{"id":26962,"date":"2026-04-01T14:27:35","date_gmt":"2026-04-01T03:27:35","guid":{"rendered":"https:\/\/enrolments.its.edu.au\/?p=26962"},"modified":"2026-04-01T14:28:55","modified_gmt":"2026-04-01T03:28:55","slug":"enrolment-in-head-spinal-injury-workshop-edfl-wednesday-06th-may-2026","status":"publish","type":"post","link":"https:\/\/enrolments.its.edu.au\/?p=26962","title":{"rendered":"Enrolment In: Head &#038; Spinal Injury Workshop @ EDFL &#8211; Wednesday 06th May 2026"},"content":{"rendered":"[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;TITLE&#8221; _builder_version=&#8221;4.18.0&#8243; background_color=&#8221;#8300E9&#8243; use_background_color_gradient=&#8221;on&#8221; background_color_gradient_stops=&#8221;#00c3ef 0%|#000dc9 100%&#8221; collapsed=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_row admin_label=&#8221;TITLE&#8221; _builder_version=&#8221;4.18.0&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; width=&#8221;auto&#8221; max_width=&#8221;1500px&#8221; collapsed=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_text admin_label=&#8221;TITLE&#8221; _builder_version=&#8221;4.27.6&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221; sticky_enabled=&#8221;0&#8243;]\n<h1 class=\"entry-title\" style=\"text-align: center;\"><span style=\"font-family: verdana, geneva, sans-serif; color: #ffffff;\">Enrolment In: Head &amp; Spinal Injury Workshop @ EDFL &#8211; Wednesday 06th May 2026<\/span><\/h1>\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;BODY&#8221; _builder_version=&#8221;4.18.0&#8243; collapsed=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_row admin_label=&#8221;BODY&#8221; _builder_version=&#8221;4.18.0&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; width=&#8221;auto&#8221; max_width=&#8221;1500px&#8221; collapsed=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_text admin_label=&#8221;BODY&#8221; _builder_version=&#8221;4.27.6&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#FFFFFF&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221; sticky_enabled=&#8221;0&#8243;]\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_3672' style='display:none'><div id='gf_3672' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_3672' id='gform_3672'  action='\/index.php?rest_route=%2Fwp%2Fv2%2Fposts%2F26962#gf_3672' data-formid='3672' novalidate>\n        <div id='gf_progressbar_wrapper_3672' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>6<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_16' style='width:16%;'><span>16%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_3672_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_3672' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3672_93\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3672_93'>Comments<\/label><div class='ginput_container'><input name='input_93' id='input_3672_93' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_3672_93'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_3672_3\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h1 style=\"text-align: center;\"><strong><span style=\"font-family: verdana, geneva, sans-serif; color: #4571b0;\">Enrolment Form for NON-VET Accredited Courses\n<\/span><\/strong><\/h1>\n<p style=\"text-align: center;\"><span style=\"color: #3366ff;\"><strong><span style=\"font-family: verdana, geneva, sans-serif; font-size: 12px;\">EMAIL: <a href=\"mailto:ENROLMENT@ITS.EDU.AU\">ENROLMENT@ITS.EDU.AU<\/a> | CALL: 1300 585 866 | WEB: <a href=\"http:\/\/www.its.vic.edu.au\/\" target=\"_blank\" rel=\"noopener\">WWW.ITS.EDU.AU<\/a><\/span><\/strong><\/span><\/p><\/div><div id=\"field_3672_4\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_4'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION A - COURSE REGISTRATION CONFIRMATION<\/span><\/h2><\/div><\/div><div id=\"field_3672_5\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_3672_5 gfield_product_3672_5 field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_3672_5_1'>Head &amp; Spinal Injury Workshop<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_5.1' value='Head &amp; Spinal Injury Workshop' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_3672_5' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_3672_5' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_5.2' id='ginput_base_price_3672_5' value='$ 0.00' aria-label='Head &amp; Spinal Injury Workshop Price'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_5.3' value='1' class='ginput_quantity_3672_5 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_3672_6\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_6'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION B - PREVIOUS APPLICATIONS AND\/OR ENROLMENTS<\/span><\/h2><\/div><\/div><fieldset id=\"field_3672_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you previously applied to, or been enrolled at Intelligent Training Solutions?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_7'>\n\t\t\t<div class='gchoice gchoice_3672_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='NO' checked='checked' id='choice_3672_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_7_0' id='label_3672_7_0' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='YES'  id='choice_3672_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_7_1' id='label_3672_7_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_7_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='UNSURE'  id='choice_3672_7_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_7_2' id='label_3672_7_2' class='gform-field-label gform-field-label--type-inline'>UNSURE<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3672_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3672_8'>If Yes, please state your I.T.S Student ID number (If known)<\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_3672_8' type='text' value='' class='large'  aria-describedby=\"gfield_description_3672_8\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_3672_8'>example: ITS000123X<\/div><\/div><fieldset id=\"field_3672_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has your name changed since your last enrolment with us?