<\/option><option value='285' >Runyankole<\/option><option value='286' >Rutooro<\/option><option value='339' >Saho<\/option><option value='157' >Samoan<\/option><option value='287' >Sango<\/option><option value='288' >Sanskrit<\/option><option value='289' >Sara<\/option><option value='158' >Scoula<\/option><option value='159' >Sechuan<\/option><option value='290' >Senufo<\/option><option value='161' >Serbo-Croatian<\/option><option value='291' >Sesotho<\/option><option value='162' >Seswi<\/option><option value='163' >Seychelles<\/option><option value='292' >Shan<\/option><option value='164' >Shanghai<\/option><option value='165' >Shansai<\/option><option value='166' >Shilluk<\/option><option value='167' >Sign Language<\/option><option value='168' >Sindhi<\/option><option value='171' >Slovak<\/option><option value='312' >Songhai<\/option><option value='174' >Soninke<\/option><option value='314' >Sorani<\/option><option value='294' >Sotho<\/option><option value='175' >Soussou<\/option><option value='295' >Southern Burun<\/option><option value='177' >Suesue<\/option><option value='296' >Sukuma<\/option><option value='179' >Swazai<\/option><option value='180' >Swedish<\/option><option value='317' >Swiss German<\/option><option value='297' >Taichew<\/option><option value='315' >Tamasheq<\/option><option value='183' >Tari<\/option><option value='298' >Tatar<\/option><option value='184' >Tatshanese<\/option><option value='299' >Temne<\/option><option value='300' >Teochew<\/option><option value='187' >Tibetan<\/option><option value='188' >Tichiew<\/option><option value='301' >Tigre<\/option><option value='190' >Timini<\/option><option value='191' >Tiv<\/option><option value='302' >Toishan<\/option><option value='192' >Tshiluba<\/option><option value='193' >Tsibula<\/option><option value='195' >Twi<\/option><option value='318' >Uduk<\/option><option value='200' >Uhrobo<\/option><option value='196' >Uigrigma<\/option><option value='303' >Umbundu<\/option><option value='304' >Unama<\/option><option value='198' >Unknown<\/option><option value='319' >Uyghur<\/option><option value='201' >Uzbek<\/option><option value='305' >Visayan<\/option><option value='306' >Waray<\/option><option value='203' >Welsh<\/option><option value='204' >Western Hemisphere Indian Lang<\/option><option value='205' >Wolof<\/option><option value='206' >Xhosa<\/option><option value='332' >Yacouba<\/option><option value='307' >Yako\/Loko\/Lokaa<\/option><option value='308' >Yekhee\/Afenmai\/Afemai<\/option><option value='207' >Yiboe<\/option><option value='208' >Yiddish<\/option><option value='210' >Zande<\/option><option value='309' >Zshiluba<\/option><option value='310' >Zuganda<\/option><option value='211' >Zulu<\/option><\/select><\/div><\/div><div id=\"field_437_15\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect gfield--width-third LANGS notranslate field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"3a888741\" data-field-span=\"4\"><label id='gfield_label_437_15' class='gfield_label gform-field-label' for='input_437_15'><span class='gform-field-label__text'>Other Spoken Languages (if applicable)<\/span><\/label><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_15[]' id='input_437_15' class='large gfield_select' tabindex='11'  aria-invalid=\"false\"  ><option value='058' >English<\/option><option value='069' >French<\/option><option value='005' >Afrikaans<\/option><option value='009' >Albanian<\/option><option value='010' >Amharic<\/option><option value='013' >Arabic<\/option><option value='014' >Armenian<\/option><option value='024' >Bengali<\/option><option value='029' >Bisaya<\/option><option value='033' >Burmese<\/option><option value='036' >Cantonese<\/option><option value='037' >Catalan<\/option><option value='038' >Cebuano<\/option><option value='044' >Chinese<\/option><option value='226' >Chinese - Simplified<\/option><option value='227' >Chinese - Traditional<\/option><option value='047' >Creole<\/option><option value='048' >Croatian<\/option><option value='049' >Czech<\/option><option value='050' >Danish<\/option><option value='055' >Dutch<\/option><option value='064' >Farsi (Persian)<\/option><option value='316' >Filipino<\/option><option value='074' >German<\/option><option value='077' >Gujarati<\/option><option value='237' >Hiligaynon<\/option><option value='083' >Hindi<\/option><option value='086' >Hungarian<\/option><option value='244' >Ilican<\/option><option value='245' >Ilocano<\/option><option value='246' >Indonesian<\/option><option value='090' >Italian<\/option><option value='247' >Itsekiri<\/option><option value='092' >Japanese<\/option><option value='099' >Karen<\/option><option value='104' >Kinyarwanda<\/option><option value='108' >Korean<\/option><option value='121' >Malagasy<\/option><option value='123' >Malayalam<\/option><option value='127' >Mandarin<\/option><option value='129' >Marathi<\/option><option value='266' >Mizo<\/option><option value='133' >Nepali<\/option><option value='144' >Other Middle Eastern Languages<\/option><option value='154' >Pashto<\/option><option value='150' >Polish<\/option><option value='151' >Portuguese<\/option><option value='153' >Punjabi<\/option><option value='155' >Romanian<\/option><option value='156' >Russian<\/option><option value='160' >Serbian<\/option><option value='293' >Shona<\/option><option value='170' >Sinhalese<\/option><option value='172' >Slovene<\/option><option value='173' >Somali<\/option><option value='176' >Spanish<\/option><option value='178' >Swahili<\/option><option value='181' >Tagalog<\/option><option value='182' >Tamil<\/option><option value='185' >Telugu<\/option><option value='186' >Thai<\/option><option value='189' >Tigrigna<\/option><option value='194' >Turkish<\/option><option value='197' >Ukrainian<\/option><option value='199' >Urdu<\/option><option value='202' >Vietnamese<\/option><option value='209' >Yoruba<\/option><option