{"id":7517,"date":"2025-09-17T09:58:20","date_gmt":"2025-09-17T16:58:20","guid":{"rendered":"https:\/\/inside.ewu.edu\/bewell\/outreach-presentation-training-request-form\/"},"modified":"2025-10-24T11:32:41","modified_gmt":"2025-10-24T18:32:41","slug":"outreach-presentation-training-request-form","status":"publish","type":"page","link":"https:\/\/inside.ewu.edu\/bewell\/outreach-presentation-training-request-form\/","title":{"rendered":"Outreach, Presentation, &#038; Training Request Form"},"content":{"rendered":"<script type=\"text\/javascript\">var 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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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var 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)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_16' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">Outreach, Presentation, & Training Request Form<\/h2>\n                            <p class='gform_description'><\/p>\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_16'  action='\/bewell\/wp-json\/wp\/v2\/pages\/7517' data-formid='16' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_16' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_16_3\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_3\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<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_16_3'>\n                            \n                            <span id='input_16_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_3.3' id='input_16_3_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_16_3_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_16_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_3.6' id='input_16_3_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_16_3_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_16_6\" class=\"gfield gfield--type-ewuemail gfield--input-type-ewuemail gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_6\" ><label class='gfield_label gform-field-label' for='input_16_6'>EWU 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_6' id='input_16_6' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_16_7\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_7\" ><label class='gfield_label gform-field-label' for='input_16_7'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_7' id='input_16_7' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_16_11\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_11\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Campus Role<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_11'><div class='gchoice gchoice_16_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='Student'  id='choice_16_11_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_11_1' id='label_16_11_1' class='gform-field-label gform-field-label--type-inline'>Student<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_11_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.2' type='checkbox'  value='Student Employee'  id='choice_16_11_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_11_2' id='label_16_11_2' class='gform-field-label gform-field-label--type-inline'>Student Employee<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_11_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.3' type='checkbox'  value='Staff'  id='choice_16_11_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_11_3' id='label_16_11_3' class='gform-field-label gform-field-label--type-inline'>Staff<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_11_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.4' type='checkbox'  value='Faculty'  id='choice_16_11_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_11_4' id='label_16_11_4' class='gform-field-label gform-field-label--type-inline'>Faculty<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_16_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-two-thirds gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_12\" ><label class='gfield_label gform-field-label' for='input_16_12'>Affiliation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_16_12' type='text' value='' class='large'  aria-describedby=\"gfield_description_16_12\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_16_12'>Department, Office, Residence Hall, Organization, Club, Class, etc. <\/div><\/div><div id=\"field_16_22\" 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\"  data-js-reload=\"field_16_22\" ><label class='gfield_label gform-field-label' for='input_16_22'>Request Type<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_16_22' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Training' >Training<\/option><option value='Presentation' >Presentation<\/option><option value='Outreach' >Outreach<\/option><option value='Tabling' >Tabling<\/option><option value='Attendance' >Attendance<\/option><\/select><\/div><\/div><div id=\"field_16_31\" 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\"  data-js-reload=\"field_16_31\" ><label class='gfield_label gform-field-label' for='input_16_31'>Presentation Topic<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_31' id='input_16_31' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Alcohol &amp; Drug Education' >Alcohol &amp; Drug Education<\/option><option value='Sexual Health Education' >Sexual Health Education<\/option><option value='Interpersonal Violence &amp; Sexual Assault Prevention' >Interpersonal Violence &amp; Sexual Assault Prevention<\/option><option value='Bystander Intervention' >Bystander Intervention<\/option><option value='Hazing Prevention' >Hazing Prevention<\/option><option value='Physical Health &amp; Wellbeing' >Physical Health &amp; Wellbeing<\/option><option value='Stress Management' >Stress Management<\/option><option value='Body Image' >Body Image<\/option><option value='Self-Care' >Self-Care<\/option><option value='Other (please specify)' >Other (please specify)<\/option><\/select><\/div><\/div><div id=\"field_16_43\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_43\" ><label class='gfield_label gform-field-label' for='input_16_43'>Other Presentation Topic<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_16_43' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_16_57\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_57\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Outreach Request<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_57'><div class='gchoice gchoice_16_57_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.1' type='checkbox'  value='Overview of Services'  id='choice_16_57_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_57_1' id='label_16_57_1' class='gform-field-label gform-field-label--type-inline'>Overview of Services<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_57_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.2' type='checkbox'  value='Let&#039;s Talk'  id='choice_16_57_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_57_2' id='label_16_57_2' class='gform-field-label gform-field-label--type-inline'>Let's Talk<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_57_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.3' type='checkbox'  value='Counselor Presence\/Support'  id='choice_16_57_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_57_3' id='label_16_57_3' class='gform-field-label gform-field-label--type-inline'>Counselor Presence\/Support<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_57_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.4' type='checkbox'  value='Other (please specify)'  id='choice_16_57_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_57_4' id='label_16_57_4' class='gform-field-label gform-field-label--type-inline'>Other (please specify)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_16_59\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_59\" ><label class='gfield_label gform-field-label' for='input_16_59'>Please provide a brief explanation of your request for counselor presence\/support.