{"id":131485,"date":"2026-05-13T09:47:51","date_gmt":"2026-05-13T14:47:51","guid":{"rendered":"https:\/\/www.erdheim-chester.org\/?page_id=131485"},"modified":"2026-05-13T10:10:35","modified_gmt":"2026-05-13T15:10:35","slug":"formular-fur-pflegepersonen-testversion","status":"publish","type":"page","link":"https:\/\/www.erdheim-chester.org\/de\/test-caregiver-form\/","title":{"rendered":"Formular f\u00fcr Pflegepersonen (Testversion)"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; custom_padding_last_edited=&#8221;off|phone&#8221; _builder_version=&#8221;4.27.6&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_slider _builder_version=&#8221;4.27.6&#8243; _module_preset=&#8221;default&#8221; header_level=&#8221;h1&#8243; header_font=&#8221;Montserrat|700|||||||&#8221; header_font_size=&#8221;48px&#8221; body_font=&#8221;Open Sans|500|||||||&#8221; body_font_size=&#8221;20px&#8221; 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heading_tablet=&#8221;@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9tZXRhX2tleSIsInNldHRpbmdzIjp7ImJlZm9yZSI6IlRvZ2V0aGVyIFdlIEFyZSAiLCJhZnRlciI6Ijxicj5TdHJvbmchIiwibWV0YV9rZXkiOiIiLCJlbmFibGVfaHRtbCI6Im9mZiJ9fQ==@&#8221; heading_phone=&#8221;Together We Are Strong!&#8221; heading_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.27.6&#8243; _dynamic_attributes=&#8221;heading&#8221; _module_preset=&#8221;default&#8221; header_level=&#8221;h1&#8243; header_font=&#8221;||||||||&#8221; header_text_align=&#8221;left&#8221; body_font=&#8221;||||||||&#8221; body_text_align=&#8221;left&#8221; background_enable_color=&#8221;off&#8221; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_direction=&#8221;90deg&#8221; background_color_gradient_stops=&#8221;rgba(0,0,0,0.8) 0%|rgba(0,0,0,0) 100%&#8221; background_image=&#8221;https:\/\/www.erdheim-chester.org\/wp-content\/uploads\/2026\/04\/hero-community-Dx9f00_s.jpg&#8221; background_enable_image=&#8221;on&#8221; background_blend=&#8221;multiply&#8221; custom_button=&#8221;on&#8221; button_text_size=&#8221;16px&#8221; button_text_color=&#8221;#FFFFFF&#8221; button_bg_color=&#8221;#35A4BB&#8221; button_border_radius=&#8221;3px&#8221; button_font=&#8221;Montserrat|600||on|||||&#8221; button_alignment=&#8221;left&#8221; button_custom_padding=&#8221;10px||10px||false|false&#8221; button_text_size_tablet=&#8221;16px&#8221; button_text_size_phone=&#8221;14px&#8221; button_text_size_last_edited=&#8221;on|phone&#8221; custom_css_slide_button=&#8221;width: 180px;||text-align: center;&#8221; global_colors_info=&#8221;{}&#8221; sticky_transition=&#8221;on&#8221;]<\/p>\n<p>ECD Global Alliance &#8211; Providing Support!<\/p>\n<p>[\/et_pb_slide][et_pb_slide heading=&#8221;@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9tZXRhX2tleSIsInNldHRpbmdzIjp7ImJlZm9yZSI6IllvdXIgU3VwcG9ydCBCcmluZ3MiLCJhZnRlciI6Ijxicj5Ib3BlISIsIm1ldGFfa2V5IjoiIiwiZW5hYmxlX2h0bWwiOiJvZmYifX0=@&#8221; button_text=&#8221;Donate&#8221; button_link=&#8221;https:\/\/secure.qgiv.com\/for\/erdheim-chesterdiseaseglobalalliance&#8221; url_new_window=&#8221;on&#8221; heading_tablet=&#8221;@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9tZXRhX2tleSIsInNldHRpbmdzIjp7ImJlZm9yZSI6IllvdXIgU3VwcG9ydCBCcmluZ3MiLCJhZnRlciI6Ijxicj5Ib3BlISIsIm1ldGFfa2V5IjoiIiwiZW5hYmxlX2h0bWwiOiJvZmYifX0=@&#8221; heading_phone=&#8221;Your Support Brings Hope!&#8221; heading_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.27.6&#8243; _dynamic_attributes=&#8221;heading&#8221; _module_preset=&#8221;default&#8221; header_level=&#8221;h1&#8243; header_font=&#8221;||||||||&#8221; header_text_align=&#8221;left&#8221; body_font=&#8221;||||||||&#8221; body_text_align=&#8221;left&#8221; background_enable_color=&#8221;off&#8221; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_direction=&#8221;90deg&#8221; background_color_gradient_stops=&#8221;rgba(0,0,0,0.8) 0%|rgba(0,0,0,0) 100%&#8221; background_image=&#8221;https:\/\/www.erdheim-chester.org\/wp-content\/uploads\/2026\/04\/hero-hope-cB1IQBRl.jpg&#8221; background_enable_image=&#8221;on&#8221; background_blend=&#8221;multiply&#8221; custom_button=&#8221;on&#8221; button_text_size=&#8221;16px&#8221; button_text_color=&#8221;#FFFFFF&#8221; button_bg_color=&#8221;#35A4BB&#8221; button_border_radius=&#8221;3px&#8221; button_font=&#8221;Montserrat|600||on|||||&#8221; button_alignment=&#8221;left&#8221; button_custom_padding=&#8221;10px||10px||false|false&#8221; button_text_size_tablet=&#8221;16px&#8221; button_text_size_phone=&#8221;14px&#8221; button_text_size_last_edited=&#8221;on|phone&#8221; custom_css_slide_button=&#8221;width: 130px;||text-align: center;&#8221; global_colors_info=&#8221;{}&#8221; sticky_transition=&#8221;on&#8221;]<\/p>\n<p>Make a difference!<\/p>\n<p>[\/et_pb_slide][et_pb_slide heading=&#8221;Care is Available&#8221; button_text=&#8221;Find a Care Center&#8221; button_link=&#8221;https:\/\/www.erdheim-chester.org\/care-centers\/&#8221; _builder_version=&#8221;4.27.6&#8243; _module_preset=&#8221;default&#8221; header_level=&#8221;h1&#8243; header_font=&#8221;||||||||&#8221; header_text_align=&#8221;left&#8221; body_font=&#8221;||||||||&#8221; body_text_align=&#8221;left&#8221; background_enable_color=&#8221;off&#8221; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_direction=&#8221;90deg&#8221; background_color_gradient_stops=&#8221;rgba(0,0,0,0.8) 0%|rgba(0,0,0,0) 100%&#8221; background_image=&#8221;https:\/\/www.erdheim-chester.org\/wp-content\/uploads\/2026\/04\/hero-doctor-DFwLcJZW.jpg&#8221; background_enable_image=&#8221;on&#8221; background_blend=&#8221;multiply&#8221; custom_button=&#8221;on&#8221; button_text_size=&#8221;16px&#8221; button_text_color=&#8221;#FFFFFF&#8221; button_bg_color=&#8221;#35A4BB&#8221; button_border_radius=&#8221;3px&#8221; button_font=&#8221;Montserrat|600||on|||||&#8221; button_alignment=&#8221;left&#8221; button_custom_padding=&#8221;10px||10px||false|false&#8221; button_text_size_tablet=&#8221;16px&#8221; button_text_size_phone=&#8221;14px&#8221; button_text_size_last_edited=&#8221;on|phone&#8221; custom_css_slide_button=&#8221;width: 240px;||text-align: center;&#8221; global_colors_info=&#8221;{}&#8221; sticky_transition=&#8221;on&#8221;]<\/p>\n<p>Learn about Care Centers<\/p>\n<p>[\/et_pb_slide][\/et_pb_fullwidth_slider][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.27.6&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.27.6&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column 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[et_pb_line_break_holder] -->'    <div class=\"section contact\">' + <!-- [et_pb_line_break_holder] -->'      <h3>Contact Information<\/h3>' + <!-- [et_pb_line_break_holder] -->'      <div class=\"field text first-name required\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"first-name\"><span class=\"label\">First Name<\/span><span class=\"required-star\">*<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"first-name\" name=\"first-name\" class=\"required\" type=\"text\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field text last-name required\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"last-name\"><span class=\"label\">Last Name<\/span><span class=\"required-star\">*<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"last-name\" name=\"last-name\" class=\"required\" type=\"text\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field email email-address required\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"email-address\"><span class=\"label\">Email<\/span><span class=\"required-star\">*<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"email-address\" name=\"email-address\" class=\"email required\" type=\"email\" placeholder=\"someone@website.com\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field tel phone-number\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"phone-number\"><span class=\"label\">Phone<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"phone-number\" name=\"phone-number\" class=\"phoneUS\" type=\"tel\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'    <div class=\"section address\">' + <!-- [et_pb_line_break_holder] -->'      <h3>Address<\/h3>' + <!-- [et_pb_line_break_holder] -->'      <div class=\"field  country\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"country\">Country<\/label>' + <!-- [et_pb_line_break_holder] -->'<select id=\"country\" name=\"country\"><option value=\"\"><\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AF\">Afghanistan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AX\">Aland Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AL\">Albania<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"DZ\">Algeria<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AS\">American Samoa<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AD\">Andorra<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AO\">Angola<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AI\">Anguilla<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AQ\">Antarctica<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AG\">Antigua and Barbuda<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AR\">Argentina<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AM\">Armenia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AW\">Aruba<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AU\">Australia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AT\">Austria<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AZ\">Azerbaijan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BS\">Bahamas<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BH\">Bahrain<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BD\">Bangladesh<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BB\">Barbados<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BY\">Belarus<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BE\">Belgium<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BZ\">Belize<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BJ\">Benin<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BM\">Bermuda<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BT\">Bhutan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BO\">Bolivia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BA\">Bosnia and Herzegovina<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BW\">Botswana<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BV\">Bouvet Island<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BR\">Brazil<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IO\">British Indian Ocean Territory<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BN\">Brunei Darussalam<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BG\">Bulgaria<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BF\">Burkina Faso<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BI\">Burundi<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KH\">Cambodia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CM\">Cameroon<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CA\">Canada<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CV\">Cape Verde<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KY\">Cayman Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CF\">Central African Republic<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TD\">Chad<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CL\">Chile<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CN\">China<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CX\">Christmas Island<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CC\">Cocos (Keeling) Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CO\">Colombia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KM\">Comoros<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CG\">Congo<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CD\">Democratic Republic of the Congo<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CK\">Cook Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CR\">Costa Rica<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CI\">Cote d\\'Ivoire<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"HR\">Croatia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CU\">Cuba<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CW\">Curacao<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CY\">Cyprus<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CZ\">Czech Republic<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"DK\">Denmark<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"DJ\">Djibouti<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"DM\">Dominica<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"DO\">Dominican