{"id":1842,"date":"2025-07-09T10:42:21","date_gmt":"2025-07-09T15:42:21","guid":{"rendered":"https:\/\/staging5.nsd.tech\/?page_id=1842"},"modified":"2025-07-09T10:46:12","modified_gmt":"2025-07-09T15:46:12","slug":"thrive-intake-form","status":"publish","type":"page","link":"https:\/\/staging5.nsd.tech\/uk\/thrive-intake-form\/","title":{"rendered":"Thrive Intake form"},"content":{"rendered":"<div id=\"cs-content\" class=\"cs-content\"><div class=\"x-section e1842-e1 m1f6-0\"><div class=\"x-row x-container max width e1842-e2 m1f6-1 m1f6-2\"><div class=\"x-row-inner\"><div class=\"x-col e1842-e3 m1f6-3 NsdSpacerSmallAll\"><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar 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Intake Form<\/h2>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_418' id='gform_418'  action='\/uk\/wp-json\/wp\/v2\/pages\/1842' data-formid='418' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_418' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_418_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\"  ><h2>Intake Request Form<\/h2><\/div><div id=\"field_418_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\"  ><h3 class=\"gsection_title\">Your Personal Details<\/h3><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_1'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_418_1' type='text' value='' class='large' maxlength='50'  tabindex='1'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MIDDLE_NAME gf_hide_charleft field_sublabel_below gfield--no-description 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value='' class='large' maxlength='50'  tabindex='3'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_111'>Preferred\/Other Name<\/label><div class='ginput_container ginput_container_text'><input name='input_111' id='input_418_111' type='text' value='' class='large' maxlength='50'  tabindex='4' placeholder='(Optional)'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_16\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter DATE_BIRTH gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_16'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_16' id='input_418_16' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='5'  placeholder='\u0434\u0434\/\u043c\u043c\/\u0440\u0440\u0440\u0440' aria-describedby=\"input_418_16_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_418_16_date_format' class='screen-reader-text'>\u0414\u0414 \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u041c\u041c \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u0420\u0420\u0420\u0420<\/span>\n                        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>Common-Law<\/option><option value='0002' >Divorced<\/option><option value='0003' >Married<\/option><option value='0004' >Separated<\/option><option value='0005' >Single<\/option><option value='0006' >Widowed<\/option><option value='0007' >Unknown<\/option><\/select><\/div><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_120'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_120' id='input_418_120' class='large gfield_select' tabindex='7'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' 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>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_418_15\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect gfield--width-three-quarter LANGS notranslate field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_15'>Other Spoken Languages (if applicable)<\/label><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_15[]' id='input_418_15' class='large gfield_select' tabindex='13'  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_418_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\"  ><h3 class=\"gsection_title\">Current Residential Address<\/h3><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_117'>Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_117' id='input_418_117' type='text' value='' class='large' maxlength='200'  tabindex='14'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_116'>Apt\/Unit #<\/label><div class='ginput_container ginput_container_text'><input name='input_116' id='input_418_116' type='text' value='' class='large' maxlength='7'  tabindex='15'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_121'>City<\/label><div class='ginput_container ginput_container_select'><select name='input_121' id='input_418_121' class='large gfield_select' tabindex='16'    aria-invalid=\"false\" ><option value='' ><\/option><option value='0400201233' >Surrey<\/option><option value='0400201012' >Armstrong<\/option><option value='0400201035' >Burnaby<\/option><option value='0400250015' >Cherryville<\/option><option value='0400201275' >Coldstream<\/option><option value='0400201056' >Cranbrook<\/option><option value='0400250014' >Edgewood<\/option><option value='0400201072' >Enderby<\/option><option value='0400201075' >Falkland<\/option><option value='0400201096' >Grand Forks<\/option><option value='0400250017' >Grindrod<\/option><option value='0400201118' >Kelowna<\/option><option value='0400201276' >Lake Country<\/option><option value='0400201141' >Lumby<\/option><option value='0400201159' >Nelson<\/option><option value='0400201170' >Osoyoos<\/option><option value='0400201174' >Peachland<\/option><option value='0400201176' >Penticton<\/option><option value='0400201191' >Prince George<\/option><option value='0400201201' >Revelstoke<\/option><option value='0400201210' >Salmon Arm<\/option><option value='0400201217' >Sicamous<\/option><option value='0400250018' >Silverton<\/option><option value='0400201253' >Vancouver<\/option><option value='0400201261' >West Kelowna<\/option><option value='0400250016' >Westbank<\/option><option value='0400201262' >Westwold<\/option><option value='0400201256' >Vernon<\/option><\/select><\/div><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_9'>Province<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_418_9' class='large gfield_select' tabindex='17'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='04002' >British Columbia<\/option><\/select><\/div><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_8'>Postal Code<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_418_8' type='text' value='' class='large'   tabindex='18' placeholder='A#A#A#' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_27\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Immigration Related Information<\/h3><\/div><div id=\"field_418_17\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third CAN_STATUS gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_17'>Status in Canada<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_17' id='input_418_17' class='large gfield_select' tabindex='19'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0001' >Citizen by birth<\/option><option value='0003' >PR - Permanent Resident<\/option><option value='0006' >RC - Refugee Claimant<\/option><option value='0007' >Student - Study Permit<\/option><option value='0016' >Work