{"id":5454,"date":"2020-08-05T19:01:32","date_gmt":"2020-08-05T23:01:32","guid":{"rendered":"https:\/\/workforcealliance.biz\/?page_id=5454"},"modified":"2024-06-21T10:46:23","modified_gmt":"2024-06-21T14:46:23","slug":"covid-resources-form","status":"publish","type":"page","link":"https:\/\/workforcealliance.biz\/es\/covid-resources-form\/","title":{"rendered":"Portal de ayuda a la formaci\u00f3n"},"content":{"rendered":"<div id=\"pl-5454\"  class=\"panel-layout\" ><div id=\"pg-5454-0\"  class=\"panel-grid panel-has-style\" ><div class=\"full_container default_order panel-row-style panel-row-style-for-5454-0\" ><div id=\"pgc-5454-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-5454-0-0-0\" class=\"so-panel widget widget_small-header panel-first-child panel-last-child\" data-index=\"0\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-small-header so-widget-small-header-default-d75171398898-5454\"\n\t\t\t\n\t\t>\n\n<div class=\"image_top_header_single  center_center_bg_sm\"  style=\"background-image:url(https:\/\/workforcealliance.biz\/wp-content\/uploads\/2024\/02\/news_podcast.png);\">\n\n\t\n\n    <div class=\"large_container\">\n\t<div class=\"cotent_header_small\"> \n\t<div class=\"content_title_subtitle\"> \n\t\t<h1 class=\"bar_top_title\" >Training <span>Assistance Portal<\/span><\/h1>\n\t\t<\/div>\t<\/div>\n\t<\/div>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><div id=\"pg-5454-1\"  class=\"panel-grid panel-has-style\" ><div class=\"small_container default_order panel-row-style panel-row-style-for-5454-1\" ><div id=\"pgc-5454-1-0\"  class=\"panel-grid-cell\" ><div id=\"panel-5454-1-0-0\" class=\"so-panel widget widget_empty-space panel-first-child\" data-index=\"1\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-empty-space so-widget-empty-space-default-d75171398898-5454\"\n\t\t\t\n\t\t><div class=\"empty_space_custom medium_space  \">\r\n<\/div><\/div><\/div><div id=\"panel-5454-1-0-1\" class=\"so-panel widget widget_sow-editor\" data-index=\"2\" ><div\n\t\t\t\n\t\t\tclass=\"so-widget-sow-editor so-widget-sow-editor-base\"\n\t\t\t\n\t\t>\n<div class=\"siteorigin-widget-tinymce textwidget\">\n\t<p><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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#112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style>\n<div id='gf_12' class='gform_anchor' tabindex='-1'><\/div>\n<div class='gform_heading'>\n<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n<\/p><\/div>\n<form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_12' id='gform_12'  action='\/es\/wp-json\/wp\/v2\/pages\/5454#gf_12' data-formid='12' novalidate>\n<div class='gform-body gform_body'>\n<div id='gform_fields_12' class='gform_fields top_label form_sublabel_below description_below validation_below'>\n<div id=\"field_12_70\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_70'>Choose Your  Career Path:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_70' id='input_12_70' class='large gfield_select'  aria-describedby=\"gfield_description_12_70\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='' >Please choose one...<\/option><option value='Manufacturing (Skill Up)' >Manufacturing (Skill Up)<\/option><option value='Health career (HCAP)' >Health career (HCAP)<\/option><\/select><\/div>\n<div class='gfield_description' id='gfield_description_12_70'>Please indicate which sector or specific training program that interests you. You will receive a follow-up email for your choice.<\/div>\n<\/div>\n<fieldset id=\"field_12_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >\n<legend class='gfield_label gform-field-label gfield_label_before_complex' >Name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>\n<div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_12_1'>\n<p>                            <span id='input_12_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' ><br \/>\n                                                    <input type='text' name='input_1.3' id='input_12_1_3' value=''   aria-required='true'     \/><br \/>\n                                                    <label for='input_12_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label><br \/>\n                                                <\/span><\/p>\n<p>                            <span id='input_12_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' ><br \/>\n                                                    <input type='text' name='input_1.6' id='input_12_1_6' value=''   aria-required='true'     \/><br \/>\n                                                    <label