Republic<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"EC\">Ecuador<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"EG\">Egypt<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SV\">El Salvador<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GQ\">Equatorial Guinea<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ER\">Eritrea<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"EE\">Estonia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SZ\">Eswatini<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ET\">Ethiopia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"FK\">Falkland Islands (Malvinas)<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"FO\">Faroe Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"FJ\">Fiji<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"FI\">Finland<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"FR\">France<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GF\">French Guiana<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PF\">French Polynesia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TF\">French Southern Territories<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GA\">Gabon<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GM\">Gambia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GE\">Georgia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"DE\">Germany<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GH\">Ghana<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GI\">Gibraltar<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GR\">Greece<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GL\">Greenland<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GD\">Grenada<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GP\">Guadeloupe<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GU\">Guam<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GT\">Guatemala<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GG\">Guernsey<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GN\">Guinea<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GW\">Guinea-Bissau<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GY\">Guyana<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"HT\">Haiti<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"HM\">Heard Island<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"HN\">Honduras<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"HK\">Hong Kong<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"HU\">Hungary<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IS\">Iceland<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IN\">India<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ID\">Indonesia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IR\">Islamic Republic of Iran<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IQ\">Iraq<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IE\">Ireland<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IM\">Isle of Man<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IL\">Israel<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IT\">Italy<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"JM\">Jamaica<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"JP\">Japan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"JE\">Jersey<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"JO\">Jordan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KZ\">Kazakhstan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KE\">Kenya<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KI\">Kiribati<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KP\">Democratic People\\'s Republic of Korea<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KR\">Republic of Korea<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KW\">Kuwait<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KG\">Kyrgyzstan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LA\">Lao People\\'s Democratic Republic<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LV\">Latvia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LB\">Lebanon<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LS\">Lesotho<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LR\">Liberia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LY\">Libya<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LI\">Liechtenstein<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LT\">Lithuania<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LU\">Luxembourg<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MO\">Macao<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MK\">Macedonia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MG\">Madagascar<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MW\">Malawi<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MY\">Malaysia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MV\">Maldives<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ML\">Mali<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MT\">Malta<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MH\">Marshall Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MQ\">Martinique<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MR\">Mauritania<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MU\">Mauritius<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"YT\">Mayotte<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MX\">Mexico<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"FM\">Federated States of Micronesia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MD\">Republic of Moldova<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MC\">Monaco<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MN\">Mongolia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ME\">Montenegro<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MS\">Montserrat<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MA\">Morocco<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MZ\">Mozambique<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MM\">Myanmar<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NA\">Namibia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NR\">Nauru<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NP\">Nepal<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NL\">Netherlands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NC\">New Caledonia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NZ\">New Zealand<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NI\">Nicaragua<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NE\">Niger<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NG\">Nigeria<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NU\">Niue<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NF\">Norfolk Island<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MP\">Northern Mariana Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NO\">Norway<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"OM\">Oman<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PK\">Pakistan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PW\">Palau<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PS\">State of Palestine<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PA\">Panama<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PG\">Papua New Guinea<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PY\">Paraguay<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PE\">Peru<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PH\">Philippines<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PN\">Pitcairn<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PL\">Poland<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PT\">Portugal<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PR\">Puerto Rico<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"QA\">Qatar<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"RE\">Reunion<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"RO\">Romania<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"RU\">Russian Federation<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"RW\">Rwanda<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BL\">Saint Barthelemy<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SH\">Ascension and Tristan da Cunha Saint Helena<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KN\">Saint Kitts and Nevis<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LC\">Saint Lucia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MF\">Saint Martin (French part)<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PM\">Saint Pierre and Miquelon<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"VC\">Saint Vincent and the Grenadines<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"WS\">Samoa<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SM\">San Marino<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ST\">Sao Tome and Principe<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SA\">Saudi Arabia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SN\">Senegal<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"RS\">Serbia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SC\">Seychelles<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SL\">Sierra Leone<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SG\">Singapore<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SX\">Sint Maarten (Dutch part)<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SK\">Slovakia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SI\">Slovenia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SB\">Solomon Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SO\">Somalia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ZA\">South Africa<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GS\">South Georgia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SS\">South Sudan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ES\">Spain<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LK\">Sri Lanka<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SD\">Sudan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SR\">Suriname<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SJ\">Svalbard and Jan Mayen<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SE\">Sweden<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CH\">Switzerland<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SY\">Syrian Arab Republic<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TW\">Taiwan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TJ\">Tajikistan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TZ\">United Republic of Tanzania<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TH\">Thailand<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TL\">Timor-Leste<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TG\">Togo<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TK\">Tokelau<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TO\">Tonga<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TT\">Trinidad and Tobago<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TN\">Tunisia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TR\">Turkey<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TM\">Turkmenistan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TC\">Turks and Caicos Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TV\">Tuvalu<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"UG\">Uganda<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"UA\">Ukraine<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AE\">United Arab Emirates<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GB\">United Kingdom<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"US\" selected>United States<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"UM\">United States Minor Outlying Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"UY\">Uruguay<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"UZ\">Uzbekistan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"VU\">Vanuatu<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"VA\">Vatican City<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"VE\">Venezuela<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"VN\">Viet Nam<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"VG\">British Virgin Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"VI\">U.S. Virgin Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"WF\">Wallis and Futuna<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"EH\">Western Sahara<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"YE\">Yemen<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ZM\">Zambia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ZW\">Zimbabwe<\/option>' + <!