Permit<\/option><option value='0025' >Protected Person<\/option><\/select><\/div><\/div><div id=\"field_418_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third FOSSIDNO gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_19'>UCI\/IUC (Unique Client Identifier)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_418_19' type='text' value='' class='large'   tabindex='20'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_109\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third FOSSIDNO field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_109'>UCI\/IUC (Unique Client Identifier)<\/label><div class='ginput_container ginput_container_text'><input name='input_109' id='input_418_109' type='text' value='' class='large'   tabindex='21'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_6\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-five-twelfths CNT_BIRTH field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_6'>Country of Birth<\/label><div class='ginput_container ginput_container_select'><select name='input_6' id='input_418_6' class='large gfield_select' tabindex='22'    aria-invalid=\"false\" ><option value='' ><\/option><option value='002' >Afghanistan<\/option><option value='003' >Albania<\/option><option value='004' >Alderney<\/option><option value='005' >Algeria<\/option><option value='006' >American Samoa<\/option><option value='007' >Andorra<\/option><option value='008' >Angola<\/option><option value='009' >Anguilla<\/option><option value='010' >Antigua and Barbuda<\/option><option value='011' >Argentina<\/option><option value='012' >Armenia<\/option><option value='014' >Australia<\/option><option value='015' >Austria<\/option><option value='016' >Azerbaijan<\/option><option value='017' >Bahamas<\/option><option value='018' >Bahrain<\/option><option value='019' >Bangladesh<\/option><option value='020' >Barbados<\/option><option value='021' >Belarus<\/option><option value='022' >Belgium<\/option><option value='023' >Belize<\/option><option value='024' >Benin<\/option><option value='025' >Bermuda<\/option><option value='026' >Bhutan<\/option><option value='027' >Bolivia<\/option><option value='029' >Bosnia and Herzegovina<\/option><option value='030' >Botswana<\/option><option value='031' >Brazil<\/option><option value='033' >British Virgin Islands<\/option><option value='034' >Brunei<\/option><option value='035' >Bulgaria<\/option><option value='036' >Burkina Faso<\/option><option value='037' >Myanmar (formerly Burma)<\/option><option value='038' >Burundi<\/option><option value='039' >Cameroon<\/option><option value='040' >Canada<\/option><option value='041' >Canary Islands<\/option><option value='042' >Cabo Verde<\/option><option value='043' >Cayman Islands<\/option><option value='044' >Central African Republic<\/option><option value='045' >Chad<\/option><option value='047' >Chile<\/option><option value='048' >China (PRC)<\/option><option value='049' >Colombia<\/option><option value='050' >Comoros<\/option><option value='051' >Congo Democratic Republic of<\/option><option value='052' >Congo (Congo Republic)<\/option><option value='054' >Costa Rica<\/option><option value='055' >Croatia<\/option><option value='056' >Cuba<\/option><option value='057' >Cyprus<\/option><option value='058' >Czechia (Czech Republic)<\/option><option value='059' >Denmark<\/option><option value='060' >Djibouti<\/option><option value='061' >Dominican Republic<\/option><option value='062' >Ecuador<\/option><option value='063' >Egypt<\/option><option value='064' >El Salvador<\/option><option value='065' >England<\/option><option value='066' >Equatorial Guinea<\/option><option value='067' >Eritrea<\/option><option value='068' >Estonia<\/option><option value='069' >Ethiopia<\/option><option value='071' >Germany<\/option><option value='072' >Fiji<\/option><option value='073' >Finland<\/option><option value='075' >Fr. Polynesia<\/option><option value='076' >France<\/option><option value='077' >French Guiana<\/option><option value='078' >Gabon<\/option><option value='079' >Gambia<\/option><option value='080' >Georgia<\/option><option value='081' >Ghana<\/option><option value='083' >Greece<\/option><option value='084' >Greenland<\/option><option value='085' >Grenada<\/option><option value='086' >Guadaloupe<\/option><option value='087' >Guam<\/option><option value='088' >Guatemala<\/option><option value='089' >Guinea<\/option><option value='090' >Guinea-bissau<\/option><option value='091' >Guyana<\/option><option value='092' >Haiti<\/option><option value='093' >Honduras<\/option><option value='094' >Hong Kong<\/option><option value='095' >Hungary<\/option><option value='096' >Iceland<\/option><option value='097' >India<\/option><option value='098' >Indonesia<\/option><option value='099' >Iran<\/option><option value='100' >Iraq<\/option><option value='101' >Ireland<\/option><option value='102' >Israel<\/option><option value='103' >Italy<\/option><option value='104' >Cote d Ivoire (Ivory Coast)<\/option><option value='105' >Jamaica<\/option><option value='106' >Japan<\/option><option value='107' >Jordan<\/option><option value='109' >Kazakhstan<\/option><option value='110' >Kenya<\/option><option value='111' >Kerguelen Islands<\/option><option value='112' >Kyrgyzstan<\/option><option value='113' >Kiribati<\/option><option value='114' >Korea, North<\/option><option value='115' >Korea, South<\/option><option value='116' >Kosovo<\/option><option value='117' >Kuwait<\/option><option value='118' >Laos<\/option><option value='119' >Latvia<\/option><option value='120' >Lebanon<\/option><option value='121' >Lesotho<\/option><option value='122' >Liberia<\/option><option value='123' >Libya<\/option><option value='124' >Liechtenstein<\/option><option value='125' >Lithuania<\/option><option value='126' >Luxembourg<\/option><option value='128' >North Macedonia<\/option><option value='129' >Madagascar<\/option><option value='130' >Malawi<\/option><option value='131' >Malaysia<\/option><option value='132' >Maldives<\/option><option value='133' >Mali<\/option><option value='134' >Malta<\/option><option value='135' >Marshall Islands<\/option><option value='137' >Mauritania<\/option><option value='138' >Mauritius<\/option><option value='140' >Mexico<\/option><option value='141' >Moldova<\/option><option value='142' >Monaco<\/option><option value='143' >Mongolia<\/option><option value='144' >Montserrat<\/option><option value='145' >Morocco<\/option><option value='146' >Mozambique<\/option><option value='147' >Namibia<\/option><option value='148' >Nauru<\/option><option value='149' >Nepal<\/option><option value='150' >Netherlands<\/option><option value='153' >New Caledonia<\/option><option value='154' >New Zealand<\/option><option value='155' >Nicaragua<\/option><option value='156' >Niger<\/option><option value='157' >Nigeria<\/option><option value='158' >Northern Ireland<\/option><option value='159' >Norway<\/option><option value='160' >Pakistan<\/option><option value='161' >Palestine<\/option><option