{"id":8043,"date":"2023-02-24T19:21:29","date_gmt":"2023-02-25T03:21:29","guid":{"rendered":"https:\/\/shayneletford.com\/test-triumph\/ambassadorapplication\/"},"modified":"2024-05-20T16:17:26","modified_gmt":"2024-05-20T23:17:26","slug":"ambassadorapplication","status":"publish","type":"page","link":"https:\/\/triumph-foundation.org\/es\/ambassadorapplication\/","title":{"rendered":"Ambassador Application"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><section class=\"vc_section\"><div class=\"vc_row wpb_row vc_row-fluid\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><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-theme gform-theme--foundation gform-theme--framework gform-theme--orbital body_wrapper .gform_wrapper_wrapper h3.gform_title_wrapper {_wrapper display:_wrapper none_wrapper !important;_wrapper }_wrapper' data-form-theme='orbital' data-form-index='0' id='gform_wrapper_29' 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0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_29' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_29' class='body .gform_wrapper h3.gform_title { display: none !important; }' action='\/es\/wp-json\/wp\/v2\/pages\/8043#gf_29' data-formid='29' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_29' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_29_22\" class=\"gfield gfield--type-html gfield--input-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\"  ><h2>Become a Triumph Ambassador<\/h2>\n\n<p> Thank you for your interest in becoming a Triumph Ambassador \u2014 a dedicated team of peer mentors supporting people with spinal cord injury (SCI) through mentorship, advocacy, and community connection. Triumph Ambassadors serve as community leaders and empower individuals with a paralyzing injury, illness, or disorder to make the best recovery possible and become more self-sufficient by providing peer mentorship, facilitating support groups, sharing resources, and representing Triumph Foundation at events and outreach activities throughout Southern California.<\/p>\n\n<h3>Eligible applicants must:<\/h3>\n<p>\u2022 Be part of the SCI community in Southern California <br>\n\u2022 Be at least two years post-injury<br>\n\u2022 Actively participate in Triumph support groups<br> \n\u2022 Have successfully reintegrated into their community<br>\n\n\n<h3>Application & Selection Process<\/h3>\n \n<p>Step 1: Complete Application<br> \nStep 2: Reference Check<br>\nStep 3: Two-Part Interview Process<br>\nStep 4: Training and Certification<br>\n\n\n<p>*Qualified applicants who advance through this process must complete training through our online learning platform, attend our annual Ambassador Training Conference, and participate in ongoing monthly education sessions. Ambassadors are also expected to complete a minimum of 15 service hours each year.\n\n<p>If you\u2019re passionate about supporting others in the SCI community and making a meaningful impact, please complete the application below by July 31, 2026 for consideration.<\/div><div id=\"field_29_107\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_29_108\" class=\"gfield gfield--type-html gfield--input-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\"  ><h3>Application<\/h3><\/div><div id=\"field_29_29\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half show-label 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_29_29'>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_29' id='input_29_29' type='text' value='' class='large'    placeholder='First Name*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half show-label 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_29_30'>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_30' id='input_29_30' type='text' value='' class='large'    placeholder='Last Name*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_29_60\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full show-label gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><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_29_60' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_29_60_1_container' >\n                                        <label for='input_29_60_1' id='input_29_60_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_60.1' id='input_29_60_1' value=''   placeholder='Street Address' aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_29_60_2_container' >\n                                        <label for='input_29_60_2' id='input_29_60_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_60.2' id='input_29_60_2' value=''   placeholder='Address Line 2'  aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_29_60_3_container' >\n                                    <label for='input_29_60_3' id='input_29_60_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_60.3' id='input_29_60_3' value=''   placeholder='City' aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_29_60_4_container' >\n                                        <label for='input_29_60_4' id='input_29_60_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                        <input type='text' name='input_60.4' id='input_29_60_4' value=''     placeholder='State \/ Province \/ Region' aria-required='true'    \/>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_29_60_5_container' >\n                                    <label for='input_29_60_5' id='input_29_60_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_60.5' id='input_29_60_5' value=''   placeholder='ZIP \/ Postal Code' aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_60.6' id='input_29_60_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_29_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half show-label 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_29_4'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_29_4' type='text' value='' class='large'    placeholder='Phone*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_18\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half show-label 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_29_18'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_18' id='input_29_18' type='email' value='' class='large'   