{"id":151673,"date":"2021-02-16T10:46:09","date_gmt":"2021-02-16T15:46:09","guid":{"rendered":"https:\/\/www.samaritanspurse.org\/?p=151673"},"modified":"2022-02-14T10:14:13","modified_gmt":"2022-02-14T15:14:13","slug":"ohop-law-enforcement-officer-application","status":"publish","type":"post","link":"https:\/\/www.samaritanspurse.org\/es\/our-ministry\/ohop-law-enforcement-officer-application\/","title":{"rendered":"OHOP Law Enforcement Officer Application"},"content":{"rendered":"<main>\r\n        <article>\r\n            <header id=\"main-header\">\r\n                <h1>Encounter God\u2019s Healing Love<\/h1>\r\n\r\n            <\/header>\r\n            \r\n            <section>\r\n                <div>\r\n                    <p>Samaritan\u2019s Purse has been serving wounded veterans and their spouses since 2012 through Operation Heal Our Patriots. This year, we are pleased to host three sessions dedicated to law enforcement officers and their spouses in partnership with the Billy Graham Evangelistic Association Rapid Response Team National Law Enforcement Ministry.<\/p>\r\n\r\n                    <p>Three groups of 10 law enforcement officers and their spouses will be welcomed at Samaritan Lodge Alaska this summer for a week of marriage enrichment with unique opportunities to find physical and spiritual refreshment in the midst of pristine wilderness. This time is also a great chance for couples to connect with each other and build lasting friendships.<\/p>\r\n                    \r\n                    <p>Through Operation Heal Our Patriots, couples enjoy the beauty of God\u2019s creation as they participate in daily outdoor activities and attend chaplain-led, Biblically based marriage classes centered on strengthening their relationship with each other and with Jesus Christ.<\/p>\r\n\r\n                    <p><strong>Before you begin filling out this application,<\/strong> please have a digital photo of you and your spouse ready to attach. Applications cannot be submitted without a photo attached.<\/p>\r\n                    \r\n                    <p><strong>Please note:<\/strong> this application may not work properly with some older browsers or mobile devices. If you have technical difficulties, please call <a href=\"tel: 1-800-788-4888\">1-800-788-4888<\/a>.<\/p>\r\n                <\/div>\r\n            <\/section>\r\n            \r\n            <section aria-label=\"Application\">\r\n                <div>\r\n                    <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 InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return 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)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_133' style='display:none'><div id='gf_133' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_133'  action='\/es\/wp-json\/wp\/v2\/posts\/151673#gf_133' data-formid='133' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_133' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_133_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Are you currently married?<\/span><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_133_10'>\n\t\t\t<li class='gchoice gchoice_133_10_0'>\n\t\t\t\t<input name='input_10' type='radio' value='Yes'  id='choice_133_10_0'    \/>\n\t\t\t\t<label for='choice_133_10_0' id='label_133_10_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_133_10_1'>\n\t\t\t\t<input name='input_10' type='radio' value='No'  id='choice_133_10_1'    \/>\n\t\t\t\t<label for='choice_133_10_1' id='label_133_10_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_133_11\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon 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_133_11'><span class='gform-field-label__text'>Marriage Date<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/aaaa'\n\t\t\t\t\tid='input_133_11'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_11'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_133_11' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_133_11' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_133_11' aria-label='Marriage Date: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_133_1\" 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\">Name of Officer<\/h2><\/li><li id=\"field_133_2\" class=\"gfield gfield--type-name 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 gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><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_133_2'>\n                            \n                            <span id='input_133_2_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.3' id='input_133_2_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_133_2_3' class='gform-field-label gform-field-label--type-sub '>Nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_133_2_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.6' id='input_133_2_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_133_2_6' class='gform-field-label gform-field-label--type-sub '>Apellidos<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_133_7\" class=\"gfield gfield--type-text preferred_name 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_133_7'><span class='gform-field-label__text'>Preferred 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_7' id='input_133_7' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_133_4\" class=\"gfield gfield--type-address 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 gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_133_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_133_4_1_container' >\n                                        <input type='text' name='input_4.1' id='input_133_4_1' value=''    aria-required='true'    \/>\n                                        <label for='input_133_4_1' id='input_133_4_1_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_133_4_2_container' >\n                                        <input type='text' name='input_4.2' id='input_133_4_2' value=''     aria-required='false'   \/>\n                                        <label for='input_133_4_2' id='input_133_4_2_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_133_4_3_container' >\n                                    <input type='text' name='input_4.3' id='input_133_4_3' value=''    aria-required='true'    \/>\n                                    <label