-- [et_pb_line_break_holder] -->'<\/select>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field  street-address\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"street-address\"><span class=\"label\">Address<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<textarea id=\"street-address\" name=\"street-address\"><\/textarea>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field text city\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"city\"><span class=\"label\">City<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"city\" name=\"city\" type=\"text\" data-us-label=\"City\" data-bm-label=\"Parish\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field  state\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"state\">State<\/label>' + <!-- [et_pb_line_break_holder] -->'<select id=\"state\" name=\"state\"><option value=\"\"><\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AL\">Alabama<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AK\">Alaska<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AS\">American Samoa<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AZ\">Arizona<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AR\">Arkansas<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AE\">Armed Forces Africa, Canada, Europe, Middle East<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AA\">Armed Forces Americas (except Canada)<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AP\">Armed Forces Pacific<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CA\">California<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CO\">Colorado<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"CT\">Connecticut<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"DE\">Delaware<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"DC\">District of Columbia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"FL\">Florida<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GA\">Georgia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"GU\">Guam<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"HI\">Hawaii<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ID\">Idaho<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IL\">Illinois<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IN\">Indiana<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"IA\">Iowa<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KS\">Kansas<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"KY\">Kentucky<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"LA\">Louisiana<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ME\">Maine<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MD\">Maryland<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MA\">Massachusetts<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MI\">Michigan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MN\">Minnesota<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MS\">Mississippi<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MO\">Missouri<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MT\">Montana<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NE\">Nebraska<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NV\">Nevada<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NH\">New Hampshire<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NJ\">New Jersey<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NM\">New Mexico<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NY\">New York<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NC\">North Carolina<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ND\">North Dakota<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"OH\">Ohio<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"OK\">Oklahoma<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"OR\">Oregon<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PA\">Pennsylvania<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PR\">Puerto Rico<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"RI\">Rhode Island<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SC\">South Carolina<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SD\">South Dakota<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TN\">Tennessee<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"TX\">Texas<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"VI\">US Virgin Islands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"UT\">Utah<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"VT\">Vermont<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"VA\">Virginia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"WA\">Washington<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"WV\">West Virginia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"WI\">Wisconsin<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"WY\">Wyoming<\/option>' + <!-- [et_pb_line_break_holder] -->'<\/select>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field  province\" style=\"display: none\">' + <!-- [et_pb_line_break_holder] -->'<label for=\"province\">Province<\/label>' + <!-- [et_pb_line_break_holder] -->'<select id=\"province\" name=\"province\"><option value=\"\"><\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"AB\">Alberta<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"BC\">British Columbia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"MB\">Manitoba<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NB\">New Brunswick<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NL\">Newfoundland and Labrador<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NT\">Northwest Territories<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NS\">Nova Scotia<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"NU\">Nunavut<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"ON\">Ontario<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"PE\">Prince Edward Island<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"QC\">Quebec<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"SK\">Saskatchewan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"YT\">Yukon Territory<\/option>' + <!-- [et_pb_line_break_holder] -->'<\/select>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field number zip-code\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"zip-code\"><span class=\"label\">ZIP Code<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"zip-code\" name=\"zip-code\" class=\"zipcodeUS\" type=\"number\" minlength=\"5\" maxlength=\"10\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field text postal-code\" style=\"display: none\">' + <!-- [et_pb_line_break_holder] -->'<label for=\"postal-code\"><span class=\"label\">Postal Code<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"postal-code\" name=\"postal-code\" type=\"text\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'    <div class=\"section custom-fields\">' + <!-- [et_pb_line_break_holder] -->'      <h3>Additional Information<\/h3>' + <!-- [et_pb_line_break_holder] -->'      <div class=\"field text CustomAccountField_34824 required\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"CustomAccountField_34824\">Individual Type<span class=\"required-star\">*<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<select id=\"CustomAccountField_34824\" name=\"CustomAccountField_34824\" class=\"required\"><option value=\"\"><\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"149910529\">Advocacy<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36177\">Caregiver<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36178\">Family<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36179\">Friend<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"20322305\">LCH Patient<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"19074055\">Media<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36180\">Medical Professional<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36181\">Other<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36182\">Patient<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"415894529\">Patient-Possible Bogus<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"19030021\">Pharma<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"20323329\">RDD Patient<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36183\">Searching For Diagnosis<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"176584705\">Staff<\/option>' + <!-- [et_pb_line_break_holder] -->'<\/select>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field text CustomAccountField_34830\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"CustomAccountField_34830\"><span class=\"label\">Birthdate<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"CustomAccountField_34830\" name=\"CustomAccountField_34830\" type=\"text\" maxlength=\"255\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field text CustomAccountField_34820\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"CustomAccountField_34820\">Preferred Language<\/label>' + <!-- [et_pb_line_break_holder] -->'<select id=\"CustomAccountField_34820\" name=\"CustomAccountField_34820\"><option value=\"\"><\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31835137\">Afrikaans<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31836161\">Albanian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36069\">Arabic<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31837185\">Armenian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31838209\">Basque<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36070\">Bengali<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"20383745\">Bulgarian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31840257\">Cambodian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31839233\">Catalan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36071\">Chinese<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31841281\">Chinese (Mandarin)<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31842305\">Croatian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31843329\">Czech<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31844353\">Danish<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36074\">Dutch<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36081\">English<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31845377\">Estonian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31846401\">Fiji<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31847425\">Finnish<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36111\">French<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31848449\">Georgian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36115\">German<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36116\">Greek<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31849473\">Gujarati<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36117\">Hebrew<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36118\">Hindi<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36120\">Hungarian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31850497\">Icelandic<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31851521\">Indonesian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31852545\">Irish<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36122\">Italian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36129\">Japanese<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31853569\">Javanese<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36130\">Korean<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31854593\">Latin<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31855617\">Latvian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31856641\">Lithuanian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31857665\">Macedonian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31858689\">Malay<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31859713\">Malayalam<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31860737\">Maltese<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36131\">Mandarin<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31861761\">Maori<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31862785\">Marathi<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31863809\">Mongolian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36132\">Nederlands<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36133\">Nepali<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36134\">Norwegian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36135\">Persian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36136\">Polish<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36137\">Polish\/English<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36140\">Portugues - Brazil<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36143\">Portuguese<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31864833\">Punjabi<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31865857\">Quechua<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36144\">Romanian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36145\">Russian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31866881\">Samoan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31867905\">Serbian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31868929\">Slovak<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31869953\">Slovenian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36148\">Spanish<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31870977\">Swahili<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36153\">Swedish<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36154\">Tagalog<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31872001\">Tamil<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31873025\">Tatar<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31874049\">Telugu<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31875073\">Thai<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31876097\">Tibetan<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31877121\">Tonga<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36157\">Turkey<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36158\">Turkish<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31878145\">Ukrainian<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"36159\">Unknown<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31879169\">Urdu<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31880193\">Uzbek<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31881217\">Vietnamese<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31882241\">Welsh<\/option>' + <!-- [et_pb_line_break_holder] -->'<option value=\"31883265\">Xhosa<\/option>' + <!-- [et_pb_line_break_holder] -->'<\/select>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field text CustomAccountField_34831\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"CustomAccountField_34831\">Languages Spoken<\/label>' + <!-- [et_pb_line_break_holder] -->'<div id=\"CustomAccountField_34831\" class=\"checkboxes\"><a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31791105\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31791105\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Afrikaans<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31792129\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31792129\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Albanian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36195\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36195\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Arabic<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31793153\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31793153\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Armenian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31794177\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31794177\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Basque<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36196\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36196\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Bengali<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"20382721\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"20382721\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Bulgarian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31796225\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31796225\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Cambodian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31795201\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31795201\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Catalan<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36197\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36197\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Chinese<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31797249\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31797249\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Chinese (Mandarin)<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36198\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36198\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Croatian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36199\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36199\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Czech<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31798273\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31798273\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Danish<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36202\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36202\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Dutch<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36209\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36209\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">English<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31799297\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31799297\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Estonian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31800321\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31800321\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Fiji<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31801345\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31801345\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Finnish<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36241\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36241\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">French<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31802369\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31802369\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Georgian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36245\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36245\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">German<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36246\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36246\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Greek<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31803393\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31803393\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Gujarati<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36247\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36247\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Hebrew<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36248\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36248\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Hindi<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36250\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36250\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Hungarian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31804417\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31804417\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Icelandic<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31805441\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31805441\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Indonesian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31806465\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31806465\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Irish<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36252\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36252\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Italian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36259\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36259\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Japanese<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31807489\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31807489\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Javanese<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36260\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36260\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Korean<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31808513\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31808513\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Latin<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31809537\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31809537\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Latvian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31810561\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31810561\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Lithuanian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31811585\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31811585\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Macedonian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36261\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36261\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Malay<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31812609\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31812609\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Malayalam<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31813633\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31813633\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Maltese<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36262\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36262\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Mandarin<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31814657\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31814657\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Maori<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31815681\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31815681\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Marathi<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31816705\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31816705\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Mongolian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36264\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36264\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Nepali<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36265\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36265\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Norwegian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36266\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36266\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Persian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36267\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36267\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Polish<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36274\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36274\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Portuguese<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31817729\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31817729\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Punjabi<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31818753\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31818753\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Quechua<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36277\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