placeholder='Email*' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_29_82\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:20px\" ><\/div><\/div><fieldset id=\"field_29_63\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full show-label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Date of birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_29_63' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_29_63_1_container'>\n                                            <input type='number' maxlength='2' name='input_63[]' id='input_29_63_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_29_63_1' class='gform-field-label gform-field-label--type-sub '>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_29_63_2_container'>\n                                            <input type='number' maxlength='2' name='input_63[]' id='input_29_63_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_29_63_2' class='gform-field-label gform-field-label--type-sub '>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_29_63_3_container'>\n                                            <input type='number' maxlength='4' name='input_63[]' id='input_29_63_3' value=''   aria-required='true'   placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                            <label for='input_29_63_3' class='gform-field-label gform-field-label--type-sub '>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_29_24\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full show-label 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_29_24'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_24' id='input_29_24' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Gender*<\/option><option value='' ><\/option><option value='Male' >Male<\/option><option value='Female' >Female<\/option><option value='Unknown' >I Choose Not To Disclose<\/option><\/select><\/div><\/div><div id=\"field_29_25\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full show-label 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_29_25'>Veteran<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_25' id='input_29_25' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Veteran*<\/option><option value='' ><\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_29_91\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full show-label 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_29_91'>Race \/ Ethnicity<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_91' id='input_29_91' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Race \/ Ethnicity*<\/option><option value='' ><\/option><option value='Caucasian' >Caucasian<\/option><option value='African American' >African American<\/option><option value='Native American\/Alaskan Native' >Native American\/Alaskan Native<\/option><option value='Hispanic\/Latino' >Hispanic\/Latino<\/option><option value='Asian' >Asian<\/option><option value='Pacific Islander\/Native Hawaiian' >Pacific Islander\/Native Hawaiian<\/option><option value='Middle Eastern' >Middle Eastern<\/option><option value='Multiple Races' >Multiple Races<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_29_11\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_44\" class=\"gfield gfield--type-select gfield--input-type-select show-label 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_29_44'>Disability Type<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_44' id='input_29_44' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Disability Type*<\/option><option value='' ><\/option><option value='Paraplegia' >Paraplegia<\/option><option value='Quadriplegia' >Quadriplegia<\/option><option value='Spinal Cord Injury' >Spinal Cord Injury<\/option><option value='Spinal Cord Disorder (TM\/GB\/Polio)' >Spinal Cord Disorder (TM\/GB\/Polio)<\/option><option value='Spina Bifida' >Spina Bifida<\/option><option value='Stroke' >Stroke<\/option><option value='Amputee' >Amputee<\/option><option value='Cerebral Palsy' >Cerebral Palsy<\/option><option value='Multiple Sclerosis' >Multiple Sclerosis<\/option><option value='Muscular Dystrophy' >Muscular Dystrophy<\/option><option value='TBI' >TBI<\/option><option value='Blind' >Blind<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_29_45\" class=\"gfield gfield--type-text gfield--input-type-text show-label 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_29_45'>Injury Level \/ Description<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_29_45' type='text' value='' class='large'    placeholder='Injury Level \/ Description*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_29_9\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield show-label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Date of Injury\/Diagnosis<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_29_9' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_29_9_1_container'>\n                                            <input type='number' maxlength='2' name='input_9[]' id='input_29_9_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_29_9_1' class='gform-field-label gform-field-label--type-sub '>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_29_9_2_container'>\n                                            <input type='number' maxlength='2' name='input_9[]' id='input_29_9_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_29_9_2' class='gform-field-label gform-field-label--type-sub '>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_29_9_3_container'>\n                                            <input type='number' maxlength='4' name='input_9[]' id='input_29_9_3' value=''   aria-required='true'   placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                            <label for='input_29_9_3' class='gform-field-label gform-field-label--type-sub '>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_29_47\" class=\"gfield gfield--type-select gfield--input-type-select show-label 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_29_47'>Cause of Injury<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_47' id='input_29_47' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Cause of Injury*<\/option><option value='' ><\/option><option value='Vehicular' >Vehicular<\/option><option value='Fall' >Fall<\/option><option value='Violence' >Violence<\/option><option value='Sports\/Recreation Activities' >Sports\/Recreation Activities<\/option><option value='Medical\/Surgical' >Medical\/Surgical<\/option><option value='Disease\/Disorder' >Disease\/Disorder<\/option><option value='Cancer' >Cancer<\/option><option value='Congenital' >Congenital<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_29_76\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full show-label 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_29_76'>Where did you attend Rehab?