for='input_12_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label><br \/>\n                                                <\/span><\/p><\/div>\n<\/fieldset>\n<div id=\"field_12_3\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_3'>Email:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_email'>\n                            <input name='input_3' id='input_12_3' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div>\n<\/div>\n<div id=\"field_12_36\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_36'>Cell Phone (area code)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_text'><input name='input_36' id='input_12_36' type='text' value='' class='large'    placeholder='ex:203' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div>\n<\/div>\n<div id=\"field_12_37\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_37'>Home Phone? ( same as cell)<\/label><\/p>\n<div class='ginput_container ginput_container_text'><input name='input_37' id='input_12_37' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div>\n<\/div>\n<div id=\"field_12_55\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_55'>Street Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_text'><input name='input_55' id='input_12_55' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div>\n<\/div>\n<div id=\"field_12_25\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_25'>City of Residence: (choose one)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_25' id='input_12_25' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>&quot;Choose one, etc&quot;<\/option><option value='Andover' >Andover<\/option><option value='Ansonia' >Ansonia<\/option><option value='Ashford' >Ashford<\/option><option value='Avon' >Avon<\/option><option value='Barkhamsted' >Barkhamsted<\/option><option value='Beacon Falls' >Beacon Falls<\/option><option value='Berlin' >Berlin<\/option><option value='Bethany' >Bethany<\/option><option value='Bethel' >Bethel<\/option><option value='Bethlehem' >Bethlehem<\/option><option value='Bloomfield' >Bloomfield<\/option><option value='Bolton' >Bolton<\/option><option value='Bozrah' >Bozrah<\/option><option value='Branford' >Branford<\/option><option value='Bridgeport' >Bridgeport<\/option><option value='Bridgewater' >Bridgewater<\/option><option value='Bristol' >Bristol<\/option><option value='Brookfield' >Brookfield<\/option><option value='Brooklyn' >Brooklyn<\/option><option value='Burlington' >Burlington<\/option><option value='Canaan' >Canaan<\/option><option value='Canterbury' >Canterbury<\/option><option value='Canton' >Canton<\/option><option value='Chaplin' >Chaplin<\/option><option value='Cheshire' >Cheshire<\/option><option value='Chester' >Chester<\/option><option value='Clinton' >Clinton<\/option><option value='Colchester' >Colchester<\/option><option value='Colebrook' >Colebrook<\/option><option value='Columbia' >Columbia<\/option><option value='Cornwall' >Cornwall<\/option><option value='Coventry' >Coventry<\/option><option value='Cromwell' >Cromwell<\/option><option value='Danbury' >Danbury<\/option><option value='Darien' >Darien<\/option><option value='Deep River' >Deep River<\/option><option value='Derby' >Derby<\/option><option value='Durham' >Durham<\/option><option value='Eastford' >Eastford<\/option><option value='East Granby' >East Granby<\/option><option value='East Haddam' >East Haddam<\/option><option value='East Hampton' >East Hampton<\/option><option value='East Hartford' >East Hartford<\/option><option value='East Haven' >East Haven<\/option><option value='East Lyme' >East Lyme<\/option><option value='Easton' >Easton<\/option><option value='East Windsor' >East Windsor<\/option><option value='Ellington' >Ellington<\/option><option value='Enfield' >Enfield<\/option><option value='Essex' >Essex<\/option><option value='Fairfield' >Fairfield<\/option><option value='Farmington' >Farmington<\/option><option value='Franklin' >Franklin<\/option><option value='Glastonbury' >Glastonbury<\/option><option value='Goshen' >Goshen<\/option><option value='Granby' >Granby<\/option><option value='Greenwich' >Greenwich<\/option><option value='Griswold' >Griswold<\/option><option value='Groton' >Groton<\/option><option value='Guilford' >Guilford<\/option><option value='Haddam' >Haddam<\/option><option value='Hamden' >Hamden<\/option><option value='Hampton' >Hampton<\/option><option value='Hartford' >Hartford<\/option><option value='Hartland' >Hartland<\/option><option value='Harwinton' >Harwinton<\/option><option value='Hebron' >Hebron<\/option><option value='Kent' >Kent<\/option><option value='Killingly' >Killingly<\/option><option