value='001' >Acholi<\/option><option value='002' >Ada<\/option><option value='003' >Affar<\/option><option value='004' >Afghan<\/option><option value='006' >Aka<\/option><option value='007' >Akan<\/option><option value='212' >Aklanon<\/option><option value='008' >Akra<\/option><option value='213' >American Sign Language (ASL)<\/option><option value='011' >Anuak (Anywa)<\/option><option value='214' >Aran<\/option><option value='015' >Ashanti<\/option><option value='215' >Assamese<\/option><option value='016' >Assyrian<\/option><option value='017' >Azeri<\/option><option value='018' >Bahasa Indonesian<\/option><option value='216' >Balochi<\/option><option value='019' >Bambara<\/option><option value='340' >Bamileke \/ Ghomala<\/option><option value='330' >Banso<\/option><option value='020' >Bantu<\/option><option value='217' >Baule<\/option><option value='218' >Belarusian<\/option><option value='021' >Belen<\/option><option value='022' >Bemba<\/option><option value='023' >Bembe<\/option><option value='025' >Beni<\/option><option value='219' >Benin<\/option><option value='026' >Berber<\/option><option value='320' >Beti<\/option><option value='027' >Bhari<\/option><option value='220' >Bicol\/Bikol\/Bicolano<\/option><option value='221' >Bijaiya<\/option><option value='222' >Bilen<\/option><option value='028' >Bini<\/option><option value='030' >Bissa<\/option><option value='223' >Bontok<\/option><option value='224' >Braille (translation only)<\/option><option value='031' >Breton<\/option><option value='032' >Bulgarian<\/option><option value='341' >Burji \/ Bembala \/ Bambala \/ Daashi<\/option><option value='034' >Busan<\/option><option value='035' >Busango<\/option><option value='039' >Chakma<\/option><option value='040' >Chaldean<\/option><option value='041' >Chaocho<\/option><option value='225' >Chavacano<\/option><option value='042' >Chichewa<\/option><option value='043' >Chin<\/option><option value='228' >Chiuchow<\/option><option value='045' >Chiyao<\/option><option value='046' >Chowchau<\/option><option value='229' >Concani<\/option><option value='325' >Cree<\/option><option value='338' >Dagaare<\/option><option value='051' >Dari<\/option><option value='336' >Daza \/ Dazaga \/ Tebu<\/option><option value='053' >Dinka<\/option><option value='054' >Dioula<\/option><option value='230' >Dzongkha<\/option><option value='056' >Edo<\/option><option value='057' >Efik<\/option><option value='321' >Esan<\/option><option value='059' >Estonian<\/option><option value='060' >Ewe<\/option><option value='062' >Fang<\/option><option value='063' >Fanti<\/option><option value='333' >Fe&#039;fe \/ Fe&#039;efe&#039;e \/ Nufi \/ Bafang<\/option><option value='065' >Finnish<\/option><option value='066' >Flemish<\/option><option value='231' >Foochow<\/option><option value='067' >Fouki<\/option><option value='068' >Foullah<\/option><option value='070' >Fukinese<\/option><option value='071' >Fulani<\/option><option value='072' >Ga<\/option><option value='073' >Gaelic<\/option><option value='232' >Georgian<\/option><option value='323' >Grebo\/Krumen<\/option><option value='075' >Greek<\/option><option value='076' >Guerze<\/option><option value='233' >Hainam<\/option><option value='234' >Hakha Chin<\/option><option value='078' >Hakka<\/option><option value='235' >Harara<\/option><option value='236' >Harary<\/option><option value='079' >Hargar<\/option><option value='080' >Hassanya<\/option><option value='081' >Hausa<\/option><option value='082' >Hebrew<\/option><option value='084' >Hindko<\/option><option value='085' >Hokkin<\/option><option value='238' >Ibibio<\/option><option value='087' >Ibo<\/option><option value='239' >Icelandic<\/option><option value='334' >Idoma<\/option><option value='240' >Igbo<\/option><option value='241' >Igorot<\/option><option value='242' >Ijaw<\/option><option value='243' >Ika<\/option><option value='088' >Ilongo<\/option><option value='089' >Ishan<\/option><option value='248' >Ivbiosakon<\/option><option value='091' >Izi<\/option><option value='249' >Jarai<\/option><option value='093' >Javanese<\/option><option value='324' >Jingpo<\/option><option value='094' >Jolay<\/option><option value='012' >Juba Arabic<\/option><option value='095' >Kacchi<\/option><option value='250' >Kakwa<\/option><option value='096' >Kanarese<\/option><option value='097' >Kandahari<\/option><option value='098' >Kankani<\/option><option value='251' >Kannada<\/option><option value='252' >Kapampangan<\/option><option value='253' >Kashmiri<\/option><option value='254' >Kazakh<\/option><option value='342' >Kenyang \/ Nyang \/ Banyang \/ Manyang<\/option><option value='100' >Khmer<\/option><option value='101' >Kifuliru<\/option><option value='102' >Kihavu<\/option><option value='322' >Kihemba\/Hemba\/Kiluba-Hemba<\/option><option value='326' >Kikamba<\/option><option value='103' >Kikongo<\/option><option value='335' >Kinnauri<\/option><option value='255' >Kinyamulenge<\/option><option value='105' >Kirega<\/option><option value='106' >Kirundi<\/option><option value='107' >Kiswahili<\/option><option value='256' >Kituba<\/option><option value='257' >Konkani<\/option><option value='328' >Kpelle<\/option><option value='109' >Krio<\/option><option value='110' >Kurdish<\/option><option value='313' >Kurmanji<\/option><option value='258' >Kyrgyz<\/option><option value='259' >La langue des signes qu\u00e9b\u00e9coise (LSQ)<\/option><option value='111' >Laotian<\/option><option value='329' >Lari<\/option><option value='112' >Latvian<\/option><option value='113' >Lebanese<\/option><option value='260' >Lengie<\/option><option value='114' >Lingala<\/option><option value='115' >Lithuanian<\/option><option value='116' >Lowma<\/option><option value='261' >Luganda<\/option><option value='262' >Lugishu<\/option><option value='263' >Lutoro<\/option><option value='117' >Maban<\/option><option value='118' >Macedonian<\/option><option value='264' >Macena<\/option><option