{"id":6077,"date":"2022-11-15T20:00:32","date_gmt":"2022-11-15T20:00:32","guid":{"rendered":"https:\/\/healourcommuni.wpenginepowered.com\/?page_id=6077"},"modified":"2022-11-17T20:56:42","modified_gmt":"2022-11-17T20:56:42","slug":"2023-event-submission","status":"publish","type":"page","link":"https:\/\/healourcommunities.org\/2023-event-submission\/","title":{"rendered":"2023 Event Submission"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"6077\" class=\"elementor elementor-6077\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-section elementor-top-section elementor-element elementor-element-11d21019 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"11d21019\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-4e245850\" data-id=\"4e245850\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-section elementor-inner-section elementor-element elementor-element-7f652e77 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"7f652e77\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;sticky&quot;:&quot;top&quot;,&quot;sticky_on&quot;:[&quot;desktop&quot;],&quot;sticky_effects_offset&quot;:14,&quot;sticky_offset&quot;:0,&quot;sticky_anchor_link_offset&quot;:0}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-3d3a326\" data-id=\"3d3a326\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9d9b2aa elementor-widget elementor-widget-image\" data-id=\"9d9b2aa\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"792\" height=\"175\" src=\"https:\/\/healourcommunities.org\/wp-content\/uploads\/2020\/11\/Form_page_Logo-1.png\" class=\"attachment-large size-large wp-image-4174\" alt=\"\" srcset=\"https:\/\/healourcommunities.org\/wp-content\/uploads\/2020\/11\/Form_page_Logo-1.png 792w, https:\/\/healourcommunities.org\/wp-content\/uploads\/2020\/11\/Form_page_Logo-1-300x66.png 300w, https:\/\/healourcommunities.org\/wp-content\/uploads\/2020\/11\/Form_page_Logo-1-768x170.png 768w\" sizes=\"(max-width: 792px) 100vw, 792px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-387c1352 elementor-widget elementor-widget-heading\" data-id=\"387c1352\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Tell Us About Your Event<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-71eb2a12 elementor-widget elementor-widget-text-editor\" data-id=\"71eb2a12\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tTo build a brighter future, we must come together to heal, exploring and understanding our shared humanity.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fa273c6 elementor-hidden-desktop elementor-view-default elementor-widget elementor-widget-icon\" data-id=\"fa273c6\" data-element_type=\"widget\" data-settings=\"{&quot;_animation_mobile&quot;:&quot;fadeInDown&quot;}\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<i aria-hidden=\"true\" class=\"fas fa-sort-down\"><\/i>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-461964ba\" data-id=\"461964ba\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-49bbf9f9 eael-gravity-form-button-custom elementor-widget elementor-widget-eael-gravity-form\" data-id=\"49bbf9f9\" data-element_type=\"widget\" data-widget_type=\"eael-gravity-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t<div class=\"eael-contact-form eael-gravity-form labels-hide eael-contact-form-align-default\">\n\t\t        <script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar 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d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_10' ><div id='gf_10' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_10'  action='\/wp-json\/wp\/v2\/pages\/6077#gf_10' data-formid='10' novalidate> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n                        <div class='gform-body gform_body'><ul id='gform_fields_10' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_10_2\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Your Information<\/h2><\/li><li id=\"field_10_1\" class=\"gfield gfield--type-post_custom_field gfield--input-type-text gfield_contains_required 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_10_1'>Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_10_1' type='text' value='' class='medium'    placeholder='*First Name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_10_3\" class=\"gfield gfield--type-email gfield_contains_required 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_10_3'>Email<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_3' id='input_10_3' type='email' value='' class='medium'   placeholder='*Email' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_10_4\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Event Information<\/h2><\/li><li id=\"field_10_5\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon event-date-field gfield_contains_required 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_10_5'>Event Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_5' id='input_10_5' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='*Event Date' aria-describedby=\"input_10_5_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_10_5_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_10_5' class='gform_hidden' value='https:\/\/healourcommunities.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_10_7\" class=\"gfield gfield--type-time half-size gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Event Start<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class=\"ginput_container ginput_complex gform-grid-row\"><div class=\"clear-multi\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_10_7'>\n                            <input type='number' maxlength='2' name='input_7[]' id='input_10_7_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   \/> <i>:<\/i>\n                            <label class='gform-field-label gform-field-label--type-sub hour_label hidden_sub_label screen-reader-text' for='input_10_7_1'>HH<\/label>\n                        <\/div>\n                        \n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' maxlength='2' name='input_7[]' id='input_10_7_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='true'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label hidden_sub_label screen-reader-text' for='input_10_7_2'>MM<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_7[]' id='input_10_7_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='gform-field-label gform-field-label--type-sub am_pm_label screen-reader-text' for='input_10_7_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/div><\/li><li id=\"field_10_6\" class=\"gfield gfield--type-time half-size gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Event End<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class=\"ginput_container ginput_complex gform-grid-row\"><div class=\"clear-multi\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_10_6'>\n                            <input type='number' maxlength='2' name='input_6[]' id='input_10_6_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   \/> <i>:<\/i>\n                            <label class='gform-field-label gform-field-label--type-sub hour_label hidden_sub_label screen-reader-text' for='input_10_6_1'>HH<\/label>\n                        <\/div>\n                        \n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' maxlength='2' name='input_6[]' id='input_10_6_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='true'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label