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_76' id='input_29_76' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Where did you attend Rehab?*<\/option><option value='' ><\/option><option value='Northridge' >Northridge<\/option><option value='Casa Colina' >Casa Colina<\/option><option value='Rancho' >Rancho<\/option><option value='Cal Rehab' >Cal Rehab<\/option><option value='Ballard' >Ballard<\/option><option value='Palmdale Regional' >Palmdale Regional<\/option><option value='St. Jude' >St. Jude<\/option><option value='Sharp' >Sharp<\/option><option value='Scripps' >Scripps<\/option><option value='Long Beach Memorial' >Long Beach Memorial<\/option><option value='Long Beach VA' >Long Beach VA<\/option><option value='Cottage Rehab' >Cottage Rehab<\/option><option value='St. Johns' >St. Johns<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_29_62\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full show-label field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_29_62'>If Rehab not listed above: Where?<\/label><div class='ginput_container ginput_container_text'><input name='input_62' id='input_29_62' type='text' value='' class='large'    placeholder='If Rehab not listed above: Where?'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_51\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><fieldset id=\"field_29_50\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox show-label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What areas are you willing to serve? (only check where you are able to visit regularly)<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_29_50'><div class='gchoice gchoice_29_50_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.1' type='checkbox'  value='Northridge (North LA)'  id='choice_29_50_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_1' id='label_29_50_1' class='gform-field-label gform-field-label--type-inline'>Northridge (North LA)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.2' type='checkbox'  value='Casa Colina (Pomona)'  id='choice_29_50_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_2' id='label_29_50_2' class='gform-field-label gform-field-label--type-inline'>Casa Colina (Pomona)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.3' type='checkbox'  value='Rancho (Downey)'  id='choice_29_50_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_3' id='label_29_50_3' class='gform-field-label gform-field-label--type-inline'>Rancho (Downey)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.4' type='checkbox'  value='Cal Rehab (South LA)'  id='choice_29_50_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_4' id='label_29_50_4' class='gform-field-label gform-field-label--type-inline'>Cal Rehab (South LA)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.5' type='checkbox'  value='Ballard (San Bernardino)'  id='choice_29_50_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_5' id='label_29_50_5' class='gform-field-label gform-field-label--type-inline'>Ballard (San Bernardino)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.6' type='checkbox'  value='St. Jude (Brea)'  id='choice_29_50_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_6' id='label_29_50_6' class='gform-field-label gform-field-label--type-inline'>St. Jude (Brea)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.7' type='checkbox'  value='Sharp (San Diego)'  id='choice_29_50_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_7' id='label_29_50_7' class='gform-field-label gform-field-label--type-inline'>Sharp (San Diego)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.8' type='checkbox'  value='Long Beach Memorial'  id='choice_29_50_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_8' id='label_29_50_8' class='gform-field-label gform-field-label--type-inline'>Long Beach Memorial<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.9' type='checkbox'  value='Long Beach VA'  id='choice_29_50_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_9' id='label_29_50_9' class='gform-field-label gform-field-label--type-inline'>Long Beach VA<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.11' type='checkbox'  value='Cottage Rehab (Santa Barbara)'  id='choice_29_50_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_11' id='label_29_50_11' class='gform-field-label gform-field-label--type-inline'>Cottage Rehab (Santa Barbara)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.12' type='checkbox'  value='Palmdale Regional'  id='choice_29_50_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_12' id='label_29_50_12' class='gform-field-label gform-field-label--type-inline'>Palmdale Regional<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_29_50_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_50.13' type='checkbox'  value='St. Johns (Oxnard)'  id='choice_29_50_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_29_50_13' id='label_29_50_13' class='gform-field-label gform-field-label--type-inline'>St. Johns (Oxnard)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_14\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_15\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full show-label 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_29_15'>Tell us about yourself<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_15' id='input_29_15' class='textarea medium'   maxlength='500' placeholder='Tell us about yourself*' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_29_65\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_64\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full show-label 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_29_64'>Why are you interested in being an Ambassador?