for='input_133_4_3' id='input_133_4_3_label' class='gform-field-label gform-field-label--type-sub '>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_133_4_4_container' >\n                                        <select name='input_4.4' id='input_133_4_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='AL' >Alabama<\/option><option value='AK' >Alaska<\/option><option value='AZ' >Arizona<\/option><option value='AR' >Arkansas<\/option><option value='CA' >California<\/option><option value='CO' >Colorado<\/option><option value='CT' >Connecticut<\/option><option value='DE' >Delaware<\/option><option value='DC' >District of Columbia<\/option><option value='FL' >Florida<\/option><option value='GA' >Georgia<\/option><option value='GU' >Guam<\/option><option value='HI' >Hawaii<\/option><option value='ID' >Idaho<\/option><option value='IL' >Illinois<\/option><option value='IN' >Indiana<\/option><option value='IA' >Iowa<\/option><option value='KS' >Kansas<\/option><option value='KY' >Kentucky<\/option><option value='LA' >Louisiana<\/option><option value='ME' >Maine<\/option><option value='MD' >Maryland<\/option><option value='MA' >Massachusetts<\/option><option value='MI' >Michigan<\/option><option value='MN' >Minnesota<\/option><option value='MS' >Mississippi<\/option><option value='MO' >Missouri<\/option><option value='MT' >Montana<\/option><option value='NE' >Nebraska<\/option><option value='NV' >Nevada<\/option><option value='NH' >New Hampshire<\/option><option value='NJ' >New Jersey<\/option><option value='NM' >New Mexico<\/option><option value='NY' >New York<\/option><option value='NC' >North Carolina<\/option><option value='ND' >North Dakota<\/option><option value='OH' >Ohio<\/option><option value='OK' >Oklahoma<\/option><option value='OR' >Oregon<\/option><option value='PA' >Pennsylvania<\/option><option value='PR' >Puerto Rico<\/option><option value='RI' >Rhode Island<\/option><option value='SC' >South Carolina<\/option><option value='SD' >South Dakota<\/option><option value='TN' >Tennessee<\/option><option value='TX' >Texas<\/option><option value='UT' >Utah<\/option><option value='VT' >Vermont<\/option><option value='VA' >Virginia<\/option><option value='WA' >Washington<\/option><option value='WV' >West Virginia<\/option><option value='WI' >Wisconsin<\/option><option value='WY' >Wyoming<\/option><\/select>\n                                        <label for='input_133_4_4' id='input_133_4_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_133_4_5_container' >\n                                    <input type='text' name='input_4.5' id='input_133_4_5' value=''    aria-required='true'    \/>\n                                    <label for='input_133_4_5' id='input_133_4_5_label' class='gform-field-label gform-field-label--type-sub '>Zip Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_133_4_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_133_5\" class=\"gfield gfield--type-phone gfield--phone-format-standard 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_133_5'><span class='gform-field-label__text'>Phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_5' id='input_133_5' type='tel' value='' class='medium'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_133_6\" class=\"gfield gfield--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_133_6'><span class='gform-field-label__text'>Alternate Phone<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_133_6' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_133_8\" class=\"gfield gfield--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_133_8'><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_8' id='input_133_8' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_133_9\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon 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_133_9'><span class='gform-field-label__text'>Date of Birth<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/aaaa'\n\t\t\t\t\tid='input_133_9'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_9'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_133_9' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_133_9' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_133_9' aria-label='Date of Birth: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_133_51\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class=\"gfield_label\">Please attach a photo of you and your spouse.<\/label><span class=\"gfield_required\">*<\/span>\n<p style=\"font-size:14px !important;padding-left:0 !important;\"><i>Images should be no larger than 5MB, and may be in one of the following formats: JPG, GIF, PNG, TIF, or BMP.  iPad users should be running iOS version 7 or higher.<\/i><\/p>\n<div class=\"container\">\n\t<span id=\"btn-photo\" class=\"btn btn-success fileinput-button\">\n\t\t<i class=\"glyphicon glyphicon-plus\"><\/i>\n\t\t<span>Add file...<\/span>\n\t\t<!-- The file input field used as target for the file upload widget -->\n\t\t<input id=\"fileupload\" type=\"file\" name=\"files[]\">\n\t<\/span>\n\t<span id=\"fileUploadedBool\">Your file has not been uploaded.<\/span>\n\t<br>\n\t<br>\n\t<!-- The global progress bar -->\n\t<div id=\"progress\" class=\"progress\">\n\t\t<div class=\"progress-bar progress-bar-success\"><\/div>\n\t<\/div>\n\t<!-- The container for the uploaded files -->\n\t<div id=\"files\" class=\"files\"><\/div>\n\t<br>\n<\/div>\n<script src=\"\/wp-content\/themes\/samaritans-purse\/lib\/js\/fileUpload\/jquery.ui.widget.js\"><\/script>\n<script src=\"\/wp-content\/themes\/samaritans-purse\/lib\/js\/fileUpload\/load-image.all.min.js\"><\/script>\n<script src=\"\/wp-content\/themes\/samaritans-purse\/lib\/js\/fileUpload\/canvas-to-blob.min.js\"><\/script>\n\n<script src=\"\/wp-content\/themes\/samaritans-purse\/lib\/js\/fileUpload\/jquery.iframe-transport.js\"><\/script>\n<script src=\"\/wp-content\/themes\/samaritans-purse\/lib\/js\/fileUpload\/jquery.fileupload.js\"><\/script>\n<script src=\"\/wp-content\/themes\/samaritans-purse\/lib\/js\/fileUpload\/jquery.fileupload-process.js\"><\/script>\n<script src=\"\/wp-content\/themes\/samaritans-purse\/lib\/js\/fileUpload\/jquery.fileupload-image.js\"><\/script>\n<script src=\"\/wp-content\/themes\/samaritans-purse\/lib\/js\/fileUpload\/jquery.fileupload-validate.js\"><\/script>\n<script>\n\n\t$ = jQuery;\n\n\tvar url = window.location.hostname;\n        if (url.indexOf('dev') > -1 || url.indexOf('beta') > -1 || url.indexOf('local') > -1) { \n\t\tvar prefix = \"https:\/\/s3.theark.cloud\/sp-service-images-dev\/\";\n\t} else {\n\t\tvar prefix = \"https:\/\/s3.theark.cloud\/sp-service-images\/\";\n\t} \n\t\n\n\t$(function() {\n\t\t\/\/check to see if part 1 of the form has been reloaded.  