value='119' >Macua<\/option><option value='120' >Mahou<\/option><option value='265' >Makonde<\/option><option value='122' >Malay<\/option><option value='124' >Maligo<\/option><option value='125' >Malinke<\/option><option value='126' >Maltese<\/option><option value='327' >Mande<\/option><option value='128' >Mandingo<\/option><option value='311' >Masalit<\/option><option value='130' >Mashi<\/option><option value='131' >Mende<\/option><option value='132' >Mina<\/option><option value='267' >Moldovan<\/option><option value='268' >Mongolian<\/option><option value='269' >Moore<\/option><option value='270' >Naandi\/Cemual<\/option><option value='271' >Ndebele<\/option><option value='337' >Ngiemboon<\/option><option value='331' >Ngomba<\/option><option value='134' >Norwegian<\/option><option value='272' >Nubian<\/option><option value='135' >Nuer<\/option><option value='136' >Nzima<\/option><option value='273' >Oko<\/option><option value='137' >Okpe<\/option><option value='138' >Oriya<\/option><option value='139' >Oromo<\/option><option value='274' >Osal<\/option><option value='140' >Other African Languages<\/option><option value='141' >Other Chinese Dialects<\/option><option value='142' >Other European Languages<\/option><option value='143' >Other Languages<\/option><option value='275' >Other Signed Languages<\/option><option value='145' >Other South Asian Languages<\/option><option value='146' >Other South East Asian Lang.<\/option><option value='276' >Otuho<\/option><option value='277' >Pahari<\/option><option value='278' >Pampango<\/option><option value='279' >Pangasinan<\/option><option value='148' >Peul<\/option><option value='280' >Phuockien<\/option><option value='149' >Pidgin<\/option><option value='281' >Plautdietsch<\/option><option value='152' >Poular<\/option><option value='282' >Rohingya<\/option><option value='283' >Romani<\/option><option value='284' >Rukiga<\/option><option value='285' >Runyankole<\/option><option value='286' >Rutooro<\/option><option value='339' >Saho<\/option><option value='157' >Samoan<\/option><option value='287' >Sango<\/option><option value='288' >Sanskrit<\/option><option value='289' >Sara<\/option><option value='158' >Scoula<\/option><option value='159' >Sechuan<\/option><option value='290' >Senufo<\/option><option value='161' >Serbo-Croatian<\/option><option value='291' >Sesotho<\/option><option value='162' >Seswi<\/option><option value='163' >Seychelles<\/option><option value='292' >Shan<\/option><option value='164' >Shanghai<\/option><option value='165' >Shansai<\/option><option value='166' >Shilluk<\/option><option value='167' >Sign Language<\/option><option value='168' >Sindhi<\/option><option value='171' >Slovak<\/option><option value='312' >Songhai<\/option><option value='174' >Soninke<\/option><option value='314' >Sorani<\/option><option value='294' >Sotho<\/option><option value='175' >Soussou<\/option><option value='295' >Southern Burun<\/option><option value='177' >Suesue<\/option><option value='296' >Sukuma<\/option><option value='179' >Swazai<\/option><option value='180' >Swedish<\/option><option value='317' >Swiss German<\/option><option value='297' >Taichew<\/option><option value='315' >Tamasheq<\/option><option value='183' >Tari<\/option><option value='298' >Tatar<\/option><option value='184' >Tatshanese<\/option><option value='299' >Temne<\/option><option value='300' >Teochew<\/option><option value='187' >Tibetan<\/option><option value='188' >Tichiew<\/option><option value='301' >Tigre<\/option><option value='190' >Timini<\/option><option value='191' >Tiv<\/option><option value='302' >Toishan<\/option><option value='192' >Tshiluba<\/option><option value='193' >Tsibula<\/option><option value='195' >Twi<\/option><option value='318' >Uduk<\/option><option value='200' >Uhrobo<\/option><option value='196' >Uigrigma<\/option><option value='303' >Umbundu<\/option><option value='304' >Unama<\/option><option value='198' >Unknown<\/option><option value='319' >Uyghur<\/option><option value='201' >Uzbek<\/option><option value='305' >Visayan<\/option><option value='306' >Waray<\/option><option value='203' >Welsh<\/option><option value='204' >Western Hemisphere Indian Lang<\/option><option value='205' >Wolof<\/option><option value='206' >Xhosa<\/option><option value='332' >Yacouba<\/option><option value='307' >Yako\/Loko\/Lokaa<\/option><option value='308' >Yekhee\/Afenmai\/Afemai<\/option><option value='207' >Yiboe<\/option><option value='208' >Yiddish<\/option><option value='210' >Zande<\/option><option value='309' >Zshiluba<\/option><option value='310' >Zuganda<\/option><option value='211' >Zulu<\/option><\/select><\/div><\/div><div id=\"field_437_113\" 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\" data-group-id=\"d6d75e05\" data-field-span=\"12\"><h3 class=\"gsection_title\">Current Residential Address<\/h3><\/div><div id=\"field_437_117\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-three-quarter ADDRESS1 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"bf3615d3\" data-field-span=\"9\"><label id='gfield_label_437_117' class='gfield_label gform-field-label' for='input_437_117'><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='200' data-text-counter-template='{current} of {max} max characters'><input name='input_117' id='input_437_117' type='text' value='' class='large' maxlength='200'  tabindex='12'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_116\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter UNIT_NO field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"bf3615d3\" data-field-span=\"3\"><label id='gfield_label_437_116' class='gfield_label gform-field-label' for='input_437_116'><span class='gform-field-label__text'>Apt\/Unit #<\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='7' data-text-counter-template='{current} of {max} max characters'><input name='input_116' id='input_437_116' type='text' value='' class='large' maxlength='7'  