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_64' id='input_29_64' class='textarea medium'   maxlength='500' placeholder='Why are you interested in being an Ambassador?*' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_29_85\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_84\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full show-label 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_29_84'>What aspects of being a peer mentor relate specifically to your talents or interests?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_84' id='input_29_84' class='textarea medium'   maxlength='500' placeholder='What aspects of being a peer mentor relate specifically to your talents or interests?*' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_29_86\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_87\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full show-label 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_29_87'>Share some of your successes since the onset of your SCI\/D<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_87' id='input_29_87' class='textarea medium'   maxlength='500' placeholder='Share some of your successes since the onset of your SCI\/D*' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_29_89\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><fieldset id=\"field_29_90\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full show-label gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >How would you rate your mental health?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_29_90'>\n\t\t\t<div class='gchoice gchoice_29_90_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='Poor'  id='choice_29_90_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_90_0' id='label_29_90_0' class='gform-field-label gform-field-label--type-inline'>Poor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_90_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='Moderate'  id='choice_29_90_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_90_1' id='label_29_90_1' class='gform-field-label gform-field-label--type-inline'>Moderate<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_90_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='Good'  id='choice_29_90_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_90_2' id='label_29_90_2' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_29_90_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='Excellent'  id='choice_29_90_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_29_90_3' id='label_29_90_3' class='gform-field-label gform-field-label--type-inline'>Excellent<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_29_66\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_111\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full show-label 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_29_111'>Do you have reliable transportation?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_111' id='input_29_111' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Do you have reliable transportation?<\/option><option value='' ><\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_29_110\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_92\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full show-label 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_29_92'>Do you currently attend a Triumph SCI support group?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_92' id='input_29_92' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Do you currently attend a Triumph SCI support group?*<\/option><option value='' ><\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_29_93\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full show-label 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_29_93'>If yes, which one?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_93' id='input_29_93' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>If yes, which one?*<\/option><option value='' ><\/option><option value='Casa Colina Spina Cord Injury Support Group' >Casa Colina Spina Cord Injury Support Group<\/option><option value='Cottage Rehab SCI Life Series Group' >Cottage Rehab SCI Life Series Group<\/option><option value='Inland Empire\/Ballard Rehab SCI Life Series Group' >Inland Empire\/Ballard Rehab SCI Life Series Group<\/option><option value='Northridge Hospital Spinal Cord Injury Group' >Northridge Hospital Spinal Cord Injury Group<\/option><option value='Oxnard SCI Life Series Group' >Oxnard SCI Life Series Group<\/option><option value='Palmdale\/Lancaster SCI Life Series Group' >Palmdale\/Lancaster SCI Life Series Group<\/option><option value='Palomar SCI Life Series Group' >Palomar SCI Life Series Group<\/option><option value='Santa Barbara North County SCI Life Series Group' >Santa Barbara North County SCI Life Series Group<\/option><option value='Scripps SCI Life Series Group' >Scripps SCI Life Series Group<\/option><option value='St. Jude SCI Life Series Group' >St. Jude SCI Life Series Group<\/option><option value='Take Control Orange County SCI Life Series Group' >Take Control Orange County SCI Life Series Group<\/option><option value='The Perfect Step SCI Life Series Group' >The Perfect Step SCI Life Series Group<\/option><option value='Women&#039;s SCI Life Series Group' >Women&#039;s SCI Life Series Group<\/option><option value='Inland Empire Women&#039;s Group' >Inland Empire Women&#039;s Group<\/option><option value='Virtual SCI Life Series Group' >Virtual SCI Life Series Group<\/option><\/select><\/div><\/div><div id=\"field_29_95\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_94\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full show-label 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_29_94'>Did you have a peer mentor?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_94' id='input_29_94' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Did you have a peer mentor?