If file path already exists, let user know\n\t\tif ($(\"input#input_133_52\").val().length>0) {\n\t\t\t$(\"span#fileUploadedBool\").css(\"color\",\"green\");\n\t\t\t$(\"span#fileUploadedBool\").text(\"Success!  Your file has been uploaded.\");\n\t\t\t$(\"span#btn-photo\").css(\"display\",\"none\");\n\t\t}\n\t\t'use strict';\n\t\t\/\/ Change this to the location of your server-side upload handler:\n\t\tvar url='\/api\/utility\/upload\/index.php?prefix=ohop-leo',\n\t\t\tuploadButton = $('<button\/>')\n\t\t\t\t.addClass('btn btn-primary')\n\t\t\t\t.prop('disabled', true)\n\t\t\t\t.text('Processing...')\n\t\t\t\t.on('click', function () {\n\t\t\t\t\tvar $this = $(this),\n\t\t\t\t\t\tdata = $this.data();\n\t\t\t\t\t$this\n\t\t\t\t\t\t.off('click')\n\t\t\t\t\t\t.text('Abort')\n\t\t\t\t\t\t.on('click', function () {\n\t\t\t\t\t\t\t$this.remove();\n\t\t\t\t\t\t\tdata.abort();\n\t\t\t\t\t\t});\n\t\t\t\t\tdata.submit().always(function () {\n\t\t\t\t\t\t$this.remove();\n\t\t\t\t\t});\n\t\t\t\t});\n\t\t$('#fileupload').fileupload({\n\t\t\turl: url,\n\t\t\tdataType: 'json',\n\t\t\tautoUpload: true,\n\t\t\tacceptFileTypes: \/(jpg)|(jpeg)|(gif)|(png)|(tif)|(tiff)|(bmp)$\/i,\n\t\t\tmaxFileSize: 5000000, \/\/ 5 MB\n\t\t\tpreviewMaxWidth: 300,\n\t\t\tpreviewMaxHeight: 300,\n\t\t\tpreviewCrop: true\n\t\t}).on('fileuploadadd', function (e, data) {\n\t\t\tdata.context = $('<div\/>').appendTo('#files');\n\t\t\t$.each(data.files, function (index, file) {\n\t\t\t\tvar node = $('<p\/>')\n\t\t\t\t\t\t.append($('<span\/>').text(file.name));\n\t\t\t\tif (!index) {\n\t\t\t\t\tnode\n\t\t\t\t\t\t.append('<br>')\n\t\t\t\t\t\t.append(uploadButton.clone(true).data(data));\n\t\t\t\t}\n\t\t\t\tnode.appendTo(data.context);\n\t\t\t});\n\t\t}).on('fileuploadprocessalways', function (e, data) {\n\t\t\tvar index = data.index,\n\t\t\t\tfile = data.files[index],\n\t\t\t\tnode = $(data.context.children()[index]);\n\t\t\tif (file.preview) {\n\t\t\t\tnode\n\t\t\t\t\t.prepend('<br>')\n\t\t\t\t\t.prepend(file.preview);\n\t\t\t}\n\t\t\tif (file.error) {\n\t\t\t\tnode\n\t\t\t\t\t.append('<br>')\n\t\t\t\t\t.append($('<span class=\"text-danger\"\/>').text(file.error));\n\t\t\t}\n\t\t\tif (index + 1 === data.files.length) {\n\t\t\t\tdata.context.find('button')\n\t\t\t\t\t.text('Upload')\n\t\t\t\t\t.prop('disabled', !!data.files.error);\n\t\t\t}\n\t\t}).on('fileuploadprogressall', function (e, data) {\n\t\t\tvar progress = parseInt(data.loaded \/ data.total * 100, 10);\n\t\t\t$('#progress .progress-bar').css(\n\t\t\t\t'width',\n\t\t\t\tprogress + '%'\n\t\t\t);\n\t\t}).on('fileuploaddone', function (e, data) {\t\n\t\t\t$(\"button.btn-primary\").remove();\n\t\t\t$(\"input#input_133_52\").val(prefix+data.result.key);\n\t\t\t$(\"span#fileUploadedBool\").css(\"color\",\"green\");\n\t\t\t$(\"span#fileUploadedBool\").text(\"Success!  Your file has been uploaded.\");\n\t\t\t$(\"span#btn-photo\").css(\"display\",\"none\");\n\t\t\t$.each(data.result.files, function (index, file) {\n\t\t\t\tif (file.url) {\n\t\t\t\t\tvar link = $('<a>')\n\t\t\t\t\t\t.attr('target', '_blank')\n\t\t\t\t\t\t.prop('href', file.url);\n\t\t\t\t\t$(data.context.children()[index])\n\t\t\t\t\t\t.wrap(link);\n\t\t\t\t} else if (file.error) {\n\t\t\t\t\tvar error = $('<span class=\"text-danger\"\/>').text(file.error);\n\t\t\t\t\t$(data.context.children()[index])\n\t\t\t\t\t\t.append('<br>')\n\t\t\t\t\t\t.append(error);\n\t\t\t\t}\n\t\t\t});\n\t\t}).on('fileuploadfail', function (e, data) {\n\t\t\t$.each(data.files, function (index) {\n\t\t\t\tvar error = $('<span class=\"text-danger\"\/>').text('File upload failed.');\n\t\t\t\t$(data.context.children()[index])\n\t\t\t\t\t.append('<br>')\n\t\t\t\t\t.append(error);\n\t\t\t});\n\t\t\treturn false;\n\t\t}).prop('disabled', !$.support.fileInput)\n\t\t\t.parent().addClass($.support.fileInput ? undefined : 'disabled');\n\t});\n\n\n<\/script>\n\n<link rel=\"stylesheet\" href=\"\/wp-content\/themes\/samaritans-purse\/lib\/css\/bootstrap.css\">\n<link rel=\"stylesheet\" href=\"\/wp-content\/themes\/samaritans-purse\/lib\/js\/fileUpload\/jquery.fileupload.css\">\n<style>\ndiv.entry-content div.social-bar {display:none !important;}\n#field_133_51 .container {width:100% !important; padding: 0 !important;}\n.ohop_multi_select input {height:25px !important;}\nspan#fileUploadedBool {color:red;margin-left: 10px;}\n<\/style><\/li><li id=\"field_133_52\" class=\"gfield gfield--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_133_52'><span class='gform-field-label__text'>Hidden - file photo path<\/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_52' id='input_133_52' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_133_13\" 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\">Service Details<\/h2><\/li><li id=\"field_133_16\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Are You Active or Retired<\/span><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_133_16'>\n\t\t\t<li class='gchoice gchoice_133_16_0'>\n\t\t\t\t<input name='input_16' type='radio' value='Active'  id='choice_133_16_0'    \/>\n\t\t\t\t<label for='choice_133_16_0' id='label_133_16_0' class='gform-field-label gform-field-label--type-inline'>Active<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_133_16_1'>\n\t\t\t\t<input name='input_16' type='radio' value='Retired'  id='choice_133_16_1'    \/>\n\t\t\t\t<label for='choice_133_16_1' id='label_133_16_1' class='gform-field-label gform-field-label--type-inline'>Retired<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_133_17\" class=\"gfield gfield--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_133_17'><span class='gform-field-label__text'>Current Department<\/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_17' id='input_133_17' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_133_50\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon 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_133_50'><span class='gform-field-label__text'>Retirement Date<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/aaaa'\n\t\t\t\t\tid='input_133_50'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_50'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_133_50' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_133_50' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_133_50' aria-label='Retirement Date: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_133_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Are you a sworn officer with power of arrest?