36277\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Romanian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36278\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36278\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Russian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31819777\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31819777\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Samoan<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31820801\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31820801\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Serbian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31821825\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31821825\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Slovak<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31822849\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31822849\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Slovenian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36281\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36281\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Spanish<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31823873\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31823873\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Swahili<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36286\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36286\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Swedish<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36287\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36287\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Tagalog<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31772673\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31772673\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Tamil<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31824897\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31824897\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Tatar<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31825921\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31825921\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Telugu<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36288\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36288\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Thai<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31826945\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31826945\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Tibetan<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31827969\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31827969\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Tonga<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36292\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36292\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Turkish<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31828993\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31828993\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Ukrainian<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"36293\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"36293\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Unknown<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31830017\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31830017\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Urdu<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31831041\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31831041\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Uzbek<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31832065\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31832065\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Vietnamese<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31833089\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31833089\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Welsh<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<a href=\"javascript:void(0)\" class=\"checkbox\" data-id=\"31834113\" onclick=\"var box = jQuery(this).children(\\'input\\'); box.prop(\\'checked\\', !box.prop(\\'checked\\'));jQuery(box).trigger(\\'change\\'); return false;\">' + <!-- [et_pb_line_break_holder] -->'                                <input type=\"checkbox\" value=\"31834113\" onchange=\"jQuery(this).closest(\\'.checkbox\\').toggleClass(\\'selected\\')\">' + <!-- [et_pb_line_break_holder] -->'                                <span class=\"text\">Xhosa<\/span>' + <!-- [et_pb_line_break_holder] -->'                              <\/a>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field date CustomAccountField_34827 required\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"CustomAccountField_34827\"><span class=\"label\">Registered<\/span><span class=\"required-star\">*<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"CustomAccountField_34827\" name=\"CustomAccountField_34827\" class=\"validDate required\" type=\"date\" maxlength=\"255\" placeholder=\"mm\/dd\/yyyy\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field text CustomAccountField_5118979\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"CustomAccountField_5118979\"><span class=\"label\">Please tell us how we can best help you<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"CustomAccountField_5118979\" name=\"CustomAccountField_5118979\" type=\"text\" maxlength=\"255\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field text CustomAccountField_14673920\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"CustomAccountField_14673920\"><span class=\"label\">Name of the ECD Patient you care for?<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"CustomAccountField_14673920\" name=\"CustomAccountField_14673920\" type=\"text\" maxlength=\"255\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field text CustomAccountField_14674944\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"CustomAccountField_14674944\"><span class=\"label\">Your Relationship to patient<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"CustomAccountField_14674944\" name=\"CustomAccountField_14674944\" type=\"text\" maxlength=\"255\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field date CustomAccountField_5118980\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"CustomAccountField_5118980\"><span class=\"label\">Patient\\'s Birthdate<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<input id=\"CustomAccountField_5118980\" name=\"CustomAccountField_5118980\" class=\"validDate\" type=\"date\" maxlength=\"255\" placeholder=\"mm\/dd\/yyyy\"><\/input>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'    <div class=\"section comment\">' + <!-- [et_pb_line_break_holder] -->'      <div class=\"field text comment\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"comment\"><span class=\"label\">Comments<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<textarea id=\"comment\" name=\"comment\" type=\"text\" value=\"Comments\"><\/textarea>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'    <div class=\"section consent hidden\">' + <!-- [et_pb_line_break_holder] -->'      <div class=\"field checkbox consent-all\" >' + <!-- [et_pb_line_break_holder] -->'<label for=\"consent-all\"><input id=\"consent-all\" name=\"consent-all\" type=\"checkbox\" maxlength=\"255\"><\/input><span class=\"label\">I would like to receive or continue receiving updates from ECD Global Alliance<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field checkbox consent-email\" style=\"display: none\">' + <!-- [et_pb_line_break_holder] -->'<label for=\"consent-email\"><input id=\"consent-email\" name=\"consent-email\" type=\"checkbox\" checked=\"checked\" maxlength=\"255\"><\/input><span class=\"label\">by email<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field checkbox consent-mail\" style=\"display: none\">' + <!-- [et_pb_line_break_holder] -->'<label for=\"consent-mail\"><input id=\"consent-mail\" name=\"consent-mail\" type=\"checkbox\" checked=\"checked\" maxlength=\"255\"><\/input><span class=\"label\">by postal mail<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'<div class=\"field checkbox consent-phone\" style=\"display: none\">' + <!-- [et_pb_line_break_holder] -->'<label for=\"consent-phone\"><input id=\"consent-phone\" name=\"consent-phone\" type=\"checkbox\" checked=\"checked\" maxlength=\"255\"><\/input><span class=\"label\">by phone<\/span><\/label>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'    <div class=\"section captcha\">' + <!-- [et_pb_line_break_holder] -->'      <label id=\\'noCaptchaResponseError\\' class=\\'error noCaptchaResponseError\\' style=\\'display: none\\'>You must fill out the CAPTCHA<\/label><div id=\"captcha14669824\"><\/div>' + <!-- [et_pb_line_break_holder] -->'' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'    <div class=\"btn-group\">' + <!-- [et_pb_line_break_holder] -->'      <input class=\"btn btn-submit btn-submit-interaction\" type=\"submit\" value=\"Submit\"\/>' + <!-- [et_pb_line_break_holder] -->'    <\/div>' + <!-- [et_pb_line_break_holder] -->'  <\/form>' + <!-- [et_pb_line_break_holder] -->'<\/div>' + <!-- [et_pb_line_break_holder] -->'' + <!-- [et_pb_line_break_holder] -->'' +  '';var successHtml14669824 = '<div class=\\'donation-success\\'>' +<!-- [et_pb_line_break_holder] -->                                                       '  <h2>Caregiver Join Form<\/h2>' +<!-- [et_pb_line_break_holder] -->                                                       '  <pee>Thank you for registering with the ECD Global Alliance (ECDGA).  Our membership is a community of people dedicated to helping those affected by Erdheim-Chester Disease and other adult histiocytic disorders.\\r\\u003cbr \/\\u003e\\r\\u003cbr \/\\u003ePlease reach out if you or your patient have a specific need we can help with.  We offer many resources and will work to help you find the resources you need.\\r\\u003cbr \/\\u003e\\r\\u003cbr \/\\u003eIf you have any questions, feel free to contact us at support@erdheim-chester.org\\r\\u003cbr \/\\u003e\\r\\u003cbr \/\\u003eThe ECDGA Team\\r\\u003cbr \/\\u003e\\r\\u003cbr \/\\u003eIf you do not receive a detailed welcome email from our team in the next five days, please email us.  There may have been technical difficulties with your form.<\/pee>' + <!-- [et_pb_line_break_holder] -->                                                        '   ' + <!-- [et_pb_line_break_holder] -->                                                        '<\/div>';( function($) {if (!Bloomerang.useInteractionId('14669824')) {<!-- [et_pb_line_break_holder] -->                                    html14669824 = '<pee style=\"color: red\">Only one Volunteer Activity or Constituent Information form can be used on each page.<\/pee>';<!-- [et_pb_line_break_holder] -->                                }<!-- [et_pb_line_break_holder] -->                                Bloomerang.Util.requireStripe();if (jQuery('#bloomerangForm14669824').length) {<!-- [et_pb_line_break_holder] -->                        <!-- [et_pb_line_break_holder] -->                        jQuery('#bloomerangForm14669824').after(html14669824);<!-- [et_pb_line_break_holder] -->                        <!-- [et_pb_line_break_holder] -->                        <!-- [et_pb_line_break_holder] -->                        <!-- [et_pb_line_break_holder] -->                        <!-- [et_pb_line_break_holder] -->                        <!-- [et_pb_line_break_holder] -->                    };<!-- [et_pb_line_break_holder] -->                    if (Bloomerang.interactionFormLoaded) {<!-- [et_pb_line_break_holder] -->                                            return false;<!-- [et_pb_line_break_holder] -->                                        }<!-- [et_pb_line_break_holder] -->                                        Bloomerang.interactionFormLoaded = true;<!-- [et_pb_line_break_holder] -->                      <!-- [et_pb_line_break_holder] -->                        Bloomerang.reCaptchaV3SiteKey = '';<!-- [et_pb_line_break_holder] -->                        Bloomerang.gRecaptchaV3Threshold = 0.5;<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                        window.captchaLoadCallback = function() {<!-- [et_pb_line_break_holder] -->                            Bloomerang.gRecaptchaLoaded = true;<!-- [et_pb_line_break_holder] -->                        };<!