tabindex='13'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_121\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-five-twelfths CITY field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"5d050737\" data-field-span=\"5\"><label id='gfield_label_437_121' class='gfield_label gform-field-label' for='input_437_121'><span class='gform-field-label__text'>City<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_121' id='input_437_121' class='large gfield_select' tabindex='14'    aria-invalid=\"false\" ><option value='' ><\/option><option value='0400301188' >Winnipeg<\/option><option value='0400301001' >Agassiz Provincial Forest<\/option><option value='0400301002' >Alexander<\/option><option value='0400301003' >Alonsa<\/option><option value='0400301004' >Altona<\/option><option value='0400301005' >Arborg<\/option><option value='0400301006' >Ashern<\/option><option value='0400301007' >Austin<\/option><option value='0400301008' >Baldur<\/option><option value='0400301009' >Basswood<\/option><option value='0400301010' >Beausejour<\/option><option value='0400301011' >Belmont<\/option><option value='0400301012' >Benito<\/option><option value='0400301013' >Berens River<\/option><option value='0400301014' >Beulah<\/option><option value='0400301015' >Binscarth<\/option><option value='0400301016' >Birtle<\/option><option value='0400301017' >Bissett<\/option><option value='0400301018' >Boissevain<\/option><option value='0400301019' >Brandon<\/option><option value='0400301020' >Brochet<\/option><option value='0400301021' >Brookdale<\/option><option value='0400301022' >Camperville<\/option><option value='0400301023' >Carberry<\/option><option value='0400301024' >Carman<\/option><option value='0400301025' >Cartwright<\/option><option value='0400301026' >Churchill<\/option><option value='0400301027' >Cormorant<\/option><option value='0400301028' >Cowan<\/option><option value='0400301029' >Cranberry Portage<\/option><option value='0400301030' >Crandall<\/option><option value='0400301031' >Cross Lake<\/option><option value='0400301032' >Crystal City<\/option><option value='0400301033' >Cypress River<\/option><option value='0400301034' >Darlingford<\/option><option value='0400301035' >Dauphin<\/option><option value='0400301036' >Deloraine<\/option><option value='0400301037' >Dominion City<\/option><option value='0400301038' >Dugald<\/option><option value='0400301039' >Easterville<\/option><option value='0400301040' >Eddystone<\/option><option value='0400301041' >Edwin<\/option><option value='0400301042' >Elgin<\/option><option value='0400301043' >Elie<\/option><option value='0400301044' >Elkhorn<\/option><option value='0400301045' >Elm Creek<\/option><option value='0400301046' >Emerson<\/option><option value='0400301047' >Erickson<\/option><option value='0400301048' >Eriksdale<\/option><option value='0400301049' >Ethelbert<\/option><option value='0400301050' >Falcon Lake<\/option><option value='0400301051' >Fisher Branch<\/option><option value='0400301052' >Fisher River<\/option><option value='0400301053' >Flin Flon<\/option><option value='0400301054' >Fork River<\/option><option value='0400301055' >Foxwarren<\/option><option value='0400301056' >Gilbert Plains<\/option><option value='0400301057' >Gillam<\/option><option value='0400301058' >Gimli<\/option><option value='0400301059' >Gladstone<\/option><option value='0400301060' >Glenboro<\/option><option value='0400301061' >Glenella<\/option><option value='0400301062' >Gods Lake Narrows<\/option><option value='0400301063' >Grand Beach<\/option><option value='0400301064' >Grand Rapids<\/option><option value='0400301065' >Grandview<\/option><option value='0400301066' >Gretna<\/option><option value='0400301067' >Gypsumville<\/option><option value='0400301068' >Hadashville<\/option><option value='0400301069' >Hamiota<\/option><option value='0400301070' >Hartney<\/option><option value='0400301071' >Hecla<\/option><option value='0400301072' >Holland<\/option><option value='0400301073' >Ilford<\/option><option value='0400301074' >Inwood<\/option><option value='0400301075' >Island Lake<\/option><option value='0400301076' >Kelwood<\/option><option value='0400301077' >Kenton<\/option><option value='0400301078' >Killarney<\/option><option value='0400301079' >La Broquerie<\/option><option value='0400301080' >Lac Brochet<\/option><option value='0400301081' >Lac du Bonnet<\/option><option value='0400301082' >Langruth<\/option><option value='0400301083' >Leaf Rapids<\/option><option value='0400301084' >Libau<\/option><option value='0400301085' >Little Grand Rapids<\/option><option value='0400301086' >Lockport<\/option><option value='0400301087' >Lundar<\/option><option value='0400301088' >Lynn Lake<\/option><option value='0400301089' >MacGregor<\/option><option value='0400301090' >Mafeking<\/option><option value='0400301091' >Manigotagan<\/option><option value='0400301092' >Manitou<\/option><option value='0400301093' >McAuley<\/option><option value='0400301094' >McCreary<\/option><option value='0400301095' >Melita<\/option><option value='0400301096' >Miami<\/option><option value='0400301097' >Miniota<\/option><option value='0400301098' >Minnedosa<\/option><option value='0400301099' >Minto<\/option><option value='0400301100' >Moose Lake<\/option><option value='0400301101' >Morden<\/option><option value='0400301102' >Morris<\/option><option value='0400301103' >Neepawa<\/option><option value='0400301104' >Nelson House<\/option><option value='0400301105' >Newdale<\/option><option value='0400301106' >Niverville<\/option><option value='0400301107' >Norway House<\/option><option value='0400301108' >Notre Dame de Lourdes<\/option><option value='0400301109' >Oak Lake<\/option><option value='0400301110' >Oak River<\/option><option value='0400301111' >Oakville<\/option><option value='0400301112' >Ochre River<\/option><option value='0400301113' >Oxford House<\/option><option value='0400301114' >Peguis<\/option><option