<\/span><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_133_14'>\n\t\t\t<li class='gchoice gchoice_133_14_0'>\n\t\t\t\t<input name='input_14' type='radio' value='Yes'  id='choice_133_14_0'    \/>\n\t\t\t\t<label for='choice_133_14_0' id='label_133_14_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_133_14_1'>\n\t\t\t\t<input name='input_14' type='radio' value='No'  id='choice_133_14_1'    \/>\n\t\t\t\t<label for='choice_133_14_1' id='label_133_14_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_133_15\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon 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_133_15'><span class='gform-field-label__text'>Start Date of Service<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/aaaa'\n\t\t\t\t\tid='input_133_15'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_15'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_133_15' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_133_15' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_133_15' aria-label='Start Date of Service: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_133_49\" 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\">Injury Information<\/h2><\/li><li id=\"field_133_19\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_133_19'><span class='gform-field-label__text'>Date of Injury<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/aaaa'\n\t\t\t\t\tid='input_133_19'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_19'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_133_19' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_133_19' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_133_19' aria-label='Date of Injury: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_133_18\" class=\"gfield gfield--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_133_18'><span class='gform-field-label__text'>Department at the Time of Injury<\/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_18' id='input_133_18' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_133_21\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_133_21'><span class='gform-field-label__text'>Injury or Injuries and Related Restrictions<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_133_21' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_133_22\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_133_22'><span class='gform-field-label__text'>Current Medical Treatment<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_22' id='input_133_22' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_133_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you rely on any special medical equipment?<\/span><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_133_23'>\n\t\t\t<li class='gchoice gchoice_133_23_0'>\n\t\t\t\t<input name='input_23' type='radio' value='Yes'  id='choice_133_23_0'    \/>\n\t\t\t\t<label for='choice_133_23_0' id='label_133_23_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_133_23_1'>\n\t\t\t\t<input name='input_23' type='radio' value='No'  id='choice_133_23_1'    \/>\n\t\t\t\t<label for='choice_133_23_1' id='label_133_23_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_133_23'>Operation Heal Our Patriots operates in a remote region of the Alaska wilderness, where access to special medical devices and equipment could be limited. Please notify us so we can prepare accordingly.<\/div><\/li><li id=\"field_133_24\" class=\"gfield gfield--type-textarea 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_133_24'><span class='gform-field-label__text'>Please Describe Special Equipment Needs<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_133_24' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_133_20\" class=\"gfield gfield--type-textarea 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_133_20'><span class='gform-field-label__text'>Incident Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_20' id='input_133_20' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_133_25\" 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\">Spouse Information<\/h2><\/li><li id=\"field_133_28\" class=\"gfield gfield--type-name 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 gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><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_133_28'>\n                            \n                            <span id='input_133_28_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_28.3' id='input_133_28_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_133_28_3' class='gform-field-label gform-field-label--type-sub '>Nombre<\/label>\n                                                <\/span>\n                            \n                            <span id='input_133_28_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_28.6' id='input_133_28_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_133_28_6' class='gform-field-label gform-field-label--type-sub '>Apellidos<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_133_29\" class=\"gfield gfield--type-text preferred_name 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_133_29'><span class='gform-field-label__text'>Preferred 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_29' id='input_133_29' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_133_30\" class=\"gfield gfield--type-phone gfield--phone-format-standard 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_133_30'><span class='gform-field-label__text'>Phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_30' id='input_133_30' type='tel' value='' class='medium'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_133_31\" class=\"gfield gfield--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_133_31'><span class='gform-field-label__text'>Alternate Phone<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_31' id='input_133_31' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_133_32\" class=\"gfield