{"id":24406,"date":"2023-07-31T17:58:20","date_gmt":"2023-07-31T21:58:20","guid":{"rendered":"https:\/\/cecortezmasto.wpengine.com\/?page_id=24406"},"modified":"2023-08-18T16:33:21","modified_gmt":"2023-08-18T20:33:21","slug":"form","status":"publish","type":"page","link":"https:\/\/www.cortezmasto.senate.gov\/es\/help\/constituent-services\/visiting-dc\/form\/","title":{"rendered":"Tour Request Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"24406\" class=\"elementor elementor-24406\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e119cab e-flex e-con-boxed e-con e-parent\" data-id=\"e119cab\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1bfc666 eael-gravity-form-button-custom elementor-widget elementor-widget-eael-gravity-form\" data-id=\"1bfc666\" data-element_type=\"widget\" data-widget_type=\"eael-gravity-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t            <div class=\"eael-contact-form eael-gravity-form eael-contact-form-align-default\">\n                                <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 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)}});<\/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_18' >\n                        <div class='gform_heading'>\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_18'  action='\/es\/wp-json\/wp\/v2\/pages\/24406' data-formid='18' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_18' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_18_37\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_18_37\" ><h3 class=\"gsection_title\">Tour Information<\/h3><\/div><fieldset id=\"field_18_38\" class=\"gfield gfield--type-checkbox gfield--type-choice 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_18_38\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please Select The Tour(s) You Are Interested In:<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_18_38'><div class='gchoice gchoice_18_38_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.1' type='checkbox'  value='U.S. Capitol'  id='choice_18_38_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_38_1' id='label_18_38_1' class='gform-field-label gform-field-label--type-inline'>U.S. Capitol<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_18_38_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.2' type='checkbox'  value='White House'  id='choice_18_38_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_38_2' id='label_18_38_2' class='gform-field-label gform-field-label--type-inline'>White House<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_18_38_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.3' type='checkbox'  value='Supreme Court'  id='choice_18_38_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_38_3' id='label_18_38_3' class='gform-field-label gform-field-label--type-inline'>Supreme Court<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_18_38_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_38.4' type='checkbox'  value='Federal Bureau of Investigation'  id='choice_18_38_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_38_4' id='label_18_38_4' class='gform-field-label gform-field-label--type-inline'>Federal Bureau of Investigation<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_18_40\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_18_40\" ><h4>What Full Dates Will You Be Present In D.C.? (Please Do Not Include Travel Days)<\/h4><\/div><div id=\"field_18_43\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-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_18_43\" ><label class='gfield_label gform-field-label' for='input_18_43'>From<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_43' id='input_18_43' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_18_43_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_18_43_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_18_43' class='gform_hidden' value='https:\/\/www.cortezmasto.senate.gov\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_18_44\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-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_18_44\" ><label class='gfield_label gform-field-label' for='input_18_44'>To<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_44' id='input_18_44' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_18_44_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_18_44_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_18_44' class='gform_hidden' value='https:\/\/www.cortezmasto.senate.gov\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_18_45\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_18_45\" ><legend class='gfield_label gform-field-label' >Group Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_18_45'>\n\t\t\t<div class='gchoice gchoice_18_45_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Family'  id='choice_18_45_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_18_45_0' id='label_18_45_0' class='gform-field-label gform-field-label--type-inline'>Family<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_18_45_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='School'  id='choice_18_45_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_18_45_1' id='label_18_45_1' class='gform-field-label gform-field-label--type-inline'>School<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_18_45_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Organization'  id='choice_18_45_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_18_45_2' id='label_18_45_2' class='gform-field-label gform-field-label--type-inline'>Organization<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_18_45_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Other'  id='choice_18_45_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_18_45_3' id='label_18_45_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_18_46\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_18_46\" ><label class='gfield_label gform-field-label' for='input_18_46'>How many tickets are you requesting?