-- [et_pb_line_break_holder] -->                        <!-- [et_pb_line_break_holder] -->                        window.captchaV3LoadCallback = function() {<!-- [et_pb_line_break_holder] -->                            Bloomerang.gRecaptchaV3Loaded = true;<!-- [et_pb_line_break_holder] -->                        };<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                        if(Bloomerang.donationFormReCaptchaV3SelfHostedFlag === undefined) {<!-- [et_pb_line_break_holder] -->                            function success (result) {<!-- [et_pb_line_break_holder] -->                                Bloomerang.donationFormReCaptchaV3SelfHostedFlag = result.DonationFormReCaptchaV3SelfHostedFlag;<!-- [et_pb_line_break_holder] -->                                initializeCaptcha();<!-- [et_pb_line_break_holder] -->                            }<!-- [et_pb_line_break_holder] -->                                <!-- [et_pb_line_break_holder] -->                            function failure (result) {<!-- [et_pb_line_break_holder] -->                                Bloomerang.donationFormReCaptchaV3SelfHostedFlag = false;<!-- [et_pb_line_break_holder] -->                                initializeCaptcha();<!-- [et_pb_line_break_holder] -->                            } <!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                            Bloomerang.Api._post('v1\/ReCaptchaV3SelfHostedFlag', {}, success, failure);<!-- [et_pb_line_break_holder] -->                        } else {<!-- [et_pb_line_break_holder] -->                            initializeCaptcha();<!-- [et_pb_line_break_holder] -->                        }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                        async function getRecaptchaV3Token() {<!-- [et_pb_line_break_holder] -->                              const token = await new Promise((resolve, reject) => {<!-- [et_pb_line_break_holder] -->                                 grecaptcha.ready(function() {<!-- [et_pb_line_break_holder] -->                                    grecaptcha.execute(Bloomerang.reCaptchaV3SiteKey, {action: 'submit'}).then(function(token) {<!-- [et_pb_line_break_holder] -->                                       resolve(token);<!-- [et_pb_line_break_holder] -->                                     });<!-- [et_pb_line_break_holder] -->                                  });<!-- [et_pb_line_break_holder] -->                                });<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                                return token;<!-- [et_pb_line_break_holder] -->                        }<!-- [et_pb_line_break_holder] -->                        <!-- [et_pb_line_break_holder] -->                        function initializeCaptcha() {<!-- [et_pb_line_break_holder] -->                            Bloomerang.Util.load('https:\/\/www.google.com\/recaptcha\/api.js?onload=captchaLoadCallback&render=explicit',<!-- [et_pb_line_break_holder] -->                                function() { return Bloomerang.gRecaptchaLoaded; },<!-- [et_pb_line_break_holder] -->                                function() {<!-- [et_pb_line_break_holder] -->                                    jQuery('.interaction-form .section.captcha').removeAttr('style');<!-- [et_pb_line_break_holder] -->                                    jQuery('form.interaction-form').data('captcha-id', grecaptcha.render('captcha14669824', { 'sitekey' : '6Lci-EQpAAAAAP6nAIlRb2L2_bgj0YU7MaovPrUn' }));<!-- [et_pb_line_break_holder] -->                                    <!-- [et_pb_line_break_holder] -->                                    if((Bloomerang.donationFormReCaptchaV3Flag && Bloomerang.isBloomerangHostedForm && Bloomerang.isDonationForm) || (Bloomerang.donationFormReCaptchaV3SelfHostedFlag && !Bloomerang.isBloomerangHostedForm && Bloomerang.reCaptchaV3SiteKey && Bloomerang.isDonationForm)) {<!-- [et_pb_line_break_holder] -->                                        jQuery('.interaction-form .section.captcha').attr('style', 'display: none');<!-- [et_pb_line_break_holder] -->                                    }<!-- [et_pb_line_break_holder] -->                                },<!-- [et_pb_line_break_holder] -->                                true,<!-- [et_pb_line_break_holder] -->                                true);<!-- [et_pb_line_break_holder] -->                            <!-- [et_pb_line_break_holder] -->                            if((Bloomerang.donationFormReCaptchaV3Flag && Bloomerang.isBloomerangHostedForm && Bloomerang.isDonationForm) || (Bloomerang.donationFormReCaptchaV3SelfHostedFlag && !Bloomerang.isBloomerangHostedForm && Bloomerang.isDonationForm && Bloomerang.reCaptchaV3SiteKey)) {<!-- [et_pb_line_break_holder] -->                                 Bloomerang.Util.load(`https:\/\/www.google.com\/recaptcha\/api.js?onload=captchaV3LoadCallback&render=${Bloomerang.reCaptchaV3SiteKey}`,<!-- [et_pb_line_break_holder] -->                                    function() { return Bloomerang.gRecaptchaV3Loaded; },<!-- [et_pb_line_break_holder] -->                                    function() {<!-- [et_pb_line_break_holder] -->                                        grecaptcha.ready(function() {<!-- [et_pb_line_break_holder] -->                                          grecaptcha.execute(Bloomerang.reCaptchaV3SiteKey, {action: 'submit'}).then(function(token) {<!-- [et_pb_line_break_holder] -->                                              async function success (result) {<!-- [et_pb_line_break_holder] -->                                                if(parseFloat(result.Score) < Bloomerang.gRecaptchaV3Threshold) {<!-- [et_pb_line_break_holder] -->                                                    Bloomerang.isForcePuzzle = true;<!-- [et_pb_line_break_holder] -->                                                    jQuery('.interaction-form .section.captcha').attr('style', 'display: block');<!-- [et_pb_line_break_holder] -->                                                } else {<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                                                    const initialRecaptchaV3Token = await getRecaptchaV3Token();<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                                                     \/\/ Append to the form data container to be included when submitting the form on bloomerangV2.js<!-- [et_pb_line_break_holder] -->                                                     Bloomerang.captchaResponseV3(initialRecaptchaV3Token);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                                                     setInterval(async ()=> {<!-- [et_pb_line_break_holder] -->                                                         const recaptchaV3Token = await getRecaptchaV3Token();<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                                                        \/\/ Append to the form data container to be included when submitting the form on bloomerangV2.js<!-- [et_pb_line_break_holder] -->                                                        Bloomerang.captchaResponseV3(recaptchaV3Token);<!-- [et_pb_line_break_holder] -->                                                     }, 80000);<!-- [et_pb_line_break_holder] -->                                                }<!-- [et_pb_line_break_holder] -->                                               }<!-- [et_pb_line_break_holder] -->                                                <!-- [et_pb_line_break_holder] -->                                               function failure (result) {<!-- [et_pb_line_break_holder] -->                                                Bloomerang.isForcePuzzle = true;<!-- [et_pb_line_break_holder] -->                                                jQuery('.interaction-form .section.captcha').attr('style', 'display: block');<!-- [et_pb_line_break_holder] -->                                               }<!-- [et_pb_line_break_holder] -->                                                <!-- [et_pb_line_break_holder] -->                                               var data = {<!-- [et_pb_line_break_holder] -->                                                  token: token,<!-- [et_pb_line_break_holder] -->                                                  isSelfHosted: !Bloomerang.isBloomerangHostedForm<!-- [et_pb_line_break_holder] -->                                               };<!-- [et_pb_line_break_holder] -->                                                <!-- [et_pb_line_break_holder] -->                                                Bloomerang.Api._post('v1\/ReCaptchaV3', data, success, failure);<!-- [et_pb_line_break_holder] -->                                          });<!-- [et_pb_line_break_holder] -->                                        });<!-- [et_pb_line_break_holder] -->                                    },<!-- [et_pb_line_break_holder] -->                                    true,<!-- [et_pb_line_break_holder] -->                                    true);<!-- [et_pb_line_break_holder] -->                               }<!-- [et_pb_line_break_holder] -->                           }<!-- [et_pb_line_break_holder] -->                            <!-- [et_pb_line_break_holder] -->                    <!-- [et_pb_line_break_holder] -->                    Bloomerang.useKey('pub_623b2883-178e-11ee-9007-06d616d7ff43');<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Register proper callbacks for various stages\/outcomes of submission<!-- [et_pb_line_break_holder] -->        Bloomerang.Widget.Interaction.OnSubmit = function (args) {<!-- [et_pb_line_break_holder] -->            jQuery(\".btn-submit-interaction\").val(\"Submitting...\").prop(\"disabled\", true).addClass(\"disabled\");<!-- [et_pb_line_break_holder] -->            var val = function (selector) { return jQuery(selector).val(); };<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->            Bloomerang.Account<!-- [et_pb_line_break_holder] -->                    .individual()<!-- [et_pb_line_break_holder] -->                    .firstName(val(\".interaction-form #first-name\"))<!-- [et_pb_line_break_holder] -->                    .lastName(val(\".interaction-form #last-name\"))<!-- [et_pb_line_break_holder] -->                    .homeEmail(val(\".interaction-form #email-address\"))<!-- [et_pb_line_break_holder] -->                    .homePhone(val(\".interaction-form #phone-number\"))<!-- [et_pb_line_break_holder] -->                    .applyInteractionCustomFields();<!-- [et_pb_line_break_holder] -->                    <!-- [et_pb_line_break_holder] -->            if (jQuery(\".interaction-form #consent-all\").prop(\"checked\")) {<!-- [et_pb_line_break_holder] -->              Bloomerang.Account.optedInStatus(jQuery(\".interaction-form #consent-email\").prop(\"checked\"),<!-- [et_pb_line_break_holder] -->                                               jQuery(\".interaction-form #consent-mail\").prop(\"checked\"),<!-- [et_pb_line_break_holder] -->                                               jQuery(\".interaction-form #consent-phone\").prop(\"checked\"));<!-- [et_pb_line_break_holder] -->            }<!-- [et_pb_line_break_holder] -->            <!-- [et_pb_line_break_holder] -->            \/\/ Always sending the address, even if it's blank, because we need to know the Country for GDPR purposes<!-- [et_pb_line_break_holder] -->            var country = val(\".interaction-form #country\");<!-- [et_pb_line_break_holder] -->            var state = Bloomerang.Util.getCorrectState(country, val(\".interaction-form #state\"), val(\".interaction-form #province\"));<!-- [et_pb_line_break_holder] -->            var zipCode = Bloomerang.Util.getCorrectZipCode(country, val(\".interaction-form #zip-code\"), val(\".interaction-form #postal-code\"));<!-- [et_pb_line_break_holder] -->            Bloomerang.Account.homeAddress(val(\".interaction-form #street-address\"), <!-- [et_pb_line_break_holder] -->                                           val(\".interaction-form #city\"),<!-- [et_pb_line_break_holder] -->                                           state,<!-- [et_pb_line_break_holder] -->                                           zipCode,<!-- [et_pb_line_break_holder] -->                                           country);<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->           Bloomerang.Interaction.note(val(\".interaction-form #comment\"));<!-- [et_pb_line_break_holder] -->           <!-- [et_pb_line_break_holder] -->           if (jQuery(\"#volunteer-date\").length) {<!