value='162' >Panama<\/option><option value='164' >Papua New Guinea<\/option><option value='165' >Paraguay<\/option><option value='166' >Peru<\/option><option value='167' >Philippines<\/option><option value='168' >Pitcairn Islands<\/option><option value='169' >Poland<\/option><option value='170' >Portugal<\/option><option value='171' >Puerto Rico<\/option><option value='172' >Qatar<\/option><option value='173' >Reunion<\/option><option value='174' >Romania<\/option><option value='175' >Russia<\/option><option value='176' >Rwanda<\/option><option value='177' >Samoa<\/option><option value='178' >San Marino<\/option><option value='179' >Sao Tome and Principe<\/option><option value='180' >Saudi Arabia<\/option><option value='181' >Scotland<\/option><option value='182' >Senegal<\/option><option value='183' >Serbia<\/option><option value='184' >Seychelles<\/option><option value='185' >Sierra Leone<\/option><option value='186' >Singapore<\/option><option value='187' >Solomon Islands<\/option><option value='188' >Somalia<\/option><option value='189' >South Africa<\/option><option value='190' >Spain<\/option><option value='191' >Sri Lanka<\/option><option value='192' >St. Helena<\/option><option value='193' >St. Kitts and Nevis<\/option><option value='194' >St. Lucia<\/option><option value='195' >St. Pierre Et Miquelon<\/option><option value='196' >St. Vincent And The Grenadines<\/option><option value='197' >Stateless<\/option><option value='198' >Sudan<\/option><option value='199' >Suriname<\/option><option value='200' >Eswatini (formerly Swaziland)<\/option><option value='201' >Sweden<\/option><option value='202' >Switzerland<\/option><option value='203' >Syria<\/option><option value='204' >Tajikistan<\/option><option value='205' >Tanzania<\/option><option value='206' >Thailand<\/option><option value='207' >Tibet<\/option><option value='208' >Togo<\/option><option value='209' >Tonga<\/option><option value='210' >Trinidad &amp; Tobago<\/option><option value='211' >Tunisia<\/option><option value='212' >Turkey<\/option><option value='213' >Turkmenistan<\/option><option value='214' >Turks &amp; Caicos<\/option><option value='215' >Tuvalu<\/option><option value='216' >U.S. Virgin Islands<\/option><option value='217' >United States of America<\/option><option value='219' >Uganda<\/option><option value='220' >Ukraine<\/option><option value='221' >United Arab Emirates<\/option><option value='223' >Uruguay<\/option><option value='224' >Uzbekistan<\/option><option value='225' >Vanuatu<\/option><option value='226' >Holy See (Vatican City)<\/option><option value='227' >Venezuela<\/option><option value='228' >Vietnam<\/option><option value='231' >Wales<\/option><option value='233' >Western Sahara<\/option><option value='234' >Yemen<\/option><option value='235' >Yugoslavia<\/option><option value='237' >Zambia<\/option><option value='238' >Zimbabwe<\/option><option value='239' >Oman<\/option><option value='240' >Sudan, South<\/option><option value='241' >United Kingdom<\/option><option value='242' >Slovenia<\/option><option value='243' >Slovakia (Slovak Republic)<\/option><option value='244' >Taiwan (ROC)<\/option><option value='245' >Cambodia<\/option><option value='246' >Dominica<\/option><option value='247' >East Timor (Timor-Leste)<\/option><option value='248' >Micronesia<\/option><option value='249' >Montenegro<\/option><option value='250' >Palau<\/option><\/select><\/div><\/div><div id=\"field_418_23\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-seven-twelfths DATE_FIRSTARRIVAL field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_23'>Date of Arrival<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_23' id='input_418_23' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='23'  placeholder='\u0434\u0434\/\u043c\u043c\/\u0440\u0440\u0440\u0440' aria-describedby=\"input_418_23_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_418_23_date_format' class='screen-reader-text'>\u0414\u0414 \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u041c\u041c \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u0420\u0420\u0420\u0420<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_418_23' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_418_122\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full REFER_BY field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_122'>How Did You Hear About Us<\/label><div class='ginput_container ginput_container_select'><select name='input_122' id='input_418_122' class='large gfield_select' tabindex='24'    aria-invalid=\"false\" ><option value='' ><\/option><option value='L001' >Not Referred<\/option><option value='L003' >Community centre \/ library<\/option><option value='L004' >Employer \/ co-worker<\/option><option value='L005' >Ethnic or religious organization<\/option><option value='L006' >Family \/ friends<\/option><option value='L007' >Canadian government agency<\/option><option value='L008' >Government publication \/ brochure \/ website<\/option><option value='L009' >Immigration consultant \/ lawyer<\/option><option value='L010' >Internal to my organization<\/option><option value='L011' >Non-governmental newspaper \/ media \/ publication \/ brochure \/ Web site<\/option><option value='L012' >In-Canada orientation session<\/option><option value='L013' >Overseas orientation session (e.g. CIIP)<\/option><option value='L014' >Other settlement service provider<\/option><option value='L015' >School<\/option><option value='L018' >Recruitment via Destination Canada and Canadian embassies<\/option><option value='L019' >Recruitment via website and social media<\/option><option value='L020' >Walk-in<\/option><\/select><\/div><\/div><div id=\"field_418_152\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full DOCUMENT_FIELD11 nsd-gravity-upload nsd-fileupload-single gf_inline field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_418_152'>Immigration Document<\/label><div class='gfield_description' id='gfield_description_418_152'><em>This can be a Confirmation of Permanent Residence, a Work Permit, a Refugee Claimant document, a Permanent Resident Card, etc.<br\/><br\/>If uploading a Permanent Resident Card or other two-sided document, please ensure <span style=\"font-weight:bold !important;font-size:110% !important;\">both<\/span> sides are attached.