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_16_59' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_16_58\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_58\" ><label class='gfield_label gform-field-label' for='input_16_58'>Other Outreach Request<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_16_58' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_16_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_38\" ><legend class='gfield_label gform-field-label' >Requested Training<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_16_38'>\n\t\t\t<div class='gchoice gchoice_16_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Mental Health First Aid (MHFA)'  id='choice_16_38_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_16_38_0' id='label_16_38_0' class='gform-field-label gform-field-label--type-inline'>Mental Health First Aid (MHFA)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_16_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='QPR (Suicide Prevention)'  id='choice_16_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_16_38_1' id='label_16_38_1' class='gform-field-label gform-field-label--type-inline'>QPR (Suicide Prevention)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_16_38_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Naloxone (Opioid Overdose Prevention)'  id='choice_16_38_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_16_38_2' id='label_16_38_2' class='gform-field-label gform-field-label--type-inline'>Naloxone (Opioid Overdose Prevention)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_16_44\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_44\" ><legend class='gfield_label gform-field-label' >Schedule Structure<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_16_44'>Mental Health First Aid is an 8-hour training course that can be taught as one full day or two half days.  <\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_16_44'>\n\t\t\t<div class='gchoice gchoice_16_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Full Day (8AM-5PM)'  id='choice_16_44_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_16_44\"   \/>\n\t\t\t\t\t<label for='choice_16_44_0' id='label_16_44_0' class='gform-field-label gform-field-label--type-inline'>Full Day (8AM-5PM)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_16_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Half Days (8:30AM-1:30PM both days)'  id='choice_16_44_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_16_44_1' id='label_16_44_1' class='gform-field-label gform-field-label--type-inline'>Half Days (8:30AM-1:30PM both days)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_16_44_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Half Days (12PM-5PM both days)'  id='choice_16_44_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_16_44_2' id='label_16_44_2' class='gform-field-label gform-field-label--type-inline'>Half Days (12PM-5PM both days)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_16_32\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_32\" ><label class='gfield_label gform-field-label' for='input_16_32'>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_32' id='input_16_32' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_16_32_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_16_32_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_16_32' class='gform_hidden' value='https:\/\/inside.ewu.edu\/bewell\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_16_33\" class=\"gfield gfield--type-time gfield--input-type-time gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_33\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Time<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class=\"ginput_container ginput_complex gform-grid-row\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_16_33'>\n                            <input type='number' maxlength='2' name='input_33[]' id='input_16_33_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   \/> \n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_16_33_1'>Hours<\/label>\n                        <\/div>\n                        <div class=\"below hour_minute_colon gform-grid-col\">:<\/div>\n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' maxlength='2' name='input_33[]' id='input_16_33_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 screen-reader-text' for='input_16_33_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_33[]' id='input_16_33_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_16_33_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><div id=\"field_16_34\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_34\" ><label class='gfield_label gform-field-label' for='input_16_34'>Date (2nd Choice)<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_34' id='input_16_34' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_16_34_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_16_34_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_16_34' class='gform_hidden' value='https:\/\/inside.ewu.edu\/bewell\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_16_35\" class=\"gfield gfield--type-time gfield--input-type-time gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_35\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Time (2nd Choice)<\/legend><div class=\"ginput_container ginput_complex gform-grid-row\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_16_35'>\n                            <input type='number' maxlength='2' name='input_35[]' id='input_16_35_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='false'   \/> \n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_16_35_1'>Hours<\/label>\n                        <\/div>\n                        <div class=\"below hour_minute_colon gform-grid-col\">:<\/div>\n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' maxlength='2' name='input_35[]' id='input_16_35_2' value=''  min='0' max='59' step='1'  placeholder='MM' aria-required='false'  \/>\n                            <label class='gform-field-label gform-field-label--type-sub minute_label screen-reader-text' for='input_16_35_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_35[]' id='input_16_35_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_16_35_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><div id=\"field_16_52\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_52\" ><label class='gfield_label gform-field-label' for='input_16_52'>Half Day Training Date (Day 1)<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_52' id='input_16_52' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_16_52_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_16_52_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_16_52' class='gform_hidden' value='https:\/\/inside.ewu.edu\/bewell\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_16_51\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_51\" ><label class='gfield_label gform-field-label' for='input_16_51'>Half Day Training Date (Day 2)<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_51' id='input_16_51' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_16_51_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_16_51_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_16_51' class='gform_hidden' value='https:\/\/inside.ewu.edu\/bewell\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_16_39\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_39\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Audience<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_39'><div class='gchoice gchoice_16_39_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.1' type='checkbox'  value='Students'  id='choice_16_39_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_39_1' id='label_16_39_1' class='gform-field-label gform-field-label--type-inline'>Students<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_39_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.2' type='checkbox'  value='Student Employees'  id='choice_16_39_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_39_2' id='label_16_39_2' class='gform-field-label gform-field-label--type-inline'>Student Employees<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_39_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.3' type='checkbox'  value='Staff'  id='choice_16_39_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_39_3' id='label_16_39_3' class='gform-field-label