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_14'>\n\t\t\t<div class='gchoice gchoice_3672_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='NO' checked='checked' id='choice_3672_14_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_3672_14\"   \/>\n\t\t\t\t\t<label for='choice_3672_14_0' id='label_3672_14_0' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='YES'  id='choice_3672_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_14_1' id='label_3672_14_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_3672_14'>If <strong>Yes<\/strong>, you <strong>must<\/strong> provide documentary evidence (Marriage Certificate etc...)<\/div><\/fieldset><div id=\"field_3672_15\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3672_15'>If Yes, please enter your previous name<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_3672_15' type='text' value='' class='large'  aria-describedby=\"gfield_description_3672_15\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_3672_15'>Please enter your previous FULL legal name<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_3672_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3672_2' class='gform_page' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_3672_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3672_9\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_9'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION C - PERSONAL DETAILS<\/span><\/h2><\/div><\/div><div id=\"field_3672_10\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter 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_3672_10'>Prefix<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_10' id='input_3672_10' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Dr' >Dr<\/option><option value='Miss' >Miss<\/option><option value='Mr.' >Mr.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Ms.' >Ms.<\/option><option value='Prof.' >Prof.<\/option><option value='Rev.' >Rev.<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_3672_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_3672_11'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_3672_11' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3672_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3672_12'>Middle Name<\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_3672_12' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3672_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_3672_13'>Surname<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_3672_13' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3672_17\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half 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_3672_17'>Date of birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_17' id='input_3672_17' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_3672_17_date_format gfield_description_3672_17\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_3672_17_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_3672_17' class='gform_hidden' value='https:\/\/enrolments.its.edu.au\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_3672_17'>Select your date of birth using the calendar to avoid formatting errors<\/div><\/div><div id=\"field_3672_18\" class=\"gfield gfield--type-select gfield--input-type-select 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_3672_18'>What is your gender?<\/label><div class='ginput_container ginput_container_select'><select name='input_18' id='input_3672_18' class='small gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Women' >Women<\/option><option value='Man' >Man<\/option><option value='Non binary' >Non binary<\/option><option value='Prefer not to say' >Prefer not to say<\/option><\/select><\/div><\/div><div id=\"field_3672_20\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #ff00ff;\"><strong><span style=\"font-family: verdana, geneva, sans-serif;\">CONTACT DETAILS<\/span><\/strong><\/span><\/div><div id=\"field_3672_21\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #ff0000;\"><span style=\"color: #3366ff;\">If possible, PLEASE provide us with BOTH your home (landline) and mobile numbers. <p>\nAs this course requires the coordination of yourself and our trainers, it may become important for our team to contact you should the need arise.<\/span>\n<\/span><\/div><div id=\"field_3672_23\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third 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_3672_23'>Telephone: Mobile<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_23' id='input_3672_23' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_3672_89\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like to provide with us an alternative number?