value='Killingworth' >Killingworth<\/option><option value='Lebanon' >Lebanon<\/option><option value='Ledyard' >Ledyard<\/option><option value='Lisbon' >Lisbon<\/option><option value='Litchfield' >Litchfield<\/option><option value='Lyme' >Lyme<\/option><option value='Madison' >Madison<\/option><option value='Manchester' >Manchester<\/option><option value='Mansfield' >Mansfield<\/option><option value='Marlborough' >Marlborough<\/option><option value='Meriden' >Meriden<\/option><option value='Middlebury' >Middlebury<\/option><option value='Middlefield' >Middlefield<\/option><option value='Middletown' >Middletown<\/option><option value='Milford' >Milford<\/option><option value='Monroe' >Monroe<\/option><option value='Montville' >Montville<\/option><option value='Morris' >Morris<\/option><option value='Naugatuck' >Naugatuck<\/option><option value='New Britain' >New Britain<\/option><option value='New Canaan' >New Canaan<\/option><option value='New Fairfield' >New Fairfield<\/option><option value='New Hartford' >New Hartford<\/option><option value='New Haven' >New Haven<\/option><option value='Newington' >Newington<\/option><option value='New London' >New London<\/option><option value='New Milford' >New Milford<\/option><option value='Newtown' >Newtown<\/option><option value='Norfolk' >Norfolk<\/option><option value='North Branford' >North Branford<\/option><option value='North Canaan' >North Canaan<\/option><option value='North Haven' >North Haven<\/option><option value='North Stonington' >North Stonington<\/option><option value='Norwalk' >Norwalk<\/option><option value='Norwich' >Norwich<\/option><option value='Old Lyme' >Old Lyme<\/option><option value='Old Saybrook' >Old Saybrook<\/option><option value='Orange' >Orange<\/option><option value='Oxford' >Oxford<\/option><option value='Plainfield' >Plainfield<\/option><option value='Plainville' >Plainville<\/option><option value='Plymouth' >Plymouth<\/option><option value='Pomfret' >Pomfret<\/option><option value='Portland' >Portland<\/option><option value='Preston' >Preston<\/option><option value='Prospect' >Prospect<\/option><option value='Putnam' >Putnam<\/option><option value='Redding' >Redding<\/option><option value='Ridgefield' >Ridgefield<\/option><option value='Rocky Hill' >Rocky Hill<\/option><option value='Roxbury' >Roxbury<\/option><option value='Salem' >Salem<\/option><option value='Salisbury' >Salisbury<\/option><option value='Scotland' >Scotland<\/option><option value='Seymour' >Seymour<\/option><option value='Sharon' >Sharon<\/option><option value='Shelton' >Shelton<\/option><option value='Sherman' >Sherman<\/option><option value='Simsbury' >Simsbury<\/option><option value='Somers' >Somers<\/option><option value='Southbury' >Southbury<\/option><option value='Southington' >Southington<\/option><option value='South Windsor' >South Windsor<\/option><option value='Sprague' >Sprague<\/option><option value='Stafford' >Stafford<\/option><option value='Stamford' >Stamford<\/option><option value='Sterling' >Sterling<\/option><option value='Stonington' >Stonington<\/option><option value='Stratford' >Stratford<\/option><option value='Suffield' >Suffield<\/option><option value='Thomaston' >Thomaston<\/option><option value='Thompson' >Thompson<\/option><option value='Tolland' >Tolland<\/option><option value='Torrington' >Torrington<\/option><option value='Trumbull' >Trumbull<\/option><option value='Union' >Union<\/option><option value='Vernon' >Vernon<\/option><option value='Voluntown' >Voluntown<\/option><option value='Wallingford' >Wallingford<\/option><option value='Warren' >Warren<\/option><option value='Washington' >Washington<\/option><option value='Waterbury' >Waterbury<\/option><option value='Waterford' >Waterford<\/option><option value='Watertown' >Watertown<\/option><option value='Westbrook' >Westbrook<\/option><option value='West Hartford' >West Hartford<\/option><option value='West Haven' >West Haven<\/option><option value='Weston' >Weston<\/option><option value='Westport' >Westport<\/option><option value='Wethersfield' >Wethersfield<\/option><option value='Willington' >Willington<\/option><option value='Wilton' >Wilton<\/option><option value='Winchester' >Winchester<\/option><option value='Windham' >Windham<\/option><option value='Windsor' >Windsor<\/option><option value='Windsor Locks' >Windsor Locks<\/option><option value='Wolcott' >Wolcott<\/option><option value='Woodbridge' >Woodbridge<\/option><option value='Woodbury' >Woodbury<\/option><option value='Woodstock' >Woodstock<\/option><\/select><\/div>\n<\/div>\n<div id=\"field_12_38\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_38'>Zip