<\/em><\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_418_152' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_418_152&quot;,&quot;container&quot;:&quot;gform_multifile_upload_418_152&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_418_152&quot;,&quot;filelist&quot;:&quot;gform_preview_418_152&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/staging5.nsd.tech\\\/?gf_page=f8eaeb02f5fcc9f&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/staging5.nsd.tech\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/staging5.nsd.tech\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;\\u0414\\u043e\\u0437\\u0432\\u043e\\u043b\\u0435\\u043d\\u0456 \\u0444\\u0430\\u0439\\u043b\\u0438&quot;,&quot;extensions&quot;:&quot;pdf,docx,doc,jpg,gif,tiff&quot;}],&quot;max_file_size&quot;:&quot;10485760b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:418,&quot;field_id&quot;:152,&quot;_gform_file_upload_nonce_418_152&quot;:&quot;3d0fbd6d9b&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;1&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_418_152&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_418_152' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_418_152' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_418_152 gfield_description_418_152\" tabindex='25' >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_418_152'>\u0422\u0438\u043f\u0438 \u0444\u0430\u0439\u043b\u0456\u0432, \u0449\u043e \u043f\u0440\u0438\u0439\u043c\u0430\u044e\u0442\u044c\u0441\u044f: pdf, docx, doc, jpg, gif, tiff, \u041c\u0430\u043a\u0441. \u0440\u043e\u0437\u043c\u0456\u0440 \u0444\u0430\u0439\u043b\u0443: 10 MB, \u041c\u0430\u043a\u0441. \u0444\u0430\u0439\u043b\u0456\u0432: 1.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_418_152'><\/ul> <div id='gform_preview_418_152' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_418_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\"  ><h3 class=\"gsection_title\">Emergency Contact Information<\/h3><\/div><div id=\"field_418_129\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter EMER_NAME field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_129'>Full Name<\/label><div class='ginput_container ginput_container_text'><input name='input_129' id='input_418_129' type='text' value='' class='large' maxlength='50'  tabindex='26'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_133\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter EMER_TELE1 field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_133'>Phone Number<\/label><div class='ginput_container ginput_container_text'><input name='input_133' id='input_418_133' type='text' value='' class='large'   tabindex='27' placeholder='___-___-____'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_131\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half EMER_EMAIL field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gpev-field\"  data-field-class=\"gpev-field\" ><label class='gfield_label gform-field-label' for='input_418_131'>Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_131' id='input_418_131' type='email' value='' class='large' tabindex='28'    aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_418_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\"  ><h3 class=\"gsection_title\">Services<\/h3><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_59'>Would you like to provide any additional information<\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_418_59' type='text' value='' class='large' maxlength='1000'  tabindex='29'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_134\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Details of Family Members<\/h3><\/div><fieldset id=\"field_418_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like to register your family members so that they can also receive services with us?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_418_43'>\n\t\t\t<div class='gchoice gchoice_418_43_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='Y'  id='choice_418_43_0' onchange='gformToggleRadioOther( this )'  tabindex='30'  \/>\n\t\t\t\t\t<label for='choice_418_43_0' id='label_418_43_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_418_43_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_43' type='radio' value='N'  id='choice_418_43_1' onchange='gformToggleRadioOther( this )'  tabindex='31'  \/>\n\t\t\t\t\t<label for='choice_418_43_1' id='label_418_43_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_418_61\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_61'>How many members would you like to add?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_61' id='input_418_61' class='large gfield_select' tabindex='32'   aria-required=\"true\" aria-invalid=\"false\" ><option value='1' selected='selected'>1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><\/select><\/div><\/div><div id=\"field_418_62\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Member 1<\/h3><\/div><div id=\"field_418_46\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER1_FIRST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_46'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_418_46' type='text' value='' class='large' maxlength='50'  tabindex='33'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_52\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER1_LAST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_52'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_418_52' type='text' value='' class='large' maxlength='50'  tabindex='34'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_54\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter MEMBER1_DATE_BIRTH gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_54'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_54' id='input_418_54' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='35'  placeholder='\u0434\u0434\/\u043c\u043c\/\u0440\u0440\u0440\u0440' aria-describedby=\"input_418_54_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_418_54_date_format' class='screen-reader-text'>\u0414\u0414 \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u041c\u041c \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u0420\u0420\u0420\u0420<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_418_54' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_418_139\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER1_CANSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_139'>Status in Canada<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_139' id='input_418_139' class='large gfield_select' tabindex='36'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0001' >Citizen by birth<\/option><option value='0003' >PR - Permanent Resident<\/option><option value='0006' >RC - Refugee Claimant<\/option><option value='0007' >Student - Study Permit<\/option><option value='0016' >Work Permit<\/option><option value='0025' >Protected Person<\/option><\/select><\/div><\/div><div id=\"field_418_55\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER1_GENDER gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_55'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_55' id='input_418_55' class='large gfield_select' tabindex='37'   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><\/select><\/div><\/div><div id=\"field_418_140\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER1_MARSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_140'>Marital Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_140' id='input_418_140' class='large gfield_select' tabindex='38'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0003' >Married<\/option><option value='0001' >Common-Law<\/option><option