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_89'>\n\t\t\t<div class='gchoice gchoice_3672_89_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='NO' checked='checked' id='choice_3672_89_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_89_0' id='label_3672_89_0' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_89_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='YES'  id='choice_3672_89_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_89_1' id='label_3672_89_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3672_22\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3672_22'>Telephone: Home<\/label><div class='ginput_container ginput_container_phone'><input name='input_22' id='input_3672_22' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_3672_24\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your preferred email address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_3672_24_container'>\n                                <span id='input_3672_24_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_24' id='input_3672_24' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_3672_24' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_3672_24_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_24_2' id='input_3672_24_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_3672_24_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_3672_91\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_3672_26\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #ff00ff;\"><strong><span style=\"font-family: verdana, geneva, sans-serif;\">RESIDENTIAL ADDRESS\u00a0<\/span><\/strong><\/span><\/div><fieldset id=\"field_3672_27\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_3672_27' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_3672_27_1_container' >\n                                        <input type='text' name='input_27.1' id='input_3672_27_1' value=''    aria-required='true'    \/>\n                                        <label for='input_3672_27_1' id='input_3672_27_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_3672_27_2_container' >\n                                        <input type='text' name='input_27.2' id='input_3672_27_2' value=''     aria-required='false'   \/>\n                                        <label for='input_3672_27_2' id='input_3672_27_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_3672_27_3_container' >\n                                    <input type='text' name='input_27.3' id='input_3672_27_3' value=''    aria-required='true'    \/>\n                                    <label for='input_3672_27_3' id='input_3672_27_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_3672_27_4_container' >\n                                        <input type='text' name='input_27.4' id='input_3672_27_4' value='Victoria'      aria-required='true'    \/>\n                                        <label for='input_3672_27_4' id='input_3672_27_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_3672_27_5_container' >\n                                    <input type='text' name='input_27.5' id='input_3672_27_5' value=''    aria-required='true'    \/>\n                                    <label for='input_3672_27_5' id='input_3672_27_5_label' class='gform-field-label gform-field-label--type-sub '>Post Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_3672_27_6_container' >\n                                        <select name='input_27.6' id='input_3672_27_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' selected='selected'>Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cape Verde' >Cape Verde<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_3672_27_6' id='input_3672_27_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><div class='gfield_description' id='gfield_description_3672_27'><span style=\"color: #ff0000; font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt;\"><span style=\"color: #3366ff;\">Please provide the <strong>physical address<\/strong> of where you usually reside - street number and name, <strong>not post office box.<\/strong> Do not provide any temporary address at which you reside for training, work or other purposes. If you are from a rural area, use the address from your state or territory's rural addressing or numbering system as your residential street.<\/span>\n<\/span><\/div><\/fieldset><div id=\"field_3672_28\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #ff00ff;\"><strong><span style=\"font-family: verdana, geneva, sans-serif;\">MAILING ADDRESS<\/span><\/strong><\/span><\/div><fieldset id=\"field_3672_29\" 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\"  ><legend class='gfield_label gform-field-label' >Is your mailing address the same as your residential address?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_29'>\n\t\t\t<div class='gchoice gchoice_3672_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='YES' checked='checked' id='choice_3672_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_29_0' id='label_3672_29_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='NO'  id='choice_3672_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_29_1' id='label_3672_29_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3672_31\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #ff0000; font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt;\"><span style=\"color: #3366ff;\">Please enter your mailing address below.<\/span>\n<\/span><\/div><fieldset id=\"field_3672_32\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please enter your mailing address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_3672_32' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_3672_32_1_container' >\n                                        <input type='text' name='input_32.1' id='input_3672_32_1' value=''    aria-required='true'    \/>\n                                        <label for='input_3672_32_1' id='input_3672_32_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_3672_32_2_container' >\n                                        <input type='text' name='input_32.2' id='input_3672_32_2' value=''     aria-required='false'   \/>\n                                        <label for='input_3672_32_2' id='input_3672_32_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_3672_32_3_container' >\n                                    <input type='text' name='input_32.3' id='input_3672_32_3' value=''    aria-required='true'    \/>\n                                    <label