Code:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_text'><input name='input_38' id='input_12_38' type='text' value='' class='large'    placeholder='Ex: &quot;06&quot;' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div>\n<\/div>\n<div id=\"field_12_39\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_39'>Date of Birth (MM\/DD\/YYYY):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_date'>\n                            <input name='input_39' id='input_12_39' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_12_39_date_format gfield_description_12_39\" aria-invalid=\"false\" aria-required=\"true\"\/><br \/>\n                            <span id='input_12_39_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n<p>                        <input type='hidden' id='gforms_calendar_icon_input_12_39' class='gform_hidden' value='https:\/\/workforcealliance.biz\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/p>\n<div class='gfield_description' id='gfield_description_12_39'>Must be at least 18 years old.<\/div>\n<\/div>\n<div id=\"field_12_35\" class=\"gfield gfield--type-number gfield--input-type-number gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_35'>Age:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_number'><input name='input_35' id='input_12_35' type='number' step='any' min='18' max='99' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_12_35\" \/><\/p>\n<div class='gfield_description instruction ' id='gfield_instruction_12_35'>Please enter a number from <strong>18<\/strong> to <strong>99<\/strong>.<\/div>\n<\/div>\n<\/div>\n<div id=\"field_12_16\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_16'>Gender:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_16' id='input_12_16' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>&quot;Choose one, etc&quot;<\/option><option value='Male' >Male<\/option><option value='Female' >Female<\/option><option value='Choose Not to Respond' >Choose Not to Respond<\/option><\/select><\/div>\n<\/div>\n<fieldset id=\"field_12_43\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >\n<legend class='gfield_label gform-field-label gfield_label_before_complex' >What is your race\/ethnicity?Check all that apply.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>\n<div class='ginput_container ginput_container_checkbox'>\n<div class='gfield_checkbox ' id='input_12_43'>\n<div class='gchoice gchoice_12_43_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.1' type='checkbox'  value='Black or African American'  id='choice_12_43_1'   \/><br \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_43_1' id='label_12_43_1' class='gform-field-label gform-field-label--type-inline'>Black or African American<\/label>\n\t\t\t\t\t\t\t<\/div>\n<div class='gchoice gchoice_12_43_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.2' type='checkbox'  value='Asian American'  id='choice_12_43_2'   \/><br \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_43_2' id='label_12_43_2' class='gform-field-label gform-field-label--type-inline'>Asian American<\/label>\n\t\t\t\t\t\t\t<\/div>\n<div class='gchoice gchoice_12_43_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.3' type='checkbox'  value='Hispanic, Latino or Spanish Origin'  id='choice_12_43_3'   \/><br \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_43_3' id='label_12_43_3' class='gform-field-label gform-field-label--type-inline'>Hispanic, Latino or Spanish Origin<\/label>\n\t\t\t\t\t\t\t<\/div>\n<div class='gchoice gchoice_12_43_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.4' type='checkbox'  value='Caucasian'  id='choice_12_43_4'   \/><br \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_43_4' id='label_12_43_4' class='gform-field-label gform-field-label--type-inline'>Caucasian<\/label>\n\t\t\t\t\t\t\t<\/div>\n<div class='gchoice gchoice_12_43_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.5' type='checkbox'  value='Native American or Alaska Native'  id='choice_12_43_5'   \/><br \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_43_5' id='label_12_43_5' class='gform-field-label gform-field-label--type-inline'>Native American or Alaska Native<\/label>\n\t\t\t\t\t\t\t<\/div>\n<div class='gchoice gchoice_12_43_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.6' type='checkbox'  value='Pacific Islander or Native Hawaiian'  id='choice_12_43_6'   \/><br \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_43_6' id='label_12_43_6' class='gform-field-label gform-field-label--type-inline'>Pacific Islander or Native Hawaiian<\/label>\n\t\t\t\t\t\t\t<\/div>\n<div class='gchoice