value='0400301115' >Pelican Rapids<\/option><option value='0400301116' >Pikwitonei<\/option><option value='0400301117' >Pilot Mound<\/option><option value='0400301118' >Pinawa<\/option><option value='0400301119' >Pine Dock<\/option><option value='0400301120' >Pine Falls<\/option><option value='0400301121' >Pine River<\/option><option value='0400301122' >Piney<\/option><option value='0400301123' >Plum Coulee<\/option><option value='0400301124' >Plumas<\/option><option value='0400301125' >Pointe du Bois<\/option><option value='0400301126' >Poplar River<\/option><option value='0400301127' >Poplarfield<\/option><option value='0400301128' >Portage la Prairie<\/option><option value='0400301129' >Rapid City<\/option><option value='0400301130' >Rathwell<\/option><option value='0400301131' >Red Sucker Lake<\/option><option value='0400301132' >Rennie<\/option><option value='0400301133' >Reston<\/option><option value='0400301134' >Rivers<\/option><option value='0400301135' >Riverton<\/option><option value='0400301136' >Roblin<\/option><option value='0400301137' >Roland<\/option><option value='0400301138' >Rorketon<\/option><option value='0400301139' >Rossburn<\/option><option value='0400301140' >Russell<\/option><option value='0400301141' >Sandy Lake<\/option><option value='0400301142' >Sanford<\/option><option value='0400301143' >Selkirk<\/option><option value='0400301144' >Shamattawa<\/option><option value='0400301145' >Shilo<\/option><option value='0400301146' >Shoal Lake<\/option><option value='0400301147' >Sidney<\/option><option value='0400301148' >Sifton<\/option><option value='0400301149' >Snow Lake<\/option><option value='0400301150' >Snowflake<\/option><option value='0400301151' >Somerset<\/option><option value='0400301152' >Souris<\/option><option value='0400301153' >South Indian Lake<\/option><option value='0400301154' >Sperling<\/option><option value='0400301155' >Split Lake<\/option><option value='0400301156' >Sprague<\/option><option value='0400301157' >St-Pierre-Jolys<\/option><option value='0400301158' >St. Claude<\/option><option value='0400301159' >St. Francois Xavier<\/option><option value='0400301160' >St. Jean Baptiste<\/option><option value='0400301161' >St. Laurent<\/option><option value='0400301162' >St. Lazare<\/option><option value='0400301163' >Starbuck<\/option><option value='0400301164' >Ste. Agathe<\/option><option value='0400301165' >Ste. Rose du Lac<\/option><option value='0400301166' >Steep Rock<\/option><option value='0400301167' >Steinbach<\/option><option value='0400301168' >Stonewall<\/option><option value='0400301169' >Strathclair<\/option><option value='0400301170' >Swan Lake<\/option><option value='0400301171' >Swan River<\/option><option value='0400301172' >Tadoule Lake<\/option><option value='0400301173' >Teulon<\/option><option value='0400301174' >The Pas<\/option><option value='0400301175' >Thicket Portage<\/option><option value='0400301176' >Thompson<\/option><option value='0400301177' >Treherne<\/option><option value='0400301178' >Virden<\/option><option value='0400301179' >Vita<\/option><option value='0400301180' >Waasagomach<\/option><option value='0400301181' >Wabowden<\/option><option value='0400301182' >Wanless<\/option><option value='0400301183' >Wasagaming<\/option><option value='0400301184' >Waterhen<\/option><option value='0400301185' >Wawanesa<\/option><option value='0400301186' >Whitemouth<\/option><option value='0400301187' >Winkler<\/option><option value='0400301189' >Winnipeg Beach<\/option><option value='0400301190' >Winnipegosis<\/option><option value='0400301191' >Woodridge<\/option><option value='0400301192' >Dufresne<\/option><option value='0400301193' >Lorette<\/option><option value='0400301194' >La Salle<\/option><option value='0400301195' >Grunthal<\/option><option value='0400301196' >Kleefeld<\/option><option value='0400301197' >Birnie<\/option><option value='0400301198' >Eden<\/option><option value='0400301199' >Anola<\/option><option value='0400301200' >Armstrong<\/option><option value='0400301201' >Aubigny<\/option><option value='0400301202' >Blumenort<\/option><option value='0400301203' >Brunkild<\/option><option value='0400301204' >Cooks Creek<\/option><option value='0400301205' >East Braintree<\/option><option value='0400301206' >Elma<\/option><option value='0400301207' >Fraserwood<\/option><option value='0400301208' >Gardenton<\/option><option value='0400301209' >Giroux<\/option><option value='0400301210' >Hazelridge<\/option><option value='0400301211' >Hodgson<\/option><option value='0400301212' >Ile Des Chenes<\/option><option value='0400301213' >Komarno<\/option><option value='0400301214' >Landmark<\/option><option value='0400301215' >Linden<\/option><option value='0400301216' >Lowe Farm<\/option><option value='0400301217' >Marchand<\/option><option value='0400301218' >Middlebro<\/option><option value='0400301219' >Oakbank<\/option><option value='0400301220' >Otterburne<\/option><option value='0400301221' >Pansy<\/option><option value='0400301222' >Prawda<\/option><option value='0400301223' >Randolph<\/option><option value='0400301224' >Richer<\/option><option value='0400301225' >Rosa<\/option><option value='0400301226' >Roseau River<\/option><option value='0400301227' >Rosenort<\/option><option value='0400301228' >Rosewood<\/option><option value='0400301229' >Sandilands<\/option><option value='0400301230' >Sarto<\/option><option value='0400301231' >Schanzenfeld<\/option><option value='0400301232' >Seven Sister Falls<\/option><option value='0400301233' >South Junction<\/option><option value='0400301234' >St. Adolphe<\/option><option value='0400301235' >St. Malo<\/option><option value='0400301236' >Ste. Anne<\/option><option value='0400301237' >Sundown<\/option><option value='0400301238' >Tolstoi<\/option><option value='0400301239' >Tourond<\/option><option value='0400301240' >Tyndale<\/option><option value='0400301241' >Vassar<\/option><option