for='input_3672_32_3' id='input_3672_32_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_3672_32_4_container' >\n                                        <input type='text' name='input_32.4' id='input_3672_32_4' value='Victoria'      aria-required='true'    \/>\n                                        <label for='input_3672_32_4' id='input_3672_32_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_3672_32_5_container' >\n                                    <input type='text' name='input_32.5' id='input_3672_32_5' value=''    aria-required='true'    \/>\n                                    <label for='input_3672_32_5' id='input_3672_32_5_label' class='gform-field-label gform-field-label--type-sub '>Post Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_3672_32_6_container' >\n                                        <select name='input_32.6' id='input_3672_32_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' selected='selected'>Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cape Verde' >Cape Verde<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_3672_32_6' id='input_3672_32_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><div class='gfield_description' id='gfield_description_3672_32'><span style=\"color: #ff0000; font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt;\"><span style=\"color: #3366ff;\">NOTE: This will be the address our team will send out your Certificate should you choose to have a printed copy sent to you<\/span>\n<\/span><\/div><\/fieldset><div id=\"field_3672_90\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3672_34\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you completing this course as part of a requirement for a Sports Club or Team<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_34'>\n\t\t\t<div class='gchoice gchoice_3672_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='NO, Self-interest only' checked='checked' id='choice_3672_34_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_34_0' id='label_3672_34_0' class='gform-field-label gform-field-label--type-inline'>NO, Self-interest only<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='YES'  id='choice_3672_34_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_34_1' id='label_3672_34_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3672_35\" 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_3672_35'>Which club do you belong to?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_3672_35' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_3672_37' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_3672_37' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3672_3' class='gform_page' data-js='page-field-id-37' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_3672_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3672_38\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_38'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION D - EMERGENCY CONTACT DETAILS<\/span><\/h2><\/div><\/div><div id=\"field_3672_42\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #000000; font-family: verdana, geneva, sans-serif; font-size: 12pt;\">This course may require you to participate in classroom activities, which may or may not involve outdoor training activities. In the unlikely event of a medical emergency such as a heart attack, asthma or anaphylaxis attack, or any other major or minor emergency, we would like to know who in your family or circle of friends to contact so that we may gather some background medical information on you. This information may be shared with the emergency services team. You are not obligated to provide us with this information; however:<\/span>\n<p>\n<span style=\"color: #ff0000;\"><strong><span style=\"font-family: verdana, geneva, sans-serif;\">PLEASE NOTE - <\/span><\/strong><\/span><span style=\"color: #ff0000;\"><strong><span style=\"font-family: verdana, geneva, sans-serif;\">If you choose not to provide us with your emergency contact details, be aware that in the event of a medical emergency, regardless of how minor, our staff are instructed to call 000 for the emergency services. Any and all associated costs will be at your expense.<\/span><\/strong><\/span><\/div><fieldset id=\"field_3672_41\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like to provide us with your preferred emergency contact?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_41'>\n\t\t\t<div class='gchoice gchoice_3672_41_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='NO' checked='checked' id='choice_3672_41_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_41_0' id='label_3672_41_0' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_41_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='YES'  id='choice_3672_41_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_41_1' id='label_3672_41_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3672_39\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">Please ensure that the person you nominate below is aware of your medical history and will be available to contact on the day of your training.<\/span>\n<p>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">Who would you like us to contact in the unlikely event of an emergency?<\/span><\/div><fieldset id=\"field_3672_40\" 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\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Emergency Contact Full Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name has_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_3672_40'>\n                            <span id='input_3672_40_2_container' class='name_prefix name_prefix_select gform-grid-col gform-grid-col--size-auto' >\n                                                    <select name='input_40.2' id='input_3672_40_2'    aria-required='false'   >\n                          <option value=''><\/option><option value='Dr.' >Dr.