-- [et_pb_line_break_holder] -->               Bloomerang.Interaction.date(jQuery(\"#volunteer-date\").val());<!-- [et_pb_line_break_holder] -->           }<!-- [et_pb_line_break_holder] -->           <!-- [et_pb_line_break_holder] -->           Bloomerang.Interaction.applyInteractionCustomFields();<!-- [et_pb_line_break_holder] -->        };<!-- [et_pb_line_break_holder] -->        Bloomerang.ValidateInteractionFormCaptcha = function() {<!-- [et_pb_line_break_holder] -->            if (typeof(grecaptcha) !== \"undefined\" && jQuery(\"#captcha\" + Bloomerang.Data.WidgetIds.Interaction).children().length) {<!-- [et_pb_line_break_holder] -->                var captchaResponse = grecaptcha.getResponse(jQuery(\".interaction-form\").data(\"captcha-id\"));<!-- [et_pb_line_break_holder] -->                if (captchaResponse) {<!-- [et_pb_line_break_holder] -->                    jQuery(\".interaction-form .noCaptchaResponseError\").hide();<!-- [et_pb_line_break_holder] -->                    Bloomerang.captchaResponse(captchaResponse);<!-- [et_pb_line_break_holder] -->                    return true;<!-- [et_pb_line_break_holder] -->                } else {<!-- [et_pb_line_break_holder] -->                    jQuery(\".interaction-form .noCaptchaResponseError\").show();<!-- [et_pb_line_break_holder] -->                    return false;<!-- [et_pb_line_break_holder] -->                }<!-- [et_pb_line_break_holder] -->            } else return true;<!-- [et_pb_line_break_holder] -->        };<!-- [et_pb_line_break_holder] -->        Bloomerang.Api.OnSuccess = Bloomerang.Widget.Interaction.OnSuccess = function (response) {<!-- [et_pb_line_break_holder] -->            jQuery(\"#interaction-form-container\").html(successHtml14669824);<!-- [et_pb_line_break_holder] -->            var distance = 100;<!-- [et_pb_line_break_holder] -->            var offset = jQuery(\"#interaction-form-container\").offset().top;<!-- [et_pb_line_break_holder] -->            var offsetTop = offset > distance ? offset - distance : offset;<!-- [et_pb_line_break_holder] -->\t\t        jQuery('html, body').animate({ scrollTop : offsetTop}, 500);<!-- [et_pb_line_break_holder] -->        };<!-- [et_pb_line_break_holder] -->        Bloomerang.Api.OnError = Bloomerang.Widget.Interaction.OnError = function (response) {<!-- [et_pb_line_break_holder] -->            jQuery(\".btn-submit-interaction\").val(\"Submit\").prop(\"disabled\", false).removeClass(\"disabled\");<!-- [et_pb_line_break_holder] -->            jQuery(\"#interaction-form-container .errors\").removeClass(\"hidden\").html(response.Message);<!-- [et_pb_line_break_holder] -->            var distance = 100;<!-- [et_pb_line_break_holder] -->            var offset = jQuery(\"#interaction-form-container .errors\").offset().top;<!-- [et_pb_line_break_holder] -->            var offsetTop = offset > distance ? offset - distance : offset;<!-- [et_pb_line_break_holder] -->\t\t        jQuery('html, body').animate({ scrollTop : offsetTop}, 500);<!-- [et_pb_line_break_holder] -->            if (typeof(grecaptcha) !== \"undefined\" && jQuery(\"#captcha\" + Bloomerang.Data.WidgetIds.Interaction).children().length) {<!-- [et_pb_line_break_holder] -->              grecaptcha.reset(jQuery(\".interaction-form\").data(\"captcha-id\"));<!-- [et_pb_line_break_holder] -->            }<!-- [et_pb_line_break_holder] -->        };<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->        Bloomerang.Util.applyInteractionCustomFields = function (obj, type) {<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->            \/\/ Clear any fields from a previous failed submission<!-- [et_pb_line_break_holder] -->            obj.clearCustomFields();<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->            \/\/ Apply all <input> (not multiselect), <select> and <textarea> fields<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .section.custom-fields :input:not(a > input, select)[id*=\" + type + \"]\").each(function() {<!-- [et_pb_line_break_holder] -->                if (jQuery(this).val().hasValue()) {<!-- [et_pb_line_break_holder] -->                    obj.customFreeformField(jQuery(this).attr(\"id\").toUntypedValue(), jQuery(this).val());<!-- [et_pb_line_break_holder] -->                }<!-- [et_pb_line_break_holder] -->            });<!-- [et_pb_line_break_holder] -->            <!-- [et_pb_line_break_holder] -->            \/\/ Apply all <select> fields<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .section.custom-fields select[id*=\" + type + \"]\").each(function() {<!-- [et_pb_line_break_holder] -->                if (jQuery(this).val().hasValue()) {<!-- [et_pb_line_break_holder] -->                    obj.customPickField(jQuery(this).attr(\"id\").toUntypedValue(), jQuery(this).val());<!-- [et_pb_line_break_holder] -->                }<!-- [et_pb_line_break_holder] -->            });<!-- [et_pb_line_break_holder] -->                <!-- [et_pb_line_break_holder] -->            \/\/ Apply all multiselect fields<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .section.custom-fields .checkboxes[id*=\" + type + \"]\").each(function() {<!-- [et_pb_line_break_holder] -->                obj.customPickField(jQuery(this).attr(\"id\").toUntypedValue(),<!-- [et_pb_line_break_holder] -->                jQuery.map(jQuery(this).children(\".checkbox.selected\"), function(v) { return jQuery(v).attr(\"data-id\"); }));<!-- [et_pb_line_break_holder] -->            });<!-- [et_pb_line_break_holder] -->        };<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->        String.prototype.hasValue = function() {<!-- [et_pb_line_break_holder] -->            return (this && jQuery.trim(this)); \/\/IE8 doesn't have a native trim function<!-- [et_pb_line_break_holder] -->        };<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->        Bloomerang.Account.applyInteractionCustomFields = function () {<!-- [et_pb_line_break_holder] -->            Bloomerang.Util.applyInteractionCustomFields(this, \"Account\");<!-- [et_pb_line_break_holder] -->            return this;<!-- [et_pb_line_break_holder] -->        };<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->        Bloomerang.Interaction.applyInteractionCustomFields = function () {<!-- [et_pb_line_break_holder] -->            Bloomerang.Util.applyInteractionCustomFields(this, \"Interaction\");<!-- [et_pb_line_break_holder] -->            return this;<!-- [et_pb_line_break_holder] -->        };<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->        String.prototype.toUntypedValue = function() {<!-- [et_pb_line_break_holder] -->            return this.substring(this.indexOf('_') + 1);<!-- [et_pb_line_break_holder] -->        };<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->        jQuery.validator.addMethod(\"phoneUS\", function(phone_number, element) {<!-- [et_pb_line_break_holder] -->            var digits = phone_number.replace(\/\\D\/g, \"\");<!-- [et_pb_line_break_holder] -->\t          return this.optional(element) || digits.length == 7 || digits.length == 10 || digits.length == 11;<!-- [et_pb_line_break_holder] -->        }, \"Please specify a valid phone number or use '+' for international.\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        jQuery.validator.addMethod(\"phoneInternational\", function (phone_number, element) {<!-- [et_pb_line_break_holder] -->            return this.optional(element) || \/^\\+[0-9\\-\\(\\)\\s.]+$\/i.test(phone_number);<!-- [et_pb_line_break_holder] -->        }, \"Please specify a valid phone number.\");<!-- [et_pb_line_break_holder] -->        jQuery.validator.classRuleSettings.phoneInternational = { phoneInternational: true };<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->        jQuery.validator.addMethod(\"zipcodeUS\", function (value, element) {<!-- [et_pb_line_break_holder] -->            return this.optional(element) || \/\\d{5}-\\d{4}$|^\\d{5}$\/.test(value)<!-- [et_pb_line_break_holder] -->        }, \"The specified US ZIP Code is invalid\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        jQuery.validator.addMethod(\"currency\", function (value, element, options) {<!-- [et_pb_line_break_holder] -->            return !value ||<!-- [et_pb_line_break_holder] -->                value<!-- [et_pb_line_break_holder] -->                  .replace(\"$\", \"\")<!-- [et_pb_line_break_holder] -->                  .replace(\".\", \"\")<!-- [et_pb_line_break_holder] -->                  .split(\",\").join(\"\")<!-- [et_pb_line_break_holder] -->                  .match(\/^\\d+$\/g);<!-- [et_pb_line_break_holder] -->        }, \"Not a valid currency\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        jQuery.validator.classRuleSettings.currency = { currency: true };<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        jQuery.validator.addMethod(\"number\", function (value, element, options) {<!-- [et_pb_line_break_holder] -->            return !value ||<!-- [et_pb_line_break_holder] -->                value<!-- [et_pb_line_break_holder] -->                  .replace(\".\", \"\")<!-- [et_pb_line_break_holder] -->                  .split(\",\").join(\"\")<!-- [et_pb_line_break_holder] -->                  .match(\/^\\d+$\/g);<!-- [et_pb_line_break_holder] -->        }, \"Not a valid number\");<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        jQuery.validator.classRuleSettings.number = { number: true };<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->        jQuery.validator.addMethod(\"validYear\", function (value, element, options) {<!-- [et_pb_line_break_holder] -->            try {<!-- [et_pb_line_break_holder] -->                return (!value || value.match(\/^[1-9]\\d\\d\\d$\/)) ? true : false;<!-- [et_pb_line_break_holder] -->            }<!-- [et_pb_line_break_holder] -->            catch (e) {<!-- [et_pb_line_break_holder] -->                return false;<!-- [et_pb_line_break_holder] -->            }<!-- [et_pb_line_break_holder] -->        }, function () { return \"Must be a 4 digit year\"; });<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        jQuery.validator.classRuleSettings.validYear = { validYear: true };<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        jQuery(\".interaction-form #country\").change(function(event) {<!-- [et_pb_line_break_holder] -->          var element = jQuery(event.target || event.srcElement); \/\/ cross-browser event target selection<!-- [et_pb_line_break_holder] -->          var isInternational = (element.val() != \"US\" && element.val() != \"CA\" && element.val() != \"BM\");<!-- [et_pb_line_break_holder] -->          \/\/ TODO: Remove this when we have figured out the canada state\/province issue<!-- [et_pb_line_break_holder] -->          Bloomerang.Util.addLog(\"Pre country change: Country=\" + element.val() + \", State=\" + jQuery(\".interaction-form #state\").val() + \", Province=\" + jQuery(\".interaction-form #province\").val() + \", City=\" + jQuery(\".interaction-form #city\").val());<!-- [et_pb_line_break_holder] -->          jQuery(\".interaction-form #state, .interaction-form #province\").val(\"\"); \/\/ clear the state when the country changes<!-- [et_pb_line_break_holder] -->          jQuery(\".interaction-form .field.city, .interaction-form .field.state, .interaction-form .field.province, .interaction-form .field.zip-code, .interaction-form .field.postal-code\").toggle(!isInternational);<!-- [et_pb_line_break_holder] -->          if (element.val() == \"BM\") {<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .field.city .label\").text(jQuery(\".interaction-form .field.city input\").data(\"bm-label\"));<!-- [et_pb_line_break_holder] -->          } else if (element.val() == \"US\" || element.val() == \"CA\") {<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .field.city .label\").text(jQuery(\".interaction-form .field.city input\").data(\"us-label\"));<!-- [et_pb_line_break_holder] -->          }<!-- [et_pb_line_break_holder] -->          jQuery(\".interaction-form #street-address\").toggleClass(\"international\", isInternational);<!-- [et_pb_line_break_holder] -->          if (element.val() == \"US\") {<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .field.state, .interaction-form .field.zip-code\").show();<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .field.province, .interaction-form .field.postal-code\").hide();<!-- [et_pb_line_break_holder] -->          } else if (element.val() == \"CA\") {<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .field.state, .interaction-form .field.zip-code\").hide();<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .field.province, .interaction-form .field.postal-code\").show();<!