gfield--type-email field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_133_32'><span class='gform-field-label__text'>Email<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_32' id='input_133_32' type='email' value='' class='medium'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_133_33\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon 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_133_33'><span class='gform-field-label__text'>Date of Birth<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/aaaa'\n\t\t\t\t\tid='input_133_33'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_33'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_133_33' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_133_33' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_133_33' aria-label='Date of Birth: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_133_35\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Does your spouse have any specific medical issues?<\/span><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_133_35'>\n\t\t\t<li class='gchoice gchoice_133_35_0'>\n\t\t\t\t<input name='input_35' type='radio' value='Yes'  id='choice_133_35_0'    \/>\n\t\t\t\t<label for='choice_133_35_0' id='label_133_35_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_133_35_1'>\n\t\t\t\t<input name='input_35' type='radio' value='No'  id='choice_133_35_1'    \/>\n\t\t\t\t<label for='choice_133_35_1' id='label_133_35_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_133_35'>Is your spouse receiving medical treatment, or do they have any specific medical issues?<\/div><\/li><li id=\"field_133_36\" class=\"gfield gfield--type-textarea 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_133_36'><span class='gform-field-label__text'>Please describe your spouse&#039;s medical issues.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_36' id='input_133_36' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_133_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Which best describes the current state of your marriage?<\/span><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_133_37'>\n\t\t\t<li class='gchoice gchoice_133_37_0'>\n\t\t\t\t<input name='input_37' type='radio' value='Healthy'  id='choice_133_37_0'    \/>\n\t\t\t\t<label for='choice_133_37_0' id='label_133_37_0' class='gform-field-label gform-field-label--type-inline'>Healthy<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_133_37_1'>\n\t\t\t\t<input name='input_37' type='radio' value='Troubled'  id='choice_133_37_1'    \/>\n\t\t\t\t<label for='choice_133_37_1' id='label_133_37_1' class='gform-field-label gform-field-label--type-inline'>Troubled<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_133_37_2'>\n\t\t\t\t<input name='input_37' type='radio' value='Separated'  id='choice_133_37_2'    \/>\n\t\t\t\t<label for='choice_133_37_2' id='label_133_37_2' class='gform-field-label gform-field-label--type-inline'>Separated<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_133_41\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Spouse Address<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_133_41' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_133_41_1_container' >\n                                        <input type='text' name='input_41.1' id='input_133_41_1' value=''    aria-required='false'    \/>\n                                        <label for='input_133_41_1' id='input_133_41_1_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_133_41_2_container' >\n                                        <input type='text' name='input_41.2' id='input_133_41_2' value=''     aria-required='false'   \/>\n                                        <label for='input_133_41_2' id='input_133_41_2_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_133_41_3_container' >\n                                    <input type='text' name='input_41.3' id='input_133_41_3' value=''    aria-required='false'    \/>\n                                    <label for='input_133_41_3' id='input_133_41_3_label' class='gform-field-label gform-field-label--type-sub '>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_133_41_4_container' >\n                                        <select name='input_41.4' id='input_133_41_4'     aria-required='false'    ><option value='' selected='selected'><\/option><option value='AL' >Alabama<\/option><option value='AK' >Alaska<\/option><option value='AZ' >Arizona<\/option><option value='AR' >Arkansas<\/option><option value='CA' >California<\/option><option value='CO' >Colorado<\/option><option value='CT' >Connecticut<\/option><option value='DE' >Delaware<\/option><option value='DC' >District of Columbia<\/option><option value='FL' >Florida<\/option><option value='GA' >Georgia<\/option><option value='GU' >Guam<\/option><option value='HI' >Hawaii<\/option><option value='ID' >Idaho<\/option><option value='IL' >Illinois<\/option><option value='IN' >Indiana<\/option><option value='IA' >Iowa<\/option><option value='KS' >Kansas<\/option><option value='KY' >Kentucky<\/option><option value='LA' >Louisiana<\/option><option value='ME' >Maine<\/option><option value='MD' >Maryland<\/option><option value='MA' >Massachusetts<\/option><option value='MI' >Michigan<\/option><option value='MN' >Minnesota<\/option><option value='MS' >Mississippi<\/option><option value='MO' >Missouri<\/option><option value='MT' >Montana<\/option><option value='NE' >Nebraska<\/option><option value='NV' >Nevada<\/option><option value='NH' >New Hampshire<\/option><option value='NJ' >New Jersey<\/option><option value='NM' >New Mexico<\/option><option value='NY' >New York<\/option><option value='NC' >North Carolina<\/option><option value='ND' >North Dakota<\/option><option value='OH' >Ohio<\/option><option value='OK' >Oklahoma<\/option><option value='OR' >Oregon<\/option><option value='PA' >Pennsylvania<\/option><option value='PR' >Puerto Rico<\/option><option value='RI' >Rhode Island<\/option><option value='SC' >South Carolina<\/option><option value='SD' >South Dakota<\/option><option value='TN' >Tennessee<\/option><option value='TX' >Texas<\/option><option value='UT' >Utah<\/option><option value='VT' >Vermont<\/option><option value='VA' >Virginia<\/option><option value='WA' >Washington<\/option><option value='WV' >West Virginia<\/option><option value='WI' >Wisconsin<\/option><option value='WY' >Wyoming<\/option><\/select>\n                                        <label for='input_133_41_4' id='input_133_41_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_133_41_5_container' >\n                                    <input type='text' name='input_41.5' id='input_133_41_5' value=''    aria-required='false'    \/>\n                                    <label for='input_133_41_5' id='input_133_41_5_label' class='gform-field-label gform-field-label--type-sub '>Zip Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_41.6' id='input_133_41_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_133_42\" class=\"gfield gfield--type-textarea 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_133_42'><span class='gform-field-label__text'>Please describe the current state of your marriage.