value='0005' >Single<\/option><\/select><\/div><\/div><div id=\"field_418_53\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER1_RELATIONSHIP notranslate gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_53'>Relationship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_53' id='input_418_53' class='large gfield_select' tabindex='39'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='44' >Spouse<\/option><option value='55' >Child<\/option><option value='61' >Sibling<\/option><option value='56' >Parent<\/option><option value='06' >Common Law Spouse<\/option><\/select><\/div><\/div><div id=\"field_418_56\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER1_FOSSIDNO field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_56'>UCI\/IUC (Unique Client Identifier)<\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_418_56' type='text' value='' class='large'   tabindex='40'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_65\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Member 2<\/h3><\/div><div id=\"field_418_63\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER2_FIRST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_63'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_418_63' type='text' value='' class='large' maxlength='50'  tabindex='41'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_64\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER2_LAST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_64'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_64' id='input_418_64' type='text' value='' class='large' maxlength='50'  tabindex='42'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_67\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter MEMBER2_DATE_BIRTH gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_67'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_67' id='input_418_67' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='43'  placeholder='\u0434\u0434\/\u043c\u043c\/\u0440\u0440\u0440\u0440' aria-describedby=\"input_418_67_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_418_67_date_format' class='screen-reader-text'>\u0414\u0414 \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u041c\u041c \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u0420\u0420\u0420\u0420<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_418_67' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_418_141\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER2_CANSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_141'>Status in Canada<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_141' id='input_418_141' class='large gfield_select' tabindex='44'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0001' >Citizen by birth<\/option><option value='0003' >PR - Permanent Resident<\/option><option value='0006' >RC - Refugee Claimant<\/option><option value='0007' >Student - Study Permit<\/option><option value='0016' >Work Permit<\/option><option value='0025' >Protected Person<\/option><\/select><\/div><\/div><div id=\"field_418_68\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER2_GENDER gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_68'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_68' id='input_418_68' class='large gfield_select' tabindex='45'   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><\/select><\/div><\/div><div id=\"field_418_142\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER2_MARSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_142'>Marital Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_142' id='input_418_142' class='large gfield_select' tabindex='46'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0003' >Married<\/option><option value='0001' >Common-Law<\/option><option value='0005' >Single<\/option><\/select><\/div><\/div><div id=\"field_418_69\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER2_RELATIONSHIP notranslate gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_69'>Relationship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_69' id='input_418_69' class='large gfield_select' tabindex='47'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='44' >Spouse<\/option><option value='55' >Child<\/option><option value='61' >Sibling<\/option><option value='56' >Parent<\/option><option value='06' >Common Law Spouse<\/option><\/select><\/div><\/div><div id=\"field_418_66\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER2_FOSSIDNO field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_66'>UCI\/IUC (Unique Client Identifier)<\/label><div class='ginput_container ginput_container_text'><input name='input_66' id='input_418_66' type='text' value='' class='large'   tabindex='48'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_70\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Member 3<\/h3><\/div><div id=\"field_418_71\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER3_FIRST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_71'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_71' id='input_418_71' type='text' value='' class='large' maxlength='50'  tabindex='49'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_72\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER3_LAST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_72'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_72' id='input_418_72' type='text' value='' class='large' maxlength='50'  tabindex='50'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_74\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter MEMBER3_DATE_BIRTH gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_74'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_74' id='input_418_74' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='51'  placeholder='\u0434\u0434\/\u043c\u043c\/\u0440\u0440\u0440\u0440' aria-describedby=\"input_418_74_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_418_74_date_format' class='screen-reader-text'>\u0414\u0414 \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u041c\u041c \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u0420\u0420\u0420\u0420<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_418_74' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_418_143\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER3_CANSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_143'>Status in Canada<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_143' id='input_418_143' class='large gfield_select' tabindex='52'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0001' >Citizen by birth<\/option><option value='0003' >PR - Permanent Resident<\/option><option value='0006' >RC - Refugee Claimant<\/option><option value='0007' >Student - Study Permit<\/option><option value='0016' >Work Permit<\/option><option value='0025' >Protected Person<\/option><\/select><\/div><\/div><div id=\"field_418_75\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER3_GENDER gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_75'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_75' id='input_418_75' class='large