hidden_sub_label screen-reader-text' for='input_10_6_2'>MM<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_6[]' id='input_10_6_3'  >\n                                    <option value='am' >AM<\/option>\n                                    <option value='pm' >PM<\/option>\n                                <\/select> \n                                <label class='gform-field-label gform-field-label--type-sub am_pm_label screen-reader-text' for='input_10_6_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/div><\/li><li id=\"field_10_22\" class=\"gfield gfield--type-select 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_10_22'>Time Zone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_22' id='input_10_22' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>*Time Zone<\/option><option value='(ST)' >Samoa Standard Time (ST) UTC-11<\/option><option value='(HAT)' >Hawaii-Aleutian Standard Time (HAT) UTC-10<\/option><option value='(AKT)' >Alaska Standard Time (AKT) UTC-9<\/option><option value='(PT)' >Pacific Standard Time (PT) UTC\u22128<\/option><option value='(MT)' >Mountain Standard Time (MT) UTC\u22127<\/option><option value='(CT)' >Central Standard Time (CT) UTC\u22126<\/option><option value='(ET)' >Eastern Standard Time (ET) UTC\u22125<\/option><option value='(AST)' >Atlantic Standard Time (AST) UTC\u22124<\/option><option value='(ChT)' >Chamorro Standard Time (ChT) UTC+10<\/option><option value='(WIT)' >Wake Island Time Zone (WIT) UTC+12<\/option><\/select><\/div><\/li><li id=\"field_10_8\" class=\"gfield gfield--type-text gfield_contains_required 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_10_8'>Event Title<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_10_8' type='text' value='' class='medium'    placeholder='*Event title' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_10_24\" class=\"gfield gfield--type-radio gfield--type-choice 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' >Is your event virtual or in-person?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_10_24'>\n\t\t\t<li class='gchoice gchoice_10_24_0'>\n\t\t\t\t<input name='input_24' type='radio' value='This is a virtual event.'  id='choice_10_24_0'    \/>\n\t\t\t\t<label for='choice_10_24_0' id='label_10_24_0' class='gform-field-label gform-field-label--type-inline'>This is a virtual event.<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_24_1'>\n\t\t\t\t<input name='input_24' type='radio' value='This is an in-person event.'  id='choice_10_24_1'    \/>\n\t\t\t\t<label for='choice_10_24_1' id='label_10_24_1' class='gform-field-label gform-field-label--type-inline'>This is an in-person event.<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_24_2'>\n\t\t\t\t<input name='input_24' type='radio' value='This event is both virtual and in-person.'  id='choice_10_24_2'    \/>\n\t\t\t\t<label for='choice_10_24_2' id='label_10_24_2' class='gform-field-label gform-field-label--type-inline'>This event is both virtual and in-person.<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_10_9\" class=\"gfield gfield--type-website gfield_contains_required 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_10_9'>Event Link<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_website'>\n                    <input name='input_9' id='input_10_9' type='url' value='' class='medium'    placeholder='*Event Link (must start with https:\/\/)' aria-required=\"true\" aria-invalid=\"false\" \/>\n                <\/div><\/li><li id=\"field_10_10\" class=\"gfield gfield--type-select 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_10_10'>Who would be most interested in this event?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_10' id='input_10_10' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>*Who would be most interested in this event?<\/option><option value='Everyone' >Everyone<\/option><option value='Students' >Students<\/option><option value='Parents' >Parents<\/option><option value='Teachers' >Teachers<\/option><option value='Libraries' >Libraries<\/option><option value='Faith &amp; Spiritual Leaders' >Faith &amp; Spiritual Leaders<\/option><option value='Business, Corporate and Financial Leaders' >Business, Corporate and Financial Leaders<\/option><option value='Artists and Cultural Institutions' >Artists and Cultural Institutions<\/option><option value='Healthcare Workforce' >Healthcare Workforce<\/option><\/select><\/div><\/li><li id=\"field_10_11\" class=\"gfield gfield--type-textarea gfield_contains_required 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_10_11'>Brief Description<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_11' id='input_10_11' class='textarea small'   maxlength='82' placeholder='*Brief description' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_10_15\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Location Information<\/h2><div class='gsection_description' id='gfield_description_10_15'>Tooltip: Even if the event is virtual, location information is provided to allow attendees to find your event in the map and event listing results.<\/div><\/li><li id=\"field_10_14\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_10_14' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_10_14_1_container' >\n                                        <input type='text' name='input_14.1' id='input_10_14_1' value=''   placeholder='*Address' aria-required='true'    \/>\n                                        <label for='input_10_14_1' id='input_10_14_1_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_10_14_3_container' >\n                                    <input type='text' name='input_14.3' id='input_10_14_3' value=''   placeholder='*City' aria-required='true'    \/>\n                                    <label for='input_10_14_3' id='input_10_14_3_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_10_14_4_container' >\n                                        <select name='input_14.4' id='input_10_14_4'     aria-required='true'    ><option value='' selected='selected'>*State<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_10_14_4' id='input_10_14_4_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_10_14_5_container' >\n                                    <input type='text' name='input_14.5' id='input_10_14_5' value=''   placeholder='*Zip' aria-required='true'    \/>\n                                    <label for='input_10_14_5' id='input_10_14_5_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_14.6' id='input_10_14_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_10_12\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Organization Information<\/h2><\/li><li id=\"field_10_16\" class=\"gfield gfield--type-text gfield_contains_required 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_10_16'>Organization Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_10_16' type='text' value='' class='medium'    placeholder='*Organization Name' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_10_17\" class=\"gfield gfield--type-text gfield_contains_required 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_10_17'>Organization Website Link<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_10_17' type='text' value='' class='medium'    placeholder='*Organization Website Link' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_10_18\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description 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