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_42' id='input_133_42' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_133_43\" 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\">Additional Information<\/h2><\/li><li id=\"field_133_44\" class=\"gfield gfield--type-textarea 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_133_44'><span class='gform-field-label__text'>How would attending OHOP benefit you and your spouse?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_44' id='input_133_44' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_133_45\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Does your support system include a church?<\/span><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_133_45'>\n\t\t\t<li class='gchoice gchoice_133_45_0'>\n\t\t\t\t<input name='input_45' type='radio' value='Yes'  id='choice_133_45_0'    \/>\n\t\t\t\t<label for='choice_133_45_0' id='label_133_45_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_133_45_1'>\n\t\t\t\t<input name='input_45' type='radio' value='No'  id='choice_133_45_1'    \/>\n\t\t\t\t<label for='choice_133_45_1' id='label_133_45_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_133_46\" class=\"gfield gfield--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_133_46'><span class='gform-field-label__text'>Church 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_46' id='input_133_46' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_133_47\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Church Address<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_133_47' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_133_47_1_container' >\n                                        <input type='text' name='input_47.1' id='input_133_47_1' value=''    aria-required='false'    \/>\n                                        <label for='input_133_47_1' id='input_133_47_1_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_133_47_3_container' >\n                                    <input type='text' name='input_47.3' id='input_133_47_3' value=''    aria-required='false'    \/>\n                                    <label for='input_133_47_3' id='input_133_47_3_label' class='gform-field-label gform-field-label--type-sub '>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_133_47_4_container' >\n                                        <input type='text' name='input_47.4' id='input_133_47_4' value=''      aria-required='false'    \/>\n                                        <label for='input_133_47_4' id='input_133_47_4_label' class='gform-field-label gform-field-label--type-sub '>Estado \/ Provincia \/ Regi\u00f3n<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_133_47_5_container' >\n                                    <input type='text' name='input_47.5' id='input_133_47_5' value=''    aria-required='false'    \/>\n                                    <label for='input_133_47_5' id='input_133_47_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ C\u00f3digo Postal<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_133_47_6_container' >\n                                        <select name='input_47.6' id='input_133_47_6'   aria-required='false'    ><option value='' ><\/option><option value='AF' >Afghanist\u00e1n<\/option><option value='AL' >Albania<\/option><option value='DE' >Alemania<\/option><option value='AD' >Andorra<\/option><option value='AO' >Angola<\/option><option value='AI' >Anguilla<\/option><option value='AG' >Antigua y Barbuda<\/option><option value='AQ' >Ant\u00e1rtida<\/option><option value='SA' >Arabia Saudita<\/option><option value='DZ' >Argelia<\/option><option value='AR' >Argentina<\/option><option value='AM' >Armenia<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australia<\/option><option value='AT' >Austria<\/option><option value='AZ' >Azerbaiy\u00e1n<\/option><option value='BS' >Bahamas<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BH' >Bar\u00e9in<\/option><option value='BZ' >Belice<\/option><option value='BJ' >Benin<\/option><option value='BM' >Bermuda<\/option><option value='BT' >Bhut\u00e1n<\/option><option value='BY' >Bielorusia<\/option><option value='BO' >Bolivia<\/option><option value='BQ' >Bonaire, San Eustaquio y Saba<\/option><option value='BA' >Bosnia y Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BR' >Brasil<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgaria<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='BE' >B\u00e9lgica<\/option><option value='CV' >Cabo Verde<\/option><option value='KH' >Camboya<\/option><option value='CM' >Camer\u00fan<\/option><option value='CA' >Canada<\/option><option value='TD' >Chad<\/option><option value='CZ' >Chequia<\/option><option value='CL' >Chile<\/option><option value='CN' >China<\/option><option value='CY' >Chipre<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoras<\/option><option value='CG' >Congo<\/option><option value='CD' >Congo, Rep\u00fablica Democr\u00e1tica del<\/option><option value='KP' >Corea, Rep\u00fablica Popular Democr\u00e1tica de<\/option><option value='KR' >Corea, Rep\u00fablica de<\/option><option value='CR' >Costa Rica<\/option><option value='CI' >Costa de Marfil<\/option><option value='HR' >Croacia<\/option><option value='CU' >Cuba<\/option><option value='CW' >Curazao<\/option><option value='DK' >Dinamarca<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egipto<\/option><option value='SV' >El Salvador<\/option><option value='AE' >Emiratos \u00c1rabes Unidos<\/option><option value='ER' >Eritrea<\/option><option value='SK' >Eslovaquia<\/option><option