gfield_select' tabindex='53'   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><\/select><\/div><\/div><div id=\"field_418_144\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER3_MARSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_144'>Marital Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_144' id='input_418_144' class='large gfield_select' tabindex='54'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0003' >Married<\/option><option value='0001' >Common-Law<\/option><option value='0005' >Single<\/option><\/select><\/div><\/div><div id=\"field_418_76\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER3_RELATIONSHIP notranslate gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_76'>Relationship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_76' id='input_418_76' class='large gfield_select' tabindex='55'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='44' >Spouse<\/option><option value='55' >Child<\/option><option value='61' >Sibling<\/option><option value='56' >Parent<\/option><option value='06' >Common Law Spouse<\/option><\/select><\/div><\/div><div id=\"field_418_73\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER3_FOSSIDNO field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_73'>UCI\/IUC (Unique Client Identifier)<\/label><div class='ginput_container ginput_container_text'><input name='input_73' id='input_418_73' type='text' value='' class='large'   tabindex='56'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_77\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Member 4<\/h3><\/div><div id=\"field_418_83\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER4_FIRST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_83'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_83' id='input_418_83' type='text' value='' class='large' maxlength='50'  tabindex='57'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_82\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER4_LAST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_82'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_418_82' type='text' value='' class='large' maxlength='50'  tabindex='58'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_80\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter MEMBER4_DATE_BIRTH gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_80'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_80' id='input_418_80' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='59'  placeholder='\u0434\u0434\/\u043c\u043c\/\u0440\u0440\u0440\u0440' aria-describedby=\"input_418_80_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_418_80_date_format' class='screen-reader-text'>\u0414\u0414 \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u041c\u041c \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u0420\u0420\u0420\u0420<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_418_80' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_418_145\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER4_CANSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_145'>Status in Canada<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_145' id='input_418_145' class='large gfield_select' tabindex='60'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0001' >Citizen by birth<\/option><option value='0003' >PR - Permanent Resident<\/option><option value='0006' >RC - Refugee Claimant<\/option><option value='0007' >Student - Study Permit<\/option><option value='0016' >Work Permit<\/option><option value='0025' >Protected Person<\/option><\/select><\/div><\/div><div id=\"field_418_79\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER4_GENDER gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_79'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_79' id='input_418_79' class='large gfield_select' tabindex='61'   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><\/select><\/div><\/div><div id=\"field_418_146\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER4_MARSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_146'>Marital Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_146' id='input_418_146' class='large gfield_select' tabindex='62'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0003' >Married<\/option><option value='0001' >Common-Law<\/option><option value='0005' >Single<\/option><\/select><\/div><\/div><div id=\"field_418_78\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER4_RELATIONSHIP notranslate gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_78'>Relationship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_78' id='input_418_78' class='large gfield_select' tabindex='63'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='44' >Spouse<\/option><option value='55' >Child<\/option><option value='61' >Sibling<\/option><option value='56' >Parent<\/option><option value='06' >Common Law Spouse<\/option><\/select><\/div><\/div><div id=\"field_418_81\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER4_FOSSIDNO field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_81'>UCI\/IUC (Unique Client Identifier)<\/label><div class='ginput_container ginput_container_text'><input name='input_81' id='input_418_81' type='text' value='' class='large'   tabindex='64'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_84\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Member 5<\/h3><\/div><div id=\"field_418_90\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER5_FIRST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_90'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_90' id='input_418_90' type='text' value='' class='large' maxlength='50'  tabindex='65'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_89\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER5_LAST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_89'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_89' id='input_418_89' type='text' value='' class='large' maxlength='50'  tabindex='66'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_87\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter MEMBER5_DATE_BIRTH gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_87'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_87' id='input_418_87' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='67'  placeholder='\u0434\u0434\/\u043c\u043c\/\u0440\u0440\u0440\u0440' aria-describedby=\"input_418_87_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_418_87_date_format' class='screen-reader-text'>\u0414\u0414 \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u041c\u041c \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u0420\u0420\u0420\u0420<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_418_87' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_418_147\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER5_CANSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_147'>Status in