<\/option><option value='Miss' >Miss<\/option><option value='Mr.' >Mr.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Ms.' >Ms.<\/option><option value='Prof.' >Prof.<\/option><option value='Rev.' >Rev.<\/option>\n                      <\/select>\n                                                    <label for='input_3672_40_2' class='gform-field-label gform-field-label--type-sub '>Prefix<\/label>\n                                                  <\/span>\n                            <span id='input_3672_40_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_40.3' id='input_3672_40_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_3672_40_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_3672_40_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_40.6' id='input_3672_40_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_3672_40_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_3672_44' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_3672_44' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3672_4' class='gform_page' data-js='page-field-id-44' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_3672_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_3672_51\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Sporting Club<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 ginput_container_address gform-grid-row' id='input_3672_51' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_3672_51_1_container' >\n                                        <input type='text' name='input_51.1' id='input_3672_51_1' value=''    aria-required='false'    \/>\n                                        <label for='input_3672_51_1' id='input_3672_51_1_label' class='gform-field-label gform-field-label--type-sub '>Contact Person<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_3672_51_2_container' >\n                                        <input type='text' name='input_51.2' id='input_3672_51_2' value=''     aria-required='false'   \/>\n                                        <label for='input_3672_51_2' id='input_3672_51_2_label' class='gform-field-label gform-field-label--type-sub '>Email Address<\/label>\n                                    <\/span><input type='hidden' class='gform_hidden' name='input_51.4' id='input_3672_51_4' value=''\/><input type='hidden' class='gform_hidden' name='input_51.6' id='input_3672_51_6' value='Australia' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_3672_92' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_3672_92' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3672_5' class='gform_page' data-js='page-field-id-92' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_3672_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3672_54\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_54'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION F - ENROLMENT PRIVACY NOTICE & TERMS AND CONDITIONS<\/span><\/h2><\/div><\/div><div id=\"field_3672_55\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\"><strong>PRIVACY NOTICE (VERSION 2) 2020 UPDATE<\/strong><\/span>\n<p>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">Your personal information, which includes the personal information contained within is registration form, may be used or disclosed by Intelligent Training Solutions for statistical, administrative, regulatory and research purposes. Intelligent Training Solutions may disclose your personal information for these purposes to:<\/span>\n<ul>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">Australian Football League (AFL)<\/span><\/li>\n<\/ul>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">Personal information that has been disclosed to the AFL may be used or disclosed by AFL for the following purposes:<\/span>\n<ul>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">populating authenticated transcripts;<\/span><\/li>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">facilitating statistics and research relating to AFL and club related activities, including surveys and data linkage;<\/span><\/li>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">pre-populating AFL registration \/ enrolment forms;<\/span><\/li>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">understanding how the AFL market operates, for policy, workforce planning and consumer information; and<\/span><\/li>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">administering AFL, including program administration, regulation, monitoring and evaluation.<\/span><\/li>\n<\/ul>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">You may receive a student survey which may be administrated by an Australian Football League (AFL) employee, agent or third-party contractor or other authorised agencies. Please note you may opt-out of the survey at the time of being contacted.<\/span>\n<p>\n<p>\n<span style=\"color: #ff00ff;\"><strong><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">TERMS AND CONDITIONS FOR ENROLLING INTO THIS COURSE<\/span><\/strong><\/span>\n<p>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\"><strong>PLEASE TAKE A MOMENT TO REVIEW OUR ENROLMENT TERMS AND CONDITIONS BY CLICKING THE LINK BELOW. <\/strong><\/span>\n<p>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">You can also download, view or print a copy of our terms and conditions, including our refund policy, assessment policy and withdrawal policy to name a few, by clicking the Student Administration link below:<\/span>\n<p class=\"standout\"><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\"><a href=\"https:\/\/www.its.vic.edu.au\/enrolment-terms\/\" target=\"_blank\" rel=\"noopener\">CLICK HERE to view the Terms and Conditions associated with your enrolment<\/a><\/span><\/p>\n<p class=\"standout\"><a href=\"https:\/\/www.its.vic.edu.au\/student-administration\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">CLICK HERE is visit our Student Administration section<\/span><\/a><\/p>\n&nbsp;<\/div><fieldset id=\"field_3672_57\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >TERMS AND CONDITIONS<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_57.1' id='input_3672_57_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_3672_57_1' >I have read and understood the above privacy notice and the terms and conditions related to my enrolment, including those terms and conditions related to government restrictions and lockdowns due to COVID-19 as found on https:\/\/www.its.vic.edu.au\/enrolment-terms\/.