{"id":5998,"date":"2019-12-04T11:57:26","date_gmt":"2019-12-04T19:57:26","guid":{"rendered":"https:\/\/www.bellevuecollege.edu\/health\/?page_id=5998"},"modified":"2024-12-11T15:13:16","modified_gmt":"2024-12-11T23:13:16","slug":"participation-request","status":"publish","type":"page","link":"https:\/\/www.bellevuecollege.edu\/health\/open-house-partners\/participation-request\/","title":{"rendered":"HSEWI Open House Participation Request"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_13' >\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_13'  action='\/health\/wp-json\/wp\/v2\/pages\/5998' data-formid='13' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_13' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_13_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Contact Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_13_1'>\n                            \n                            <span id='input_13_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_13_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_13_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_13_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_13_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_13_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_13_2\" class=\"gfield gfield--type-email gfield--input-type-email 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_13_2'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_13_2' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_13_3\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_13_3'><span class='gform-field-label__text'>Phone<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_13_3' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_13_5\" class=\"gfield gfield--type-text gfield--input-type-text 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_13_5'><span class='gform-field-label__text'>Business or Department Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_13_5' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_13_6\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Dates Attending<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_6'>Please mark which day(s) you will be attending the Open House<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_6'><div class='gchoice gchoice_13_6_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.1' type='checkbox'  value='April 24, 6:30 pm - 8:30 pm'  id='choice_13_6_1'   aria-describedby=\"gfield_description_13_6\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_6_1' id='label_13_6_1' class='gform-field-label gform-field-label--type-inline'>April 24, 6:30 pm &#8211; 8:30 pm<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_6_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_6.2' type='checkbox'  value='April 25, 11:00 am - 2:00 pm'  id='choice_13_6_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_6_2' id='label_13_6_2' class='gform-field-label gform-field-label--type-inline'>April 25, 11:00 am &#8211; 2:00 pm<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_13_10\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Participation Preferences<\/span><\/legend><div class='gfield_description' id='gfield_description_13_10'>Check all that apply.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_10'><div class='gchoice gchoice_13_10_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.1' type='checkbox'  value='Table'  id='choice_13_10_1'   aria-describedby=\"gfield_description_13_10\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_13_10_1' id='label_13_10_1' class='gform-field-label gform-field-label--type-inline'>Table<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_10_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.2' type='checkbox'  value='Information Session'  id='choice_13_10_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_10_2' id='label_13_10_2' class='gform-field-label gform-field-label--type-inline'>Information Session<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_10_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.3' type='checkbox'  value='Engagement activity'  id='choice_13_10_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_10_3' id='label_13_10_3' class='gform-field-label gform-field-label--type-inline'>Engagement activity<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_13_10_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_10.4' type='checkbox'  value='Panel participant'  id='choice_13_10_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_13_10_4' 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aria-invalid=\"false\" ><option value='Table' >Table<\/option><option value='Standing' >Standing<\/option><\/select><\/div><\/div><fieldset id=\"field_13_8\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Materials Requested<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_13_8'>Please mark the materials needed.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_13_8'><div class='gchoice gchoice_13_8_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.1' 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