Canada<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_147' id='input_418_147' class='large gfield_select' tabindex='68'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0001' >Citizen by birth<\/option><option value='0003' >PR - Permanent Resident<\/option><option value='0006' >RC - Refugee Claimant<\/option><option value='0007' >Student - Study Permit<\/option><option value='0016' >Work Permit<\/option><option value='0025' >Protected Person<\/option><\/select><\/div><\/div><div id=\"field_418_85\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER5_GENDER gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_85'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_85' id='input_418_85' class='large gfield_select' tabindex='69'   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><\/select><\/div><\/div><div id=\"field_418_148\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER5_MARSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_148'>Marital Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_148' id='input_418_148' class='large gfield_select' tabindex='70'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0003' >Married<\/option><option value='0001' >Common-Law<\/option><option value='0005' >Single<\/option><\/select><\/div><\/div><div id=\"field_418_86\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER5_RELATIONSHIP notranslate gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_86'>Relationship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_86' id='input_418_86' class='large gfield_select' tabindex='71'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='44' >Spouse<\/option><option value='55' >Child<\/option><option value='61' >Sibling<\/option><option value='56' >Parent<\/option><option value='06' >Common Law Spouse<\/option><\/select><\/div><\/div><div id=\"field_418_88\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER5_FOSSIDNO field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_88'>UCI\/IUC (Unique Client Identifier)<\/label><div class='ginput_container ginput_container_text'><input name='input_88' id='input_418_88' type='text' value='' class='large'   tabindex='72'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_91\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Member 6<\/h3><\/div><div id=\"field_418_97\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER6_FIRST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_97'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_97' id='input_418_97' type='text' value='' class='large' maxlength='50'  tabindex='73'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_96\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER6_LAST_NAME gf_hide_charleft gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_96'>Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_96' id='input_418_96' type='text' value='' class='large' maxlength='50'  tabindex='74'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_94\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter MEMBER6_DATE_BIRTH gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_94'>Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_94' id='input_418_94' type='text' value='' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='75'  placeholder='\u0434\u0434\/\u043c\u043c\/\u0440\u0440\u0440\u0440' aria-describedby=\"input_418_94_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_418_94_date_format' class='screen-reader-text'>\u0414\u0414 \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u041c\u041c \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u0420\u0420\u0420\u0420<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_418_94' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_418_149\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER6_CANSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_149'>Status in Canada<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_149' id='input_418_149' class='large gfield_select' tabindex='76'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0001' >Citizen by birth<\/option><option value='0003' >PR - Permanent Resident<\/option><option value='0006' >RC - Refugee Claimant<\/option><option value='0007' >Student - Study Permit<\/option><option value='0016' >Work Permit<\/option><option value='0025' >Protected Person<\/option><\/select><\/div><\/div><div id=\"field_418_92\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER6_GENDER gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_92'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_92' id='input_418_92' class='large gfield_select' tabindex='77'   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><\/select><\/div><\/div><div id=\"field_418_150\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER6_MARSTAT gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_150'>Marital Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_150' id='input_418_150' class='large gfield_select' tabindex='78'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='0003' >Married<\/option><option value='0001' >Common-Law<\/option><option value='0005' >Single<\/option><\/select><\/div><\/div><div id=\"field_418_93\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter MEMBER6_RELATIONSHIP notranslate gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_93'>Relationship<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_93' id='input_418_93' class='large gfield_select' tabindex='79'   aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='44' >Spouse<\/option><option value='55' >Child<\/option><option value='61' >Sibling<\/option><option value='56' >Parent<\/option><option value='06' >Common Law Spouse<\/option><\/select><\/div><\/div><div id=\"field_418_95\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter MEMBER6_FOSSIDNO field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_418_95'>UCI\/IUC (Unique Client Identifier)<\/label><div class='ginput_container ginput_container_text'><input name='input_95' id='input_418_95' type='text' value='' class='large'   tabindex='80'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_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\"  ><h3 class=\"gsection_title\">Consents and Confidentiality Statement<\/h3><\/div><fieldset id=\"field_418_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\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mail Consent<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_418_127'><div class='gchoice gchoice_418_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_418_127_1' tabindex='81'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_418_127_1' id='label_418_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_418_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\"  ><p>I consent to your organization collecting, storing, and using my personal information for the purposes of providing services and communications related to events, workshops, and other relevant activities. I understand that appropriate security measures will be in place to protect my data from unauthorized access or misuse.