<\/label><input type='hidden' name='input_57.2' value='I have read and understood the above privacy notice and the terms and conditions related to my enrolment, including those terms and conditions related to government restrictions and lockdowns due to COVID-19 as found on https:\/\/www.its.vic.edu.au\/enrolment-terms\/.' class='gform_hidden' \/><input type='hidden' name='input_57.3' value='292' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_3672_58\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_58'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION G - STUDENT DECLARATION<\/span><\/h2><\/div><\/div><div id=\"field_3672_59\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><strong>PLEASE NOTE:<P>TO SUBMIT THIS ENROLMENT FORM, YOU MUST AGREE TO ALL THE TERMS AND CONDITIONS LISTED BELOW & SIGN YOUR NAME WHEN PROMPTED. <\/strong><\/div><fieldset id=\"field_3672_62\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >STUDENT DECLARATION<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox gfield_choice--select_all_enabled' id='input_3672_62'><div class='gchoice gchoice_3672_62_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.1' type='checkbox'  value='I declare that the information I have provided, to the best of my knowledge, is true and correct.'  id='choice_3672_62_1'   aria-describedby=\"gfield_description_3672_62\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_1' id='label_3672_62_1' class='gform-field-label gform-field-label--type-inline'>I declare that the information I have provided, to the best of my knowledge, is true and correct.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3672_62_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.2' type='checkbox'  value='I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice listed on the previous page.'  id='choice_3672_62_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_2' id='label_3672_62_2' class='gform-field-label gform-field-label--type-inline'>I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice listed on the previous page.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3672_62_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.3' type='checkbox'  value='I understand the terms and conditions of this written agreement, including the refund policy. I have been advised and understand the fees involved with my enrolment and agree to be a student of Intelligent Training Solutions Pty Ltd (RTO: 22570)'  id='choice_3672_62_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_3' id='label_3672_62_3' class='gform-field-label gform-field-label--type-inline'>I understand the terms and conditions of this written agreement, including the refund policy. I have been advised and understand the fees involved with my enrolment and agree to be a student of Intelligent Training Solutions Pty Ltd (RTO: 22570)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3672_62_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.4' type='checkbox'  value='I agree to pay all the fees and charges associated with my enrolment. I understand that if I nominate a third party to make payment for this enrolment, I remain liable for all enrolment fees until such time as the nominated third party has settled the account.'  id='choice_3672_62_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_4' id='label_3672_62_4' class='gform-field-label gform-field-label--type-inline'>I agree to pay all the fees and charges associated with my enrolment. I understand that if I nominate a third party to make payment for this enrolment, I remain liable for all enrolment fees until such time as the nominated third party has settled the account.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3672_62_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.5' type='checkbox'  value='I understand that I must give I.T.S 7-days notice if I cannot attend this course. Should I fail to provide 7-days notice, I understand that I am liable and must pay the FULL course fees. Failure to do so will result in my account being sent to a debt collection agency. I understand that failure to officially withdraw from a course, as stated in the refund clause, will result in a vacant position within the course and will deprive I.T.S and the course from the revenue it would provide.'  id='choice_3672_62_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_5' id='label_3672_62_5' class='gform-field-label gform-field-label--type-inline'>I understand that I must give I.T.S 7-days notice if I cannot attend this course. Should I fail to provide 7-days notice, I understand that I am liable and must pay the FULL course fees. Failure to do so will result in my account being sent to a debt collection agency. I understand that failure to officially withdraw from a course, as stated in the refund clause, will result in a vacant position within the course and will deprive I.T.S and the course from the revenue it would provide.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3672_62_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.6' type='checkbox'  value='I understand that I can view my own records held by Intelligent Training Solutions by contacting the administration office.'  