gform-field-label--type-inline'>Staff<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_39_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_39.4' type='checkbox'  value='Faculty'  id='choice_16_39_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_39_4' id='label_16_39_4' class='gform-field-label gform-field-label--type-inline'>Faculty<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_16_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_37\" ><label class='gfield_label gform-field-label' for='input_16_37'>Expected # of Attendees<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_37' id='input_16_37' type='text' value='' class='large'  aria-describedby=\"gfield_description_16_37\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_16_37'>Most trainings\/presentations have a minimum of 10. MHFA has a minimum of 8. <\/div><\/div><div id=\"field_16_41\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_41\" ><label class='gfield_label gform-field-label' for='input_16_41'>Preferred Location<\/label><div class='ginput_container ginput_container_text'><input name='input_41' id='input_16_41' type='text' value='' class='large'  aria-describedby=\"gfield_description_16_41\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_16_41'>Due to specific set up and technology needs, we may need to reserve our own space, but please let us know if you have a preferred building\/location and we will try our best to accommodate.<\/div><\/div><fieldset id=\"field_16_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_28\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Requested Tables<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_16_28'><div class='gchoice gchoice_16_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='Counseling &amp; Wellness'  id='choice_16_28_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_28_1' id='label_16_28_1' class='gform-field-label gform-field-label--type-inline'>Counseling &amp; Wellness<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_28_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.2' type='checkbox'  value='Food Pantry'  id='choice_16_28_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_28_2' id='label_16_28_2' class='gform-field-label gform-field-label--type-inline'>Food Pantry<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_28_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.3' type='checkbox'  value='Health Hut'  id='choice_16_28_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_28_3' id='label_16_28_3' class='gform-field-label gform-field-label--type-inline'>Health Hut<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_16_28_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.4' type='checkbox'  value='Eagles for Recovery'  id='choice_16_28_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_16_28_4' id='label_16_28_4' class='gform-field-label gform-field-label--type-inline'>Eagles for Recovery<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_16_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-five-twelfths gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_23\" ><label class='gfield_label gform-field-label' for='input_16_23'>Event 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_23' id='input_16_23' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_16_24\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-quarter gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_24\" ><label class='gfield_label gform-field-label' for='input_16_24'>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_24' id='input_16_24' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_16_24_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_16_24_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_16_24' class='gform_hidden' value='https:\/\/inside.ewu.edu\/bewell\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_16_25\" class=\"gfield gfield--type-time gfield--input-type-time gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_25\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Event Start Time<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class=\"ginput_container ginput_complex gform-grid-row\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_16_25'>\n                            <input type='number' maxlength='2' name='input_25[]' id='input_16_25_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   \/> \n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_16_25_1'>Hours<\/label>\n                        <\/div>\n                        <div class=\"below hour_minute_colon gform-grid-col\">:<\/div>\n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' maxlength='2' name='input_25[]' id='input_16_25_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 screen-reader-text' for='input_16_25_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_25[]' id='input_16_25_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_16_25_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><fieldset id=\"field_16_26\" class=\"gfield gfield--type-time gfield--input-type-time gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_26\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Event End Time<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class=\"ginput_container ginput_complex gform-grid-row\">\n                        <div class='gfield_time_hour ginput_container ginput_container_time gform-grid-col' id='input_16_26'>\n                            <input type='number' maxlength='2' name='input_26[]' id='input_16_26_1' value=''  min='0' max='12' step='1'  placeholder='HH' aria-required='true'   \/> \n                            <label class='gform-field-label gform-field-label--type-sub hour_label screen-reader-text' for='input_16_26_1'>Hours<\/label>\n                        <\/div>\n                        <div class=\"below hour_minute_colon gform-grid-col\">:<\/div>\n                        <div class='gfield_time_minute ginput_container ginput_container_time gform-grid-col'>\n                            <input type='number' maxlength='2' name='input_26[]' id='input_16_26_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 screen-reader-text' for='input_16_26_2'>Minutes<\/label>\n                        <\/div>\n                        <div class='gfield_time_ampm ginput_container ginput_container_time below gform-grid-col' >\n                                \n                                <select name='input_26[]' id='input_16_26_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_16_26_3'>AM\/PM<\/label>                                \n                           <\/div>\n                    <\/div><\/fieldset><div id=\"field_16_27\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_27\" ><label class='gfield_label gform-field-label' for='input_16_27'>Location<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_16_27' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_16_56\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_56\" ><label class='gfield_label gform-field-label' for='input_16_56'>Roster<\/label><div class='gfield_description' id='gfield_description_16_56'>All participants must attend all 8 hours of training. If you already have a roster, please include that below. First and last name along with email address is required. If not, this will need to be submitted to the MHFA coordinator at least one week before the class.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_56' id='input_16_56' class='textarea small'  aria-describedby=\"gfield_description_16_56\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_16_29\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_16_29\" ><label class='gfield_label gform-field-label' for='input_16_29'>Additional Information<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_29' id='input_16_29' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_16' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_16' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_16' id='gform_theme_16' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_16' id='gform_style_settings_16' value='' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_16' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='16' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_16' 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