gchoice_12_43_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.7' type='checkbox'  value='Choose not to answer'  id='choice_12_43_7'   \/><br \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_43_7' id='label_12_43_7' class='gform-field-label gform-field-label--type-inline'>Choose not to answer<\/label>\n\t\t\t\t\t\t\t<\/div>\n<\/div>\n<\/div>\n<\/fieldset>\n<div id=\"field_12_66\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_66'>Are you a U.S. military veteran? &quot;Choose one, etc&quot;<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_66' id='input_12_66' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div>\n<\/div>\n<div id=\"field_12_67\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_67'>Is your spouse either an active member of the U.S. military or a veteran? &quot;Choose one&quot;<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_67' id='input_12_67' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value=''  class='gf_placeholder'>&quot;Choose one, etc&quot;<\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div>\n<\/div>\n<div id=\"field_12_34\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_34'>Do you have a disability? This may be a physical, mental or other documented disability. Auxiliary aids are provided upon request.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_34' id='input_12_34' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>&quot;Choose one, etc&quot;<\/option><option value='Yes' >Yes<\/option><option value='No' >No<\/option><option value='Choose not to answer' >Choose not to answer<\/option><\/select><\/div>\n<\/div>\n<div id=\"field_12_60\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_60'>Number of Children in Your Household Under 18: (Please enter a number from 0 to 6)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_number'><input name='input_60' id='input_12_60' type='number' step='any' min='0' max='6' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_instruction_12_60\" \/><\/p>\n<div class='gfield_description instruction ' id='gfield_instruction_12_60'>Please enter a number from <strong>0<\/strong> to <strong>6<\/strong>.<\/div>\n<\/div>\n<\/div>\n<div id=\"field_12_63\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_63'>Please List Ages for Any Children Under 18 (For Example: 2, 4, 6):<\/label><\/p>\n<div class='ginput_container ginput_container_text'><input name='input_63' id='input_12_63' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div>\n<\/div>\n<div id=\"field_12_12\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_12'>What is your current employment status?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_12' id='input_12_12' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Not Working' >Not Working<\/option><option value='Working Part Time' >Working Part Time<\/option><option value='Working Full Time' >Working Full Time<\/option><option value='Never Worked - Not Employed' >Never Worked - Not Employed<\/option><\/select><\/div>\n<\/div>\n<div id=\"field_12_68\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_68'>Have you received a lay-off notice?<\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_68' id='input_12_68' class='large gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div>\n<\/div>\n<div id=\"field_12_69\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_69'>Are you currently receiving Unemployment compensation?<\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_69' id='input_12_69' class='large gfield_select'     aria-invalid=\"false\" ><option value='Yes' >Yes<\/option><option value='No' >No<\/option><\/select><\/div>\n<\/div>\n<div id=\"field_12_44\" class=\"gfield gfield--type-number gfield--input-type-number field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_44'>If you are working, please enter your hourly rate of pay. For example, 15.00:<\/label><\/p>\n<div class='ginput_container ginput_container_number'><input name='input_44' id='input_12_44' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div>\n<\/div>\n<div id=\"field_12_53\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_53'>If your current job is temporary, enter your end date (MM\/DD\/YYYY):<\/label><\/p>\n<div class='ginput_container ginput_container_date'>\n                            <input name='input_53' id='input_12_53' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_12_53_date_format\" aria-invalid=\"false\" \/><br \/>\n                            <span id='input_12_53_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n<p>                        <input