id='choice_3672_62_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_6' id='label_3672_62_6' class='gform-field-label gform-field-label--type-inline'>I understand that I can view my own records held by Intelligent Training Solutions by contacting the administration office.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3672_62_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.7' type='checkbox'  value='I have made my own enquiries and believe that this training course is suitable for my personal and\/or career purposes. I consider that, based on my educational attainment, capabilities, aspirations and interests, this training is appropriate for me.'  id='choice_3672_62_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_7' id='label_3672_62_7' class='gform-field-label gform-field-label--type-inline'>I have made my own enquiries and believe that this training course is suitable for my personal and\/or career purposes. I consider that, based on my educational attainment, capabilities, aspirations and interests, this training is appropriate for me.<\/label>\n\t\t\t\t\t\t\t<\/div><div class=\"gfield-choice-toggle-all\"><button type=\"button\" id=\"button_62_select_all\" class=\"gfield_choice_all_toggle gform-theme-button--size-sm\" onclick=\"gformToggleCheckboxes( this )\" data-checked=\"0\" data-label-select=\"Select All\" data-label-deselect=\"Deselect All\">Select All<\/button><\/div><\/div><\/div><div class='gfield_description' id='gfield_description_3672_62'>You must tick all the boxes above to be presented with the 'SUBMIT YOUR ENROLMENT' button. <P>If you have any concerns about our terms and conditions, please contact our office on 03 5415 0204 during business hours<\/div><\/fieldset><div id=\"field_3672_63\" class=\"gfield gfield--type-signature gfield--input-type-signature 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_3672_63'>STUDENT SIGNATURE<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><input type='hidden' value='' name='input_63' id='input_3672_63_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_3672_63_Container' class='gfield_signature_container ginput_container' style='height:180px; width:600px; ' ><canvas id='input_3672_63' width='600' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/enrolments.its.edu.au\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_3672_63_toolbar' style='margin:5px 0;position:relative;height:20px;width:600px;max-width:100%;'><img id = 'input_3672_63_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_3672_63_data' name='input_3672_63_data' value=''><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_3672_64' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_3672_64' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3672_6' class='gform_page' data-js='page-field-id-64' style='display:none;'>\n                    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bug in chrome *\/ jQuery(document).scrollTop(jQuery('#gform_wrapper_3672').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_3672').val();gformInitSpinner( 3672, 'https:\/\/enrolments.its.edu.au\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [3672, current_page]);window['gf_submitting_3672'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}jQuery('#gform_wrapper_3672').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_3672').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [3672]);window['gf_submitting_3672'] = 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id='gform_wrapper_3672' style='display:none'><div id='gf_3672' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_3672' id='gform_3672'  action='\/index.php?rest_route=%2Fwp%2Fv2%2Fposts%2F26962#gf_3672' data-formid='3672' novalidate>\n        <div id='gf_progressbar_wrapper_3672' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>6<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_16' style='width:16%;'><span>16%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_3672_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_3672' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3672_93\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3672_93'>Facebook<\/label><div class='ginput_container'><input name='input_93' id='input_3672_93' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_3672_93'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_3672_3\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h1 style=\"text-align: center;\"><strong><span style=\"font-family: verdana, geneva, sans-serif; color: #4571b0;\">Enrolment Form for NON-VET Accredited Courses\n<\/span><\/strong><\/h1>\n<p style=\"text-align: center;\"><span style=\"color: #3366ff;\"><strong><span style=\"font-family: verdana, geneva, sans-serif; font-size: 12px;\">EMAIL: <a href=\"mailto:ENROLMENT@ITS.EDU.AU\">ENROLMENT@ITS.EDU.AU<\/a> | CALL: 1300 585 866 | WEB: <a href=\"http:\/\/www.its.vic.edu.au\/\" target=\"_blank\" rel=\"noopener\">WWW.ITS.EDU.AU<\/a><\/span><\/strong><\/span><\/p><\/div><div id=\"field_3672_4\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_4'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION A - COURSE REGISTRATION CONFIRMATION<\/span><\/h2><\/div><\/div><div id=\"field_3672_5\" class=\"gfield gfield--type-product gfield--input-type-singleproduct gfield--width-full gfield_price gfield_price_3672_5 gfield_product_3672_5 field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_3672_5_1'>Head &amp; Spinal Injury Workshop<\/label><div class='ginput_container ginput_container_singleproduct'>\n\t\t\t\t\t<input type='hidden' name='input_5.1' value='Head &amp; Spinal Injury Workshop' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_3672_5' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<label for='ginput_base_price_3672_5' class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/label>\n\t\t\t\t\t\t<input type='text' readonly class='ginput_product_price gform-text-input-reset' name='input_5.2' id='ginput_base_price_3672_5' value='$ 0.00' aria-label='Head &amp; Spinal Injury Workshop Price'  \/>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_5.3' value='1' class='ginput_quantity_3672_5 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_3672_6\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_6'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION B - PREVIOUS APPLICATIONS AND\/OR ENROLMENTS<\/span><\/h2><\/div><\/div><fieldset id=\"field_3672_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you previously applied to, or been enrolled at Intelligent Training Solutions?