<\/p>\n<p>I 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. I am aware that I have the right to withdraw my consent at any time, which may impact the services provided to me.<\/p><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_125'>Please either enter your initials here  OR Sign in next box<\/label><div class='ginput_container ginput_container_text'><input name='input_125' id='input_418_125' type='text' value='' class='small' maxlength='5'  tabindex='82'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_124'>Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(\u041e\u0431\u043e\u0432&#039;\u044f\u0437\u043a\u043e\u0432\u043e)<\/span><\/span><\/label><input type='hidden' value='' name='input_124' id='input_418_124_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_418_124_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_418_124' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_418_124_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_418_124_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_418_124_data' name='input_418_124_data' value=''><\/div><\/div><div id=\"field_418_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\"  ><label class='gfield_label gform-field-label' for='input_418_105'>Captcha<\/label><div id='input_418_105' class='ginput_container ginput_recaptcha' data-sitekey='6LdQ_KQqAAAAAOZ5dT_twxSmxS7Hk-VjwJnkXATw'  data-theme='light' data-tabindex='83'  data-badge=''><\/div><\/div><div id=\"field_418_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\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"\u0426\u0435 \u043f\u043e\u043b\u0435 \u043f\u0440\u0438\u0445\u043e\u0432\u0430\u043d\u0435 \u043f\u0456\u0434 \u0447\u0430\u0441 \u043f\u0435\u0440\u0435\u0433\u043b\u044f\u0434\u0443 \u0444\u043e\u0440\u043c\u0438\"><\/i><span>\u0426\u0435 \u043f\u043e\u043b\u0435 \u043f\u0440\u0438\u0445\u043e\u0432\u0430\u043d\u0435 \u043f\u0456\u0434 \u0447\u0430\u0441 \u043f\u0435\u0440\u0435\u0433\u043b\u044f\u0434\u0443 \u0444\u043e\u0440\u043c\u0438<\/span><\/div><label class='gfield_label gform-field-label' for='input_418_151'>Programs (Admin Only)<\/label><div class='ginput_container ginput_container_text'><input name='input_151' id='input_418_151' type='text' value='' class='large'   tabindex='84'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_32\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-quarter DATE_VISITED exclude field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"\u0426\u0435 \u043f\u043e\u043b\u0435 \u043f\u0440\u0438\u0445\u043e\u0432\u0430\u043d\u0435 \u043f\u0456\u0434 \u0447\u0430\u0441 \u043f\u0435\u0440\u0435\u0433\u043b\u044f\u0434\u0443 \u0444\u043e\u0440\u043c\u0438\"><\/i><span>\u0426\u0435 \u043f\u043e\u043b\u0435 \u043f\u0440\u0438\u0445\u043e\u0432\u0430\u043d\u0435 \u043f\u0456\u0434 \u0447\u0430\u0441 \u043f\u0435\u0440\u0435\u0433\u043b\u044f\u0434\u0443 \u0444\u043e\u0440\u043c\u0438<\/span><\/div><label class='gfield_label gform-field-label' for='input_418_32'>Date Visited (Admin Only)<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_32' id='input_418_32' type='text' value='26\/04\/2026' class='datepicker gform-datepicker dmy datepicker_no_icon gdatepicker-no-icon' tabindex='85'  placeholder='\u0434\u0434\/\u043c\u043c\/\u0440\u0440\u0440\u0440' aria-describedby=\"input_418_32_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_418_32_date_format' class='screen-reader-text'>\u0414\u0414 \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u041c\u041c \u0441\u043a\u0456\u0441\u043d\u0430 \u0440\u0438\u0441\u043a\u0430 \u0420\u0420\u0420\u0420<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_418_32' class='gform_hidden' value='https:\/\/staging5.nsd.tech\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_418_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\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"\u0426\u0435 \u043f\u043e\u043b\u0435 \u043f\u0440\u0438\u0445\u043e\u0432\u0430\u043d\u0435 \u043f\u0456\u0434 \u0447\u0430\u0441 \u043f\u0435\u0440\u0435\u0433\u043b\u044f\u0434\u0443 \u0444\u043e\u0440\u043c\u0438\"><\/i><span>\u0426\u0435 \u043f\u043e\u043b\u0435 \u043f\u0440\u0438\u0445\u043e\u0432\u0430\u043d\u0435 \u043f\u0456\u0434 \u0447\u0430\u0441 \u043f\u0435\u0440\u0435\u0433\u043b\u044f\u0434\u0443 \u0444\u043e\u0440\u043c\u0438<\/span><\/div><label class='gfield_label gform-field-label' for='input_418_137'>Official Language (Admin Only)<\/label><div class='ginput_container ginput_container_text'><input name='input_137' id='input_418_137' type='text' value='1' class='large'   tabindex='86'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_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\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"\u0426\u0435 \u043f\u043e\u043b\u0435 \u043f\u0440\u0438\u0445\u043e\u0432\u0430\u043d\u0435 \u043f\u0456\u0434 \u0447\u0430\u0441 \u043f\u0435\u0440\u0435\u0433\u043b\u044f\u0434\u0443 \u0444\u043e\u0440\u043c\u0438\"><\/i><span>\u0426\u0435 \u043f\u043e\u043b\u0435 \u043f\u0440\u0438\u0445\u043e\u0432\u0430\u043d\u0435 \u043f\u0456\u0434 \u0447\u0430\u0441 \u043f\u0435\u0440\u0435\u0433\u043b\u044f\u0434\u0443 \u0444\u043e\u0440\u043c\u0438<\/span><\/div><label class='gfield_label gform-field-label' for='input_418_138'>Current Emp Status (Admin Only)<\/label><div class='ginput_container ginput_container_text'><input name='input_138' id='input_418_138' type='text' value='0005' class='large'   tabindex='87'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_418_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\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"\u0426\u0435 \u043f\u043e\u043b\u0435 \u043f\u0440\u0438\u0445\u043e\u0432\u0430\u043d\u0435 \u043f\u0456\u0434 \u0447\u0430\u0441 \u043f\u0435\u0440\u0435\u0433\u043b\u044f\u0434\u0443 \u0444\u043e\u0440\u043c\u0438\"><\/i><span>\u0426\u0435 \u043f\u043e\u043b\u0435 \u043f\u0440\u0438\u0445\u043e\u0432\u0430\u043d\u0435 \u043f\u0456\u0434 \u0447\u0430\u0441 \u043f\u0435\u0440\u0435\u0433\u043b\u044f\u0434\u0443 \u0444\u043e\u0440\u043c\u0438<\/span><\/div><label class='gfield_label gform-field-label' for='input_418_153'>DOC_1 TYPE<\/label><div class='ginput_container ginput_container_text'><input name='input_153' id='input_418_153' type='text' value='0010' class='small'   tabindex='88'   aria-invalid=\"false\"   \/><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_418' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit' tabindex='89' \/> <input type='hidden' name='gform_ajax' value='form_id=418&amp;title=1&amp;description=1&amp;tabindex=1&amp;theme=orbital&amp;styles=[]&amp;hash=efb4b5cef0069eeab2e532ce9e5a452c' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_418' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_418' id='gform_theme_418' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_418' id='gform_style_settings_418' 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