<\/label><div class='ginput_container ginput_container_text'><input name='input_46' id='input_18_46' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_18_4\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_18_4\" ><h3 class=\"gsection_title\">Your Name<\/h3><\/div><div id=\"field_18_1\" class=\"gfield gfield--type-select 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_18_1\" ><label class='gfield_label gform-field-label' for='input_18_1'>Prefix<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_1' id='input_18_1' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>- Select -<\/option><option value='Mr.' >Mr.<\/option><option value='Ms.' >Ms.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Prefer not to identify' >Prefer not to identify<\/option><option value='Professor' >Professor<\/option><option value='Dr.' >Dr.<\/option><option value='Father' >Father<\/option><option value='Sister' >Sister<\/option><option value='Rabbi' >Rabbi<\/option><option value='Reverend' >Reverend<\/option><option value='Air Force - General' >Air Force - General<\/option><option value='Air Force - Lieutenant General' >Air Force - Lieutenant General<\/option><option value='Air Force - Major General' >Air Force - Major General<\/option><option value='Air Force - Brigadier General' >Air Force - Brigadier General<\/option><option value='Air Force - Colonel' >Air Force - Colonel<\/option><option value='Air Force - Lieutenant Colonel' >Air Force - Lieutenant Colonel<\/option><option value='Air Force - Major' >Air Force - Major<\/option><option value='Air Force - Captain' >Air Force - Captain<\/option><option value='Air Force - First Lieutenant' >Air Force - First Lieutenant<\/option><option value='Air Force - Second Lieutenant' >Air Force - Second Lieutenant<\/option><option value='Air Force - Chief Master Sergeant of the Air Force' >Air Force - Chief Master Sergeant of the Air Force<\/option><option value='Air Force - Command Chief Master Sergeant' >Air Force - Command Chief Master Sergeant<\/option><option value='Air Force - First Sergeant (E-9)' >Air Force - First Sergeant (E-9)<\/option><option value='Air Force - Chief Master Sergeant' >Air Force - Chief Master Sergeant<\/option><option value='Air Force - First Sergeant (E-8)' >Air Force - First Sergeant (E-8)<\/option><option value='Air Force - Senior Master Sergeant' >Air Force - Senior Master Sergeant<\/option><option value='Air Force - First Sergeant (E-7)' >Air Force - First Sergeant (E-7)<\/option><option value='Air Force - Master Sergeant' >Air Force - Master Sergeant<\/option><option value='Air Force - Technical Sergeant' >Air Force - Technical Sergeant<\/option><option value='Air Force - Staff Sergeant' >Air Force - Staff Sergeant<\/option><option value='Air Force - Senior Airman' >Air Force - Senior Airman<\/option><option value='Air Force - Airman First Class' >Air Force - Airman First Class<\/option><option value='Air Force - Airman' >Air Force - Airman<\/option><option value='Air Force - Airman Basic' >Air Force - Airman Basic<\/option><option value='Army - General' >Army - General<\/option><option value='Army - Lieutenant General' >Army - Lieutenant General<\/option><option value='Army - Major General' >Army - Major General<\/option><option value='Army - Brigadier General' >Army - Brigadier General<\/option><option value='Army - Colonel' >Army - Colonel<\/option><option value='Army - Lieutenant Colonel' >Army - Lieutenant Colonel<\/option><option value='Army - Major' >Army - Major<\/option><option value='Army - Captain' >Army - Captain<\/option><option value='Army - First Lieutenant' >Army - First Lieutenant<\/option><option value='Army - Second Lieutenant' >Army - Second Lieutenant<\/option><option value='Army - Chief Warrant Officer - 5' >Army - Chief Warrant Officer - 5<\/option><option value='Army - Chief Warrant Officer - 4' >Army - Chief Warrant Officer - 4<\/option><option value='Army - Chief Warrant Officer - 3' >Army - Chief Warrant Officer - 3<\/option><option value='Army - Chief Warrant Officer - 2' >Army - Chief Warrant Officer - 2<\/option><option value='Army - Warrant Officer' >Army - Warrant Officer<\/option><option value='Army - Sergeant Major of the Army' >Army - Sergeant Major of the Army<\/option><option value='Army - Command Sergeant Major' >Army - Command Sergeant Major<\/option><option value='Army - Sergeant Major' >Army - Sergeant Major<\/option><option value='Army - First Sergeant' >Army - First Sergeant<\/option><option value='Army - Master Sergeant' >Army - Master Sergeant<\/option><option value='Army - Sergeant First Class' >Army - Sergeant First Class<\/option><option value='Army - Staff Sergeant' >Army - Staff Sergeant<\/option><option value='Army - Sergeant' >Army - Sergeant<\/option><option value='Army - Corporal' >Army - Corporal<\/option><option value='Army - Specialist' >Army - Specialist<\/option><option value='Army - Private First Class' >Army - Private First Class<\/option><option value='Army - Private (E-2)' >Army - Private (E-2)<\/option><option value='Army - Private' >Army - Private<\/option><option value='Coast Guard - Admiral' >Coast Guard - Admiral<\/option><option value='Coast Guard - Vice Admiral' >Coast Guard - Vice Admiral<\/option><option value='Coast Guard - Rear Admiral, Upper Half' >Coast Guard - Rear Admiral, Upper Half<\/option><option value='Coast Guard - Rear Admiral, Lower Half' >Coast Guard - Rear Admiral, Lower Half<\/option><option value='Coast Guard - Captain' >Coast Guard - Captain<\/option><option value='Coast Guard - Commander' >Coast Guard - Commander<\/option><option value='Coast Guard - Lieutenant Commander' >Coast Guard - Lieutenant Commander<\/option><option value='Coast Guard - Lieutenant' >Coast Guard - Lieutenant<\/option><option value='Coast Guard - Lieutenant Junior Grade' >Coast Guard - Lieutenant Junior Grade<\/option><option value='Coast Guard - Ensign' >Coast Guard - Ensign<\/option><option value='Coast Guard - Chief Warrant Officer - 4' >Coast Guard - Chief Warrant Officer - 4<\/option><option value='Coast Guard - Chief Warrant Officer - 3' >Coast Guard - Chief Warrant Officer - 3<\/option><option value='Coast Guard - Chief Warrant Officer - 2' >Coast Guard - Chief Warrant Officer - 2<\/option><option value='Coast Guard - Master Chief Petty Officer of the Coast Guard' >Coast Guard - Master Chief Petty Officer of the Coast Guard<\/option><option value='Coast Guard - Master Chief Petty Officer' >Coast Guard - Master Chief Petty Officer<\/option><option value='Coast Guard - Senior Chief Petty Officer' >Coast Guard - Senior Chief Petty Officer<\/option><option value='Coast Guard - Chief Petty Officer' >Coast Guard - Chief Petty Officer<\/option><option value='Coast Guard - Petty Officer First Class' >Coast Guard - Petty Officer First Class<\/option><option value='Coast Guard - Petty Officer Second Class' >Coast Guard - Petty Officer Second Class<\/option><option value='Coast Guard - Petty Officer Third Class' >Coast Guard - Petty Officer Third Class<\/option><option value='Coast Guard - Seaman' >Coast Guard - Seaman<\/option><option value='Coast Guard - Seaman Apprentice' >Coast Guard - Seaman Apprentice<\/option><option value='Coast Guard - Seaman Recruit' >Coast Guard - Seaman Recruit<\/option><option value='Marine Corps - General' >Marine Corps - General<\/option><option value='Marine Corps - Lieutenant General' >Marine Corps - Lieutenant General<\/option><option value='Marine Corps - Major General' >Marine Corps - Major General<\/option><option value='Marine Corps - Brigadier General' >Marine Corps - Brigadier General<\/option><option value='Marine Corps - Colonel' >Marine Corps - Colonel<\/option><option value='Marine Corps - Lieutenant Colonel' >Marine Corps - Lieutenant Colonel<\/option><option value='Marine Corps - Major' >Marine Corps - Major<\/option><option value='Marine Corps - Captain' >Marine Corps - Captain<\/option><option value='Marine Corps - First Lieutenant' >Marine Corps - First Lieutenant<\/option><option value='Marine Corps - Second Lieutenant' >Marine Corps - Second Lieutenant<\/option><option value='Marine Corps - Chief Warrant Officer - 5' >Marine Corps - Chief Warrant Officer - 5<\/option><option value='Marine Corps - Chief Warrant Officer - 4' >Marine Corps - Chief Warrant Officer - 4<\/option><option value='Marine Corps - Chief Warrant Officer - 3' >Marine Corps - Chief Warrant Officer - 3<\/option><option value='Marine Corps - Chief Warrant Officer - 2' >Marine Corps - Chief Warrant Officer - 2<\/option><option value='Marine Corps - Warrant Officer' >Marine Corps - Warrant Officer<\/option><option value='Marine Corps - Sergeant Major of the Marine Corps' >Marine Corps - Sergeant Major of the Marine Corps<\/option><option value='Marine Corps - Sergeant Major' >Marine Corps - Sergeant Major<\/option><option value='Marine Corps - Master Gunnery Sergeant' >Marine Corps - Master Gunnery Sergeant<\/option><option value='Marine Corps - First Sergeant' >Marine Corps - First Sergeant<\/option><option value='Marine Corps - Master Sergeant' >Marine Corps - Master Sergeant<\/option><option value='Marine Corps - Gunnery Sergeant' >Marine Corps - Gunnery Sergeant<\/option><option value='Marine Corps - Staff Sergeant' >Marine Corps - Staff Sergeant<\/option><option value='Marine Corps - Sergeant' >Marine Corps - Sergeant<\/option><option value='Marine Corps - Corporal' >Marine Corps - Corporal<\/option><option value='Marine Corps - Lance Corporal' >Marine Corps - Lance Corporal<\/option><option value='Marine Corps - Private First Class' >Marine Corps - Private First Class<\/option><option value='Marine Corps - Private' >Marine Corps - Private<\/option><option value='Navy - Admiral' >Navy - Admiral<\/option><option value='Navy - Vice Admiral' >Navy - Vice Admiral<\/option><option value='Navy - Rear Admiral, Upper Half' >Navy - Rear Admiral, Upper