-- [et_pb_line_break_holder] -->          } else if (element.val() == \"BM\") {<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .field.state, .interaction-form .field.province, .interaction-form .field.zip-code\").hide();<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .field.postal-code\").show();<!-- [et_pb_line_break_holder] -->          } else {<!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form #city, .interaction-form #zip-code, .interaction-form #postal-code\").val(\"\");<!-- [et_pb_line_break_holder] -->          }<!-- [et_pb_line_break_holder] -->          jQuery(\".interaction-form .section.consent\").toggleClass(\"hidden\", !Bloomerang.Util.isCountryInEurope(element.val()));<!-- [et_pb_line_break_holder] -->          \/\/ TODO: Remove this when we have figured out the canada state\/province issue<!-- [et_pb_line_break_holder] -->          Bloomerang.Util.addLog(\"Post country change: Country=\" + element.val() + \", State=\" + jQuery(\".interaction-form #state\").val() + \", Province=\" + jQuery(\".interaction-form #province\").val()+ \", City=\" + jQuery(\".interaction-form #city\").val());<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ TODO: Remove this when we have figured out the canada state\/province issue<!-- [et_pb_line_break_holder] -->        \/\/ We use the focusin function to save the previous value so we can log out the previous and new values on change<!-- [et_pb_line_break_holder] -->        \/\/ https:\/\/stackoverflow.com\/questions\/29118178\/input-jquery-get-old-value-before-onchange-and-get-value-after-on-change\/29118530<!-- [et_pb_line_break_holder] -->        jQuery(\".interaction-form #state\").focusin(function(e) {<!-- [et_pb_line_break_holder] -->          var element = jQuery(e.target || e.srcElement); \/\/ cross-browser event target selection<!-- [et_pb_line_break_holder] -->          element.data('val', element.val());<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ TODO: Remove this when we have figured out the canada state\/province issue<!-- [et_pb_line_break_holder] -->        jQuery(\".interaction-form #state\").change(function(e) {<!-- [et_pb_line_break_holder] -->          var element = jQuery(e.target || e.srcElement); \/\/ cross-browser event target selection<!-- [et_pb_line_break_holder] -->          var prev = element.data('val');<!-- [et_pb_line_break_holder] -->          var current = element.val();<!-- [et_pb_line_break_holder] -->          var provinceElement = jQuery(\".interaction-form #province\");<!-- [et_pb_line_break_holder] -->          var prevProvince = provinceElement.data('val');<!-- [et_pb_line_break_holder] -->          var currentProvince = provinceElement.val();<!-- [et_pb_line_break_holder] -->          Bloomerang.Util.addLog(\"State Changed: Target=\" + e.target.name + \", PreValue=\" + prev + \", Value=\" + current + \", Province PreValue =\" + prevProvince + \", Province CurrentValue =\" + currentProvince);<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ TODO: Remove this when we have figured out the canada state\/province issue<!-- [et_pb_line_break_holder] -->        \/\/ We use the focusin function to save the previous value so we can log out the previous and new values on change<!-- [et_pb_line_break_holder] -->        \/\/ https:\/\/stackoverflow.com\/questions\/29118178\/input-jquery-get-old-value-before-onchange-and-get-value-after-on-change\/29118530<!-- [et_pb_line_break_holder] -->        jQuery(\".interaction-form #province\").focusin(function(e) {<!-- [et_pb_line_break_holder] -->          var element = jQuery(e.target || e.srcElement); \/\/ cross-browser event target selection<!-- [et_pb_line_break_holder] -->          element.data('val', element.val());<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ TODO: Remove this when we have figured out the canada state\/province issue<!-- [et_pb_line_break_holder] -->        jQuery(\".interaction-form #province\").change(function(e) {<!-- [et_pb_line_break_holder] -->          var element = jQuery(e.target || e.srcElement); \/\/ cross-browser event target selection<!-- [et_pb_line_break_holder] -->          var prev = element.data('val');<!-- [et_pb_line_break_holder] -->          var current = element.val();<!-- [et_pb_line_break_holder] -->          var stateElement = jQuery(\".interaction-form #state\");<!-- [et_pb_line_break_holder] -->          var prevState = stateElement.data('val');<!-- [et_pb_line_break_holder] -->          var currentState = stateElement.val();<!-- [et_pb_line_break_holder] -->          Bloomerang.Util.addLog(\"Province Changed: Target=\" + e.target.name + \", PreValue=\" + prev + \", Value=\" + current + \", State PrevValue=\" + prevState + \", State Current=\" + currentState);<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ TODO: Remove this when we have figured out the canada state\/province issue<!-- [et_pb_line_break_holder] -->        \/\/ We use the focusin function to save the previous value so we can log out the previous and new values on change<!-- [et_pb_line_break_holder] -->        \/\/ https:\/\/stackoverflow.com\/questions\/29118178\/input-jquery-get-old-value-before-onchange-and-get-value-after-on-change\/29118530<!-- [et_pb_line_break_holder] -->        jQuery(\".interaction-form #city\").focusin(function(e) {<!-- [et_pb_line_break_holder] -->          var element = jQuery(e.target || e.srcElement); \/\/ cross-browser event target selection<!-- [et_pb_line_break_holder] -->          element.data('val', element.val());<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ TODO: Remove this when we have figured out the canada state\/province issue<!-- [et_pb_line_break_holder] -->        jQuery(\".interaction-form #city\").change(function(e) {<!-- [et_pb_line_break_holder] -->          var element = jQuery(e.target || e.srcElement); \/\/ cross-browser event target selection<!-- [et_pb_line_break_holder] -->          var prev = element.data('val');<!-- [et_pb_line_break_holder] -->          var current = element.val();<!-- [et_pb_line_break_holder] -->          Bloomerang.Util.addLog(\"City Changed: Target=\" + e.target.name + \", PreValue=\" + prev + \", Value=\" + current);<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        jQuery(\".interaction-form #phone-number\").change(function () {<!-- [et_pb_line_break_holder] -->          var phoneField = jQuery(\".interaction-form #phone-number\");<!-- [et_pb_line_break_holder] -->          var internationalNumber = phoneField.val().substring(0,1) === '+';<!-- [et_pb_line_break_holder] -->          phoneField.toggleClass(\"phoneUS\", !internationalNumber);<!-- [et_pb_line_break_holder] -->          phoneField.toggleClass(\"phoneInternational\", internationalNumber);<!-- [et_pb_line_break_holder] -->        })<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Intercept form submission to validate then submit via API<!-- [et_pb_line_break_holder] -->        jQuery(\"#interaction-form-container form\").validate({<!-- [et_pb_line_break_holder] -->            submitHandler: function () {<!-- [et_pb_line_break_holder] -->                if (!Bloomerang.ValidateInteractionFormCaptcha()) {<!-- [et_pb_line_break_holder] -->                  return false;<!-- [et_pb_line_break_holder] -->                }<!-- [et_pb_line_break_holder] -->            <!-- [et_pb_line_break_holder] -->                \/\/ Restore proper callbacks in case there are multiple widgets on the page<!-- [et_pb_line_break_holder] -->                Bloomerang.Api.OnSubmit = Bloomerang.Widget.Interaction.OnSubmit;<!-- [et_pb_line_break_holder] -->                Bloomerang.Api.OnSuccess = Bloomerang.Widget.Interaction.OnSuccess;<!-- [et_pb_line_break_holder] -->                Bloomerang.Api.OnError = Bloomerang.Widget.Interaction.OnError;<!-- [et_pb_line_break_holder] -->                Bloomerang.Api.submitInteraction();<!-- [et_pb_line_break_holder] -->            }<!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->        \/\/ Show opt-in options based on the setting of the global opt-in<!-- [et_pb_line_break_holder] -->        jQuery(\".interaction-form .field.consent-all\").change(function() { <!-- [et_pb_line_break_holder] -->            jQuery(\".interaction-form .field.consent-all\").siblings().each(function(i, e) { <!-- [et_pb_line_break_holder] -->                jQuery(e).toggle();<!-- [et_pb_line_break_holder] -->            }); <!-- [et_pb_line_break_holder] -->        });<!-- [et_pb_line_break_holder] -->        <!-- [et_pb_line_break_holder] -->})(jQuery);<!-- [et_pb_line_break_holder] -->    };<!-- [et_pb_line_break_holder] -->    <!-- [et_pb_line_break_holder] -->                var startBloomerangLoad = function() {<!-- [et_pb_line_break_holder] -->                    if (window.bloomerangLoadStarted == undefined) {<!-- [et_pb_line_break_holder] -->                        window.bloomerangLoadStarted = true;<!-- [et_pb_line_break_holder] -->                        var script = document.createElement('script');<!-- [et_pb_line_break_holder] -->                        script.type = 'text\/javascript';<!-- [et_pb_line_break_holder] -->                        script.src = 'https:\/\/crm.bloomerang.co\/Content\/Scripts\/Api\/Bloomerang-v2.js?nocache=1777481633';<!-- [et_pb_line_break_holder] -->                        document.getElementsByTagName('head')[0].appendChild(script);<!-- [et_pb_line_break_holder] -->                        waitForBloomerangLoad(function() { Bloomerang.Util.requireJQueryValidation(function() { insertForm14669824(); })});<!-- [et_pb_line_break_holder] -->                    }<!-- [et_pb_line_break_holder] -->                    else {<!-- [et_pb_line_break_holder] -->                        waitForBloomerangLoad(function() { Bloomerang.Util.requireJQueryValidation(function() { insertForm14669824(); })});<!-- [et_pb_line_break_holder] -->                    }<!-- [et_pb_line_break_holder] -->                };<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                var waitForBloomerangLoad = function(callback) {<!-- [et_pb_line_break_holder] -->                    if (typeof(Bloomerang) === 'undefined' || !Bloomerang._isReady) {<!-- [et_pb_line_break_holder] -->                        setTimeout(function () { waitForBloomerangLoad(callback) }, 500);<!-- [et_pb_line_break_holder] -->                    }<!-- [et_pb_line_break_holder] -->                    else {<!-- [et_pb_line_break_holder] -->                        if (true) {<!-- [et_pb_line_break_holder] -->                            callback();<!-- [et_pb_line_break_holder] -->                        } else {<!-- [et_pb_line_break_holder] -->                            window.bloomerangLoadStarted = undefined;<!-- [et_pb_line_break_holder] -->                            Bloomerang = undefined; \/\/ The version of Blomerang.js is not what we want. So blow it away and reload.<!-- [et_pb_line_break_holder] -->                            startBloomerangLoad();<!-- [et_pb_line_break_holder] -->                        }<!-- [et_pb_line_break_holder] -->                    }<!-- [et_pb_line_break_holder] -->                };<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] -->                startBloomerangLoad();<!-- [et_pb_line_break_holder] --><\/script><\/pre>\n<p>[\/et_pb_code][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ECD Global Alliance &#8211; Providing Support!Make a difference!Learn about Care Centers<\/p>","protected":false},"author":14,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","cybocfi_hide_featured_image":"","footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-131485","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.erdheim-chester.org\/de\/wp-json\/wp\/v2\/pages\/131485","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.erdheim-chester.org\/de\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.erdheim-chester.org\/de\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.erdheim-chester.org\/de\/wp-json\/wp\/v2\/users\/14"}],"replies":[{"embeddable":true,"href":"https:\/\/www.erdheim-chester.org\/de\/wp-json\/wp\/v2\/comments?post=131485"}],"version-history":[{"count":0,"href":"https:\/\/www.erdheim-chester.org\/de\/wp-json\/wp\/v2\/pages\/131485\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.erdheim-chester.org\/de\/wp-json\/wp\/v2\/media?parent=131485"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}