value='SI' >Eslovenia<\/option><option value='ES' >Espa\u00f1a<\/option><option value='US' >Estados Unidos<\/option><option value='EE' >Estonia<\/option><option value='SZ' >Esuatini<\/option><option value='ET' >Etiop\u00eda<\/option><option value='RU' >Federaci\u00f3n Rusa<\/option><option value='FJ' >Fiji<\/option><option value='PH' >Filipinas<\/option><option value='FI' >Finlandia<\/option><option value='FR' >Francia<\/option><option value='GA' >Gab\u00f3n<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgia<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GD' >Granada<\/option><option value='GR' >Grecia<\/option><option value='GL' >Groenlandia<\/option><option value='GP' >Guadalupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GY' >Guayana<\/option><option value='GF' >Guayana Francesa<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinea<\/option><option value='GW' >Guinea Bissau<\/option><option value='GQ' >Guinea Ecuatorial<\/option><option value='HT' >Hait\u00ed<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hungr\u00eda<\/option><option value='IN' >India<\/option><option value='ID' >Indonesia<\/option><option value='IQ' >Iraq<\/option><option value='IE' >Irlanda<\/option><option value='IR' >Ir\u00e1n<\/option><option value='BV' >Isla Bouvet<\/option><option value='NF' >Isla Norfolk<\/option><option value='IM' >Isla de Man<\/option><option value='CX' >Isla de Navidad<\/option><option value='IS' >Islandia<\/option><option value='KY' >Islas Caim\u00e1n<\/option><option value='CC' >Islas Cocos<\/option><option value='CK' >Islas Cook<\/option><option value='FO' >Islas Faroe<\/option><option value='HM' >Islas Heard y McDonald<\/option><option value='FK' >Islas Malvinas<\/option><option value='MP' >Islas Marianas del Norte<\/option><option value='MH' >Islas Marshall<\/option><option value='SB' >Islas Salom\u00f3n<\/option><option value='TC' >Islas Turcas y Caicos<\/option><option value='UM' >Islas Ultramarinas Menores de Estados Unidos<\/option><option value='VG' >Islas V\u00edrgenes Brit\u00e1nicas<\/option><option value='VI' >Islas V\u00edrgenes de los Estados Unidos<\/option><option value='AX' >Islas \u00c5land<\/option><option value='IL' >Israel<\/option><option value='IT' >Italia<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Jap\u00f3n<\/option><option value='JE' >Jersey<\/option><option value='GS' >Ji\u017en\u00ed Georgie a Ji\u017en\u00ed Sandwichovy ostrovy<\/option><option value='JO' >Jord\u00e1n<\/option><option value='KZ' >Kazajist\u00e1n<\/option><option value='KE' >Kenia<\/option><option value='KG' >Kirguist\u00e1n<\/option><option value='KI' >Kiribati<\/option><option value='KW' >Kuwait<\/option><option value='LY' >LIbia<\/option><option value='LS' >Lesoto<\/option><option value='LR' >Liberia<\/option><option value='LI' >Liechtenstein<\/option><option value='LV' >Lituania<\/option><option value='LT' >Lituania<\/option><option value='LU' >Luxemburgo<\/option><option value='LB' >L\u00edbano<\/option><option value='MO' >Macau<\/option><option value='MK' >Macedonia del Norte<\/option><option value='MG' >Madagascar<\/option><option value='MY' >Malasia<\/option><option value='MW' >Malawi<\/option><option value='MV' >Maldivas<\/option><option value='ML' >Mali<\/option><option value='MT' >Malta<\/option><option value='MA' >Marruecos<\/option><option value='MQ' >Martinica<\/option><option value='MU' >Mauricio<\/option><option value='MR' >Mauritania<\/option><option value='YT' >Mayotte<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldavia<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongolia<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='MX' >M\u00e9xico<\/option><option value='NA' >Namibia<\/option><option value='NR' >Nauru<\/option><option value='NP' >Nepal<\/option><option value='NI' >Nicaragua<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='NO' >Noruega<\/option><option value='NC' >Nueva Caledonia<\/option><option value='NZ' >Nueva Zelanda<\/option><option value='NE' >N\u00edger<\/option><option value='OM' >Om\u00e1n<\/option><option value='NL' >Paises Bajos<\/option><option value='PK' >Pakist\u00e1n<\/option><option value='PW' >Palau<\/option><option value='PS' >Palestina, Estado de<\/option><option value='PA' >Panam\u00e1<\/option><option value='PG' >Pap\u00faa Nueva Guinea<\/option><option value='PY' >Paraguay<\/option><option value='PE' >Per\u00fa<\/option><option value='PN' >Pitcairn<\/option><option value='PF' >Polinesia Francesa<\/option><option value='PL' >Polonia<\/option><option value='PT' >Portugal<\/option><option value='PR' >Puerto Rico<\/option><option value='QA' >Qatar<\/option><option value='GB' >Reino Unido<\/option><option value='CF' >Rep\u00fablica Centroafricana<\/option><option value='LA' >Rep\u00fablica Democr\u00e1tica Popular de Laos<\/option><option value='DO' >Rep\u00fablica Dominicana<\/option><option value='SY' >Rep\u00fablica \u00c1rabe de Siria<\/option><option value='RE' >Reuni\u00f3n<\/option><option value='RW' >Ruanda<\/option><option value='RO' >Ruman\u00eda<\/option><option value='EH' >Sahara Occidental<\/option><option value='WS' >Samoa<\/option><option value='AS' >Samoa Americana<\/option><option value='BL' >San Bartolom\u00e9<\/option><option value='KN' >San Crist\u00f3bal y Nieves<\/option><option value='SM' >San Marino<\/option><option value='MF' >San Mart\u00edn<\/option><option value='PM' >San Pedro y Miquel\u00f3n<\/option><option value='VC' >San Vicente y las Granadinas<\/option><option value='SH' >Santa Elena, Ascensi\u00f3n y Trist\u00e1n de Acu\u00f1a<\/option><option value='LC' >Santa Luc\u00eda<\/option><option value='VA' >Santa Sede<\/option><option value='ST' >Santo Tom\u00e9 y Principe<\/option><option value='SN' >Senegal<\/option><option value='RS' >Serbia<\/option><option value='SC' >Seychelles<\/option><option value='SL' >Sierra Leona<\/option><option value='SG' >Singapur<\/option><option value='SX' >Sint Maarten<\/option><option value='SO' >Somalia<\/option><option value='LK' >Sri Lanka<\/option><option value='ZA' >Sud\u00e1frica<\/option><option value='SD' >Sud\u00e1n<\/option><option value='SS' >Sud\u00e1n del Sur<\/option><option value='SE' >Suecia<\/option><option value='CH' >Suiza<\/option><option value='SR' >Surinam<\/option><option value='SJ' >Svalbard y Jan Mayen<\/option><option value='TH' >Tailandia<\/option><option value='TW' >Taiwan<\/option><option