Half<\/option><option value='Navy - Rear Admiral, Lower Half' >Navy - Rear Admiral, Lower Half<\/option><option value='Navy - Captain' >Navy - Captain<\/option><option value='Navy - Commander' >Navy - Commander<\/option><option value='Navy - Lieutenant Commander' >Navy - Lieutenant Commander<\/option><option value='Navy - Lieutenant' >Navy - Lieutenant<\/option><option value='Navy - Lieutenant Junior Grade' >Navy - Lieutenant Junior Grade<\/option><option value='Navy - Ensign' >Navy - Ensign<\/option><option value='Navy - Chief Warrant Officer - 4' >Navy - Chief Warrant Officer - 4<\/option><option value='Navy - Chief Warrant Officer - 3' >Navy - Chief Warrant Officer - 3<\/option><option value='Navy - Chief Warrant Officer - 2' >Navy - Chief Warrant Officer - 2<\/option><option value='Navy - Master Chief Petty Officer of the Navy' >Navy - Master Chief Petty Officer of the Navy<\/option><option value='Navy - Master Chief Petty Officer' >Navy - Master Chief Petty Officer<\/option><option value='Navy - Senior Chief Pretty Officer' >Navy - Senior Chief Pretty Officer<\/option><option value='Navy - Chief Petty Officer' >Navy - Chief Petty Officer<\/option><option value='Navy - Petty Officer First Class' >Navy - Petty Officer First Class<\/option><option value='Navy - Petty Officer Second Class' >Navy - Petty Officer Second Class<\/option><option value='Navy - Petty Officer Third Class' >Navy - Petty Officer Third Class<\/option><option value='Navy - Seaman Apprentice' >Navy - Seaman Apprentice<\/option><option value='Navy - Seaman' >Navy - Seaman<\/option><option value='Navy - Seaman Recruit' >Navy - Seaman Recruit<\/option><\/select><\/div><\/div><div id=\"field_18_2\" class=\"gfield gfield--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_18_2\" ><label class='gfield_label gform-field-label' for='input_18_2'>First 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_2' id='input_18_2' type='text' value='' class='large'    placeholder='Required' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_18_3\" class=\"gfield gfield--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_18_3\" ><label class='gfield_label gform-field-label' for='input_18_3'>Last 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_3' id='input_18_3' type='text' value='' class='large'    placeholder='Required' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_18_6\" class=\"gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_18_6\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \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_18_6' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_18_6_1_container' >\n                                        <label for='input_18_6_1' id='input_18_6_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_6.1' id='input_18_6_1' value=''   placeholder='Required' aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_18_6_2_container' >\n                                        <label for='input_18_6_2' id='input_18_6_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_6.2' id='input_18_6_2' value=''   placeholder='Optional'  aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_18_6_3_container' >\n                                    <label for='input_18_6_3' id='input_18_6_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_6.3' id='input_18_6_3' value=''   placeholder='Required' aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_18_6_4_container' >\n                                        <label for='input_18_6_4' id='input_18_6_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                        <select name='input_6.4' id='input_18_6_4'     aria-required='true'    ><option value='' >Required<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' selected='selected'>Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_18_6_5_container' >\n                                    <label for='input_18_6_5' id='input_18_6_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                    <input type='text' name='input_6.5' id='input_18_6_5' value=''   placeholder='Required' aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_6.6' id='input_18_6_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_18_8\" class=\"gfield gfield--type-phone 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_18_8\" ><label class='gfield_label gform-field-label' for='input_18_8'>Home 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_8' id='input_18_8' type='tel' value='' class='large'  placeholder='Required' aria-required=\"true\" aria-invalid=\"false\"   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gfield_label_before_complex' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_18_9_container'>\n                                <span id='input_18_9_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_18_9' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                    <input class='' type='email' name='input_9' id='input_18_9' value=''   placeholder='Required' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                <\/span>\n                                <span id='input_18_9_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <label for='input_18_9_2' class='gform-field-label gform-field-label--type-sub 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