*<\/option><option value='' ><\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div><\/div><div id=\"field_29_98\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full show-label 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_29_98'>If yes, discuss the most rewarding and challenging aspect of your peer mentor experience?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_98' id='input_29_98' class='textarea large'   maxlength='500' placeholder='If yes, discuss the most rewarding and challenging aspect of your peer mentor experience?*' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_29_97\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full show-label 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_29_97'>If no, discuss what you wish someone could have shared with you to help improve your experience and recovery.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_97' id='input_29_97' class='textarea large'   maxlength='500' placeholder='If no, discuss what you wish someone could have shared with you to help improve your experience and recovery.*' aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_29_99\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_100\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full show-label 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_29_100'>How did you learn about Triumph?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_100' id='input_29_100' type='text' value='' class='large'    placeholder='How did you learn about Triumph?*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_29_101\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_102\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full show-label 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_29_102'>Upload a current full body picture of yourself<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1073741824' \/><input name='input_102' id='input_29_102' type='file' class='large' aria-describedby=\"gfield_upload_rules_29_102\" onchange='javascript:gformValidateFileSize( this, 1073741824 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_29_102'>Max. file size: 1 GB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_29_102'><\/div> <\/div><\/div><div id=\"field_29_104\" class=\"gfield gfield--type-html gfield--input-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\"  ><div style=\"width:100%; height:30px\" ><\/div><\/div><div id=\"field_29_59\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_29_59'>Hidden: Form Date<\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_59' id='input_29_59' type='text' value='08\/11\/2026' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_29_59_date_format\" aria-invalid=\"false\" \/>\n                            <span id='input_29_59_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_29_59' class='gform_hidden' value='https:\/\/triumph-foundation.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_29_81\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_29_81'>Hidden: 01. Has a Disability?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_81' id='input_29_81' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' selected='selected'>Yes<\/option><\/select><\/div><\/div><div id=\"field_29_109\" class=\"gfield gfield--type-turnstile gfield--input-type-turnstile gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_turnstile'><div class=\"cf-turnstile\" id=\"cf-turnstile_29\" data-js-turnstile data-response-field-name=\"cf-turnstile-response_29\" data-theme=\"auto\" data-size=\"\" data-sitekey=\"0x4AAAAAAAY83axIfvtpRenB\"><\/div><\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_29' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_29' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_29' id='gform_theme_29' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_29' id='gform_style_settings_29' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_29' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='29' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='hzr3CgkPMFz4W309CcZEOD31ZHcbx2Gz7fabfs01C4n3+Lzxw6EVz9HpGCIPw5LLC2asSA8X9cDNFsr8eZbhyCI+jLQGRilu5lxdlMtrYCj47Ps=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_29' value='WyJ7XCI5MFwiOltcIjdiNWRiY2U2NTMyN2MyYjRjZTVhMmI0MmE0ZGJkZmJhXCIsXCJlN2M4MDlkNzhhMjEyOGQ0ZWVkYjJiYmZkNDlkYmQyOVwiLFwiZDc5NDJiYTA2OTRjNjIyMWI5ZDA5YTIwMTRkYjY3N2FcIixcImU2M2E1MzY5YjEyNDFkY2Y0MTA3YTEyZTQxODlhNDNkXCJdfSIsIjNlZjI5YjgzZTQxYjNjNjcyOGFjNGY1MjQzMzgxMDJmIl0=' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_29' id='gform_target_page_number_29' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_29' id='gform_source_page_number_29' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><script>\ngform.initializeOnLoaded( function() {gformInitSpinner( 29, 'https:\/\/triumph-foundation.org\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', false );jQuery('#gform_ajax_frame_29').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_29');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_29').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! 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Triumph Ambassadors serve as community leaders and empower individuals with a paralyzing injury, illness, or disorder to [...]","protected":false},"author":888,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","meta":{"_acf_changed":false,"footnotes":"","_members_access_role":[],"_members_access_error":""},"class_list":["post-8043","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/triumph-foundation.org\/es\/wp-json\/wp\/v2\/pages\/8043","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/triumph-foundation.org\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/triumph-foundation.org\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/triumph-foundation.org\/es\/wp-json\/wp\/v2\/users\/888"}],"replies":[{"embeddable":true,"href":"https:\/\/triumph-foundation.org\/es\/wp-json\/wp\/v2\/comments?post=8043"}],"version-history":[{"count":1,"href":"https:\/\/triumph-foundation.org\/es\/wp-json\/wp\/v2\/pages\/8043\/revisions"}],"predecessor-version":[{"id":8104,"href":"https:\/\/triumph-foundation.org\/es\/wp-json\/wp\/v2\/pages\/8043\/revisions\/8104"}],"wp:attachment":[{"href":"https:\/\/triumph-foundation.org\/es\/wp-json\/wp\/v2\/media?parent=8043"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}