value='0400301242' >Woodlands<\/option><option value='0400301243' >Woodmore<\/option><option value='0400301244' >Zhoda<\/option><option value='0400301245' >Kola<\/option><option value='0400301246' >Ross<\/option><option value='0400301247' >Headingley<\/option><\/select><\/div><\/div><div id=\"field_437_9\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third PROVINCE gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"5d050737\" data-field-span=\"4\"><label id='gfield_label_437_9' class='gfield_label gform-field-label' for='input_437_9'><span class='gform-field-label__text'>Province<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_437_9' class='large gfield_select' tabindex='15'   aria-required=\"true\" aria-invalid=\"false\" ><option value='04003' >Manitoba<\/option><\/select><\/div><\/div><div id=\"field_437_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter POSTALCODE gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"5d050737\" data-field-span=\"3\"><label id='gfield_label_437_8' class='gfield_label gform-field-label' for='input_437_8'><span class='gform-field-label__text'>Postal Code<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_437_8' type='text' value='' class='large'   tabindex='16' placeholder='A#A#A#' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"a9a9a9\"\/><\/div><\/div><div id=\"field_437_128\" 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\" data-group-id=\"7886ca21\" data-field-span=\"12\"><h3 class=\"gsection_title\">Emergency Contact Information<\/h3><\/div><div id=\"field_437_129\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter EMER_NAME gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"0ca43572\" data-field-span=\"3\"><label id='gfield_label_437_129' class='gfield_label gform-field-label' for='input_437_129'><span class='gform-field-label__text'>Full Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='50' data-text-counter-template='{current} of {max} max characters'><input name='input_129' id='input_437_129' type='text' value='' class='large' maxlength='50'  tabindex='17'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_133\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter EMER_TELE1 gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"0ca43572\" data-field-span=\"3\"><label id='gfield_label_437_133' class='gfield_label gform-field-label' for='input_437_133'><span class='gform-field-label__text'>Phone Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_133' id='input_437_133' type='text' value='' class='large'   tabindex='18' placeholder='___-___-____' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"999-999-9999\"\/><\/div><\/div><div id=\"field_437_131\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half EMER_EMAIL gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gpev-field\" data-field-class=\"gpev-field\" data-group-id=\"0ca43572\" data-field-span=\"6\"><label id='gfield_label_437_131' class='gfield_label gform-field-label' for='input_437_131'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_131' id='input_437_131' type='email' value='' class='large' tabindex='19'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_437_42\" 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\" data-group-id=\"62b3e544\" data-field-span=\"12\"><h3 class=\"gsection_title\">Additional Information<\/h3><\/div><div id=\"field_437_236\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect gfield--width-full ServInterested gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"1cc30a15\" data-field-span=\"12\"><label id='gfield_label_437_236' class='gfield_label gform-field-label' for='input_437_236'><span class='gform-field-label__text'>Which type of services are you interested in:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_236[]' id='input_437_236' class='large gfield_select' tabindex='20'  aria-invalid=\"false\" aria-required=\"true\" ><option value='' ><\/option><option value='0485' >Drop In<\/option><option value='0486' >Senior Hub<\/option><option value='0487' >Community Garden<\/option><option value='0488' >Education-STEM-Mentorship<\/option><option value='0489' >Mental Health &amp; Wellness<\/option><option value='0490' >Community Care Program<\/option><option value='0491' >After School &amp; Mentorship Program<\/option><\/select><\/div><\/div><div id=\"field_437_59\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full GENREMARKS gf_hide_charleft field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"56dd5751\" data-field-span=\"12\"><label id='gfield_label_437_59' class='gfield_label gform-field-label' for='input_437_59'><span class='gform-field-label__text'>Would you like to provide any additional information<\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='1000' data-text-counter-template='{current} of {max} max characters'><input name='input_59' id='input_437_59' type='text' value='' class='large' maxlength='1000'  tabindex='21'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_126\" 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\" data-group-id=\"53e827f3\" data-field-span=\"12\"><h3 class=\"gsection_title\">Consents and Confidentiality Statement<\/h3><\/div><fieldset id=\"field_437_127\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full EMAILSCONSENT field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"011164ad\" data-field-span=\"12\"><legend id='gfield_label_437_127' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Mail Consent<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_437_127'><div class='gchoice gchoice_437_127_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_127.1' type='checkbox'  value='Y'  id='choice_437_127_1' tabindex='22'   aria-labelledby=\"label_437_127_1 gfield_label_437_127\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_437_127_1' id='label_437_127_1' class='gform-field-label gform-field-label--type-inline'>I consent to be added to the mailing list for information on events and workshops.