type='hidden' id='gforms_calendar_icon_input_12_53' class='gform_hidden' value='https:\/\/workforcealliance.biz\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div>\n<div id=\"field_12_33\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_33'>Current school status:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_33' id='input_12_33' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Not attending school' >Not attending school<\/option><option value='Attending post-high school institution' >Attending post-high school institution<\/option><\/select><\/div>\n<\/div>\n<div id=\"field_12_15\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_15'>Highest grade completed:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><\/p>\n<div class='ginput_container ginput_container_select'><select name='input_15' id='input_12_15' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='High School Diploma\/GED' >High School Diploma\/GED<\/option><option value='Trade or Technical School' >Trade or Technical School<\/option><option value='Some College' >Some College<\/option><option value='Bachelors Degree' >Bachelors Degree<\/option><option value='Some Post-Grad' >Some Post-Grad<\/option><option value='Masters Degree' >Masters Degree<\/option><option value='PhD or Other Doctorate' >PhD or Other Doctorate<\/option><option value='8-11th Grade Only' >8-11th Grade Only<\/option><\/select><\/div>\n<\/div>\n<fieldset id=\"field_12_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >\n<legend class='gfield_label gform-field-label' >Have you received Job Training or Placement assistance from Workforce Alliance or the American Job Centers in the last 2 years?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>\n<div class='ginput_container ginput_container_radio'>\n<div class='gfield_radio' id='input_12_49'>\n<div class='gchoice gchoice_12_49_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Yes'  id='choice_12_49_0' onchange='gformToggleRadioOther( this )'    \/><br \/>\n\t\t\t\t\t<label for='choice_12_49_0' id='label_12_49_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n<div class='gchoice gchoice_12_49_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='No'  id='choice_12_49_1' onchange='gformToggleRadioOther( this )'    \/><br \/>\n\t\t\t\t\t<label for='choice_12_49_1' id='label_12_49_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n<\/div>\n<\/div>\n<\/fieldset>\n<fieldset id=\"field_12_48\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  >\n<legend class='gfield_label gform-field-label' >Are you a U.S. citizen and able to work in the United States?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>\n<div class='ginput_container ginput_container_radio'>\n<div class='gfield_radio' id='input_12_48'>\n<div class='gchoice gchoice_12_48_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='Yes'  id='choice_12_48_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_12_48\"   \/><br \/>\n\t\t\t\t\t<label for='choice_12_48_0' id='label_12_48_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n<div class='gchoice gchoice_12_48_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_48' type='radio' value='No'  id='choice_12_48_1' onchange='gformToggleRadioOther( this )'    \/><br \/>\n\t\t\t\t\t<label for='choice_12_48_1' id='label_12_48_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n<\/div>\n<\/div>\n<div class='gfield_description' id='gfield_description_12_48'>If no, please answer the next question.<\/div>\n<\/fieldset>\n<fieldset id=\"field_12_47\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >\n<legend class='gfield_label gform-field-label' >If you are NOT a citizen, can you provide documentation that you are eligible to work in the United States?<\/legend>\n<div class='ginput_container ginput_container_radio'>\n<div class='gfield_radio' id='input_12_47'>\n<div class='gchoice gchoice_12_47_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='Yes'  id='choice_12_47_0' onchange='gformToggleRadioOther( this )'    \/><br \/>\n\t\t\t\t\t<label for='choice_12_47_0' id='label_12_47_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n<div class='gchoice gchoice_12_47_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='No'  id='choice_12_47_1' onchange='gformToggleRadioOther( this )'    \/><br \/>\n\t\t\t\t\t<label for='choice_12_47_1' id='label_12_47_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n<\/div>\n<\/div>\n<\/fieldset>\n<fieldset id=\"field_12_46\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >\n<legend class='gfield_label gform-field-label' >FOR PLANNING PURPOSES ONLY. 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