value='TZ' >Tanzania (Rep\u00fablica Unida de)<\/option><option value='TJ' >Tayikist\u00e1n<\/option><option value='IO' >Territorio Brit\u00e1nico del Oc\u00e9ano \u00cdndico<\/option><option value='TF' >Tierras Australes y Ant\u00e1rticas Francesas<\/option><option value='TL' >Timor Oriental<\/option><option value='TG' >Togo<\/option><option value='TK' >Tokelau<\/option><option value='TO' >Tonga<\/option><option value='TT' >Trinidad y Tobago<\/option><option value='TM' >Turkmenist\u00e1n<\/option><option value='TR' >Turqu\u00eda<\/option><option value='TV' >Tuvalu<\/option><option value='TN' >T\u00fanez<\/option><option value='UA' >Ucrania<\/option><option value='UG' >Uganda<\/option><option value='UY' >Uruguay<\/option><option value='UZ' >Uzbekist\u00e1n<\/option><option value='VU' >Vanuatu<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Vietnam<\/option><option value='WF' >Wallis y Futuna<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbaue<\/option><\/select>\n                                        <label for='input_133_47_6' id='input_133_47_6_label' class='gform-field-label gform-field-label--type-sub '>Pa\u00eds<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_133_48\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_133_48'><span class='gform-field-label__text'>Please list any other counseling\/programs previously attended.<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_48' id='input_133_48' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_133_53\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Consent<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_53.1' id='input_133_53_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_133_53_1' ><span class='gform-field-label__text'>By completing and submitting this application, you consent to Samaritan\u2019s Purse collecting the information requested in the application from you and sharing the information with Billy Graham Evangelistic Association for the following purposes: (1) to review your application for participation in Law Enforcement Appreciation Program, and (2) if selected to participate, to facilitate your participation in Law Enforcement Appreciation Program.<\/span><\/label><input type='hidden' name='input_53.2' value='By completing and submitting this application, you consent to Samaritan\u2019s Purse collecting the information requested in the application from you and sharing the information with Billy Graham Evangelistic Association for the following purposes: (1) to review your application for participation in Law Enforcement Appreciation Program, and (2) if selected to participate, to facilitate your participation in Law Enforcement Appreciation Program.' class='gform_hidden' \/><input type='hidden' name='input_53.3' value='9' class='gform_hidden' \/><\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_133' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_133' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_133' id='gform_theme_133' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_133' id='gform_style_settings_133' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_133' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='133' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='EN2nYwr61K6EYbECaNsfSWMDA401WZ3PhPu2OoSo1EanRK58VMJ85VKLDuoRuv1njXj7BBnDVEdDujFotMk1AlTbWyOSD2R6SjTtxoTlIS+ajp8=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_133' value='WyJ7XCI1My4xXCI6XCIwMDIwMTdhYjczM2M0MzZiYzZkNTcxZDQzZGU5NDE5N1wiLFwiNTMuMlwiOlwiYzhmNDhhZDI1OWIyZDdmMGVjM2RkODUyZTEzNmY0ZjRcIixcIjUzLjNcIjpcImY2Nzg5NTQ2ZjMyYTE4ZTlkODJmMDg0ZDgyYWNlMTVjXCIsXCJnZm9ybV9zdWJtaXNzaW9uX21ldGhvZFwiOltcIjAyNGFmZTIxOGVkOTEzZjMxZmI2NjI2OTlkMDUxNTY2XCIsXCIyYWNiM2JjZmQzZDc4YWU0NzU3YmYxZGJlNzRhMzI2Y1wiXSxcImdmb3JtX3RoZW1lXCI6XCI4OWNiY2I5OWViZDM2OWM2ZGE5NzA5YWZhMTM0NmQ2ZlwiLFwiZ2Zvcm1fc3R5bGVfc2V0dGluZ3NcIjpcImY1NWE3NzI4ZGQzNzNiYzY0OTQ0ZGU3ZjllY2NmYjU0XCIsXCJmb3JtX2lkXCI6XCJmNjgzNDEyMTFjYjM0OWE5OTE4YTZjNDQxZmJhZGRhMVwiLFwidXJsXCI6XCJlNWRhOWQ3OTljNTNhMDAyNDM2ZGY2NzY1NWYwNTlkMVwiLFwic3RhdGVfdGltZXN0YW1wXCI6XCI1YmRiZDRjZmE1MjJmZmFiZTc4YmVkMGRhYjM5NzQ1N1wifSIsIjY2YTRkNDNhOTE4NmI2YzQzMjQzYjNmM2E3MGRhMWI3IiwxNzkzNzA2NTcyXQ==' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_133' id='gform_target_page_number_133' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_133' id='gform_source_page_number_133' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div>\r\n                <\/div>\r\n            <\/section>\r\n            \r\n        <\/article>\r\n    <\/main>","protected":false},"excerpt":{"rendered":"Encounter God\u2019s Healing Love Samaritan\u2019s Purse has been serving wounded veterans and their spouses since 2012 through Operation Heal Our Patriots. This year, we are pleased to host three sessions dedicated to law enforcement officers and their spouses in partnership with the Billy Graham Evangelistic Association Rapid Response Team National Law Enforcement Ministry. Three groups [&hellip","protected":false},"author":86,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":"","_links_to":"","_links_to_target":""},"categories":[1],"tags":[],"class_list":["post-151673","post","type-post","status-publish","format-standard","hentry","category-our-ministry","entry"],"_links":{"self":[{"href":"https:\/\/www.samaritanspurse.org\/es\/wp-json\/wp\/v2\/posts\/151673","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.samaritanspurse.org\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.samaritanspurse.org\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.samaritanspurse.org\/es\/wp-json\/wp\/v2\/users\/86"}],"replies":[{"embeddable":true,"href":"https:\/\/www.samaritanspurse.org\/es\/wp-json\/wp\/v2\/comments?post=151673"}],"version-history":[{"count":10,"href":"https:\/\/www.samaritanspurse.org\/es\/wp-json\/wp\/v2\/posts\/151673\/revisions"}],"predecessor-version":[{"id":206354,"href":"https:\/\/www.samaritanspurse.org\/es\/wp-json\/wp\/v2\/posts\/151673\/revisions\/206354"}],"wp:attachment":[{"href":"https:\/\/www.samaritanspurse.org\/es\/wp-json\/wp\/v2\/media?parent=151673"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.samaritanspurse.org\/es\/wp-json\/wp\/v2\/categories?post=151673"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.samaritanspurse.org\/es\/wp-json\/wp\/v2\/tags?post=151673"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}