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_437_135\" 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\" data-group-id=\"f24dda36\" data-field-span=\"12\">\n<h3>Purpose of Collection and Use<\/h3>\n<p>\nI consent to your organization collecting, recording, storing, and using my personal information for the purpose of providing services and communications related to events, workshops, programs, and other relevant activities. This may include administrative purposes, service coordination, follow-up communications, and internal record-keeping.\n<\/p>\n\n<h3>Types of Information<\/h3>\n<p>\nI understand that the personal information collected may include my name, contact details, and any other information I voluntarily provide that is necessary to deliver services or communications effectively.\n<\/p>\n\n<h3>Storage and Security of Information<\/h3>\n<p>\nI understand that my personal information will be stored securely and that appropriate administrative, technical, and physical safeguards will be in place to protect my data from unauthorized access, loss, misuse, or disclosure.\n<\/p>\n\n<h3>Sharing of Information<\/h3>\n<p>\nI consent to the sharing of my personal information with trusted third-party partners of your organization solely for the purpose of delivering services and communications as described above. I understand that such third parties are required to protect my information and use it only for authorized purposes.\n<\/p>\n\n<h3>Retention of Information<\/h3>\n<p>\nI understand that my personal information will be retained only for as long as necessary to fulfill the purposes for which it was collected, or as required by applicable laws or organizational policies.\n<\/p>\n\n<h3>Withdrawal of Consent<\/h3>\n<p>\nI am aware that I have the right to withdraw my consent at any time by contacting your organization. I understand that withdrawing consent may limit or affect the services or communications that can be provided to me.\n<\/p>\n\n<h3>Acknowledgement and Consent<\/h3>\n<p>\nBy providing my information and\/or participating in your organization\u2019s services, events, or communications, I acknowledge that I have read, understood, and agree to the terms of this consent.\n<\/p><\/div><div id=\"field_437_125\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half SIGN1_PATH gf_hide_charleft field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"afef8c76\" data-field-span=\"6\"><label id='gfield_label_437_125' class='gfield_label gform-field-label' for='input_437_125'><span class='gform-field-label__text'>Please either enter your initials here  OR Sign in next box<\/span><\/label><div class='ginput_container ginput_container_text' data-text-counter-max='5' data-text-counter-template='{current} of {max} max characters'><input name='input_125' id='input_437_125' type='text' value='' class='small' maxlength='5'  tabindex='23'   aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_437_124\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-half SIGN1_PATH gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"afef8c76\" data-field-span=\"6\"><legend id='gfield_label_437_124' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Signature<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class=\"ginput_container ginput_container_signature\"><input type='hidden' value='' name='input_124' id='input_437_124_signature_filename' class='gfield_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_437_124_Container' class='gfield_signature_container' style='height:90px; width:300px; ' ><input type='hidden' id='input_437_124_data' name='input_437_124_data' class='gfield_signature_data' \/><canvas id=\"input_437_124\" width=\"300\" height=\"90\" style=\"border-style: Dashed; border-width: 2px; border-color: #757575; background-color:#FFFFFF; cursor: url(https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;\" tabindex=\"0\" aria-label=\"Signature pad\" ><\/canvas><input type='text' id='input_437_124_textinput' name='input_437_124_textinput' class='gfield_signature_text_input' style='text-indent:10px;display:none;width:300px;height:90px;border-style:Dashed;border-width:2px;border-color:#757575;background-color:#FFFFFF;font-family:&quot;Snell Roundhand&quot;, &quot;Segoe Script&quot;, cursive;font-size:2em;padding:0 12px;box-sizing:border-box;color:#000000;' placeholder='Type your signature' autocomplete='off' aria-label='Type your signature' \/><style type='text\/css'>\n                #input_437_124_textinput::placeholder {\n                    font-size: 1.5rem;\n                    font-family: Arial;\n                    opacity: 0.8;\n                }\n            <\/style><\/div><div id='input_437_124_toolbar' class='gfield_signature_toolbar' dir='ltr' style='margin:5px 0;position:relative;height:35px;width:300px;max-width:100%;display:flex;align-items:center;'><div id='input_437_124_status' class='gfield_signature_status gform-visually-hidden' role='status' aria-live='polite' aria-atomic='true' style='position:absolute;width:1px;height:1px;padding:0;margin:-1px;overflow:hidden;clip:rect(0,0,0,0);white-space:nowrap;border:0;'><\/div><input type='hidden' id='input_437_124_font_select' class='gfield_signature_font_select' value='script' \/><div id='input_437_124_font_dropdown' class='gfield_signature_font_dropdown'><span class='gform-common-icon gform-common-icon--chevron-down gfield_signature_font_dropdown_icon'><\/span><button type='button' id='input_437_124_font_select_button' class='gfield_signature_font_select_button gform-theme__disable' tabindex='0' aria-haspopup='listbox' aria-expanded='false' aria-label='Font Options' style='width:100%;box-sizing:border-box;overflow:hidden;text-overflow:ellipsis;white-space:nowrap;font-family:\"Snell Roundhand\", \"Segoe Script\", cursive;color:#000000'>Your Name<\/button><ul id='input_437_124_font_select_list' class='gfield_signature_font_select_list' role='listbox' tabindex='-1' style='display:none;position:absolute;top:100%;left:0;right:0;margin:0;padding:0;list-style:none;background:#fff;border:1px solid #ccc;z-index:10;max-height:200px;overflow-y:auto;box-sizing:border-box;'><li class='gfield_signature_font_option' role='option' data-value='script' tabindex='0' style='font-family:&quot;Snell Roundhand&quot;, &quot;Segoe Script&quot;, cursive; color:#000000' aria-label='Your Name, Script style'>Your Name<\/li><li class='gfield_signature_font_option' role='option' data-value='handwritten' tabindex='0' style='font-family:&quot;Bradley Hand&quot;, &quot;Comic Sans MS&quot;, cursive; color:#000000' aria-label='Your Name, Handwritten style'>Your Name<\/li><li class='gfield_signature_font_option' role='option' data-value='print' tabindex='0' style='font-family:&quot;Noteworthy&quot;, &quot;Segoe Print&quot;, cursive; color:#000000' aria-label='Your Name, Print style'>Your Name<\/li><\/ul><\/div><div class='gfield_signature_toolbar_icons' style='margin-left:auto;display:flex;align-items:center;'><button type='button' id='input_437_124_textbutton' class='gform-common-icon gform-common-icon--text-field gfield_signature_text_button gform-theme-no-framework' tabindex='0' style='background:none;border:0;padding:0;margin:0;appearance:none;-webkit-appearance:none;cursor:pointer;' alt='Text Signature' aria-label='Text Signature'><\/button><button type='button' id='input_437_124_drawbutton' class='gform-common-icon gform-common-icon--pencil gfield_signature_draw_button gform-theme-no-framework' tabindex='0' style='display:none;background:none;border:0;padding:0;margin:0;appearance:none;-webkit-appearance:none;cursor:pointer;' alt='Draw Signature' aria-label='Draw Signature'><\/button><button type='button' id='input_437_124_resetbutton' class='gform-common-icon gform-common-icon--arrow-path gfield_signature_reset_button gform-theme-no-framework' tabindex='0' style='background:none;border:0;padding:0;margin:0;appearance:none;-webkit-appearance:none;cursor:pointer;' alt='Clear Signature' aria-label='Clear Signature'><\/button><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_437_105\" class=\"gfield gfield--type-captcha gfield--input-type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\" data-group-id=\"eb610193\" data-field-span=\"12\"><label id='gfield_label_437_105' class='gfield_label gform-field-label' for='input_437_105'><span class='gform-field-label__text'>Captcha<\/span><\/label><div id='input_437_105' class='ginput_container ginput_recaptcha' data-sitekey='6LdQ_KQqAAAAAOZ5dT_twxSmxS7Hk-VjwJnkXATw'  data-theme='light' data-tabindex='24'  data-badge=''><\/div><\/div><div id=\"field_437_151\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter REASON exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\" data-group-id=\"ff1ccc0f\" data-field-span=\"3\"><label id='gfield_label_437_151' class='gfield_label gform-field-label' for='input_437_151'><span class='gform-field-label__text'>Programs (Admin Only)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_151' id='input_437_151' type='text' value='0001' class='large'   tabindex='25'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_32\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-quarter DATE_VISITED exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\" data-group-id=\"ff1ccc0f\" data-field-span=\"3\"><label id='gfield_label_437_32' class='gfield_label gform-field-label' for='input_437_32'><span class='gform-field-label__text'>Date Visited (Admin Only)<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='dd\/mm\/yyyy'\n\t\t\t\t\tid='input_437_32'\n\t\t\t\t\tclass='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_32'\n\t\t\t\t\tvalue='28\/10\/2026'\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\ttabindex='26' \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_437_32' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_437_32' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_437_32' aria-label='Date Visited (Admin Only): Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_437_137\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter OF_LANG exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\" data-group-id=\"ff1ccc0f\" data-field-span=\"3\"><label id='gfield_label_437_137' class='gfield_label gform-field-label' for='input_437_137'><span class='gform-field-label__text'>Official Language (Admin Only)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_137' id='input_437_137' type='text' value='1' class='large'   tabindex='27'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_138\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter CurrentJobStatus exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\" data-group-id=\"ff1ccc0f\" data-field-span=\"3\"><label id='gfield_label_437_138' class='gfield_label gform-field-label' for='input_437_138'><span class='gform-field-label__text'>Current Emp Status (Admin Only)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_138' id='input_437_138' type='text' value='0005' class='large'   tabindex='28'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_437_153\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full DOCUMENT_TYPE11 exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\" data-group-id=\"c2b41e77\" data-field-span=\"12\"><label id='gfield_label_437_153' class='gfield_label gform-field-label' for='input_437_153'><span class='gform-field-label__text'>DOC_1 TYPE<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_153' id='input_437_153' type='text' value='0010' class='small'   tabindex='29'   aria-invalid=\"false\"   \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_437' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' tabindex='30'>Submit<\/button> 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