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_7'>\n\t\t\t<div class='gchoice gchoice_3672_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='NO' checked='checked' id='choice_3672_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_7_0' id='label_3672_7_0' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='YES'  id='choice_3672_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_7_1' id='label_3672_7_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_7_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='UNSURE'  id='choice_3672_7_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_7_2' id='label_3672_7_2' class='gform-field-label gform-field-label--type-inline'>UNSURE<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3672_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3672_8'>If Yes, please state your I.T.S Student ID number (If known)<\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_3672_8' type='text' value='' class='large'  aria-describedby=\"gfield_description_3672_8\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_3672_8'>example: ITS000123X<\/div><\/div><fieldset id=\"field_3672_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Has your name changed since your last enrolment with us?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_14'>\n\t\t\t<div class='gchoice gchoice_3672_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='NO' checked='checked' id='choice_3672_14_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_3672_14\"   \/>\n\t\t\t\t\t<label for='choice_3672_14_0' id='label_3672_14_0' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='YES'  id='choice_3672_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_14_1' id='label_3672_14_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_3672_14'>If <strong>Yes<\/strong>, you <strong>must<\/strong> provide documentary evidence (Marriage Certificate etc...)<\/div><\/fieldset><div id=\"field_3672_15\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3672_15'>If Yes, please enter your previous name<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_3672_15' type='text' value='' class='large'  aria-describedby=\"gfield_description_3672_15\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_3672_15'>Please enter your previous FULL legal name<\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_3672_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3672_2' class='gform_page' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_3672_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3672_9\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_9'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION C - PERSONAL DETAILS<\/span><\/h2><\/div><\/div><div id=\"field_3672_10\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter 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_3672_10'>Prefix<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_10' id='input_3672_10' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' ><\/option><option value='Dr' >Dr<\/option><option value='Miss' >Miss<\/option><option value='Mr.' >Mr.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Ms.' >Ms.<\/option><option value='Prof.' >Prof.<\/option><option value='Rev.' >Rev.<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_3672_11\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_3672_11'>First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_3672_11' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3672_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3672_12'>Middle Name<\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_3672_12' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3672_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_3672_13'>Surname<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_3672_13' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_3672_17\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half 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_3672_17'>Date of birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_17' id='input_3672_17' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon'   placeholder='dd\/mm\/yyyy' aria-describedby=\"input_3672_17_date_format gfield_description_3672_17\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_3672_17_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_3672_17' class='gform_hidden' value='https:\/\/enrolments.its.edu.au\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><div class='gfield_description' id='gfield_description_3672_17'>Select your date of birth using the calendar to avoid formatting errors<\/div><\/div><div id=\"field_3672_18\" class=\"gfield gfield--type-select gfield--input-type-select 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_3672_18'>What is your gender?<\/label><div class='ginput_container ginput_container_select'><select name='input_18' id='input_3672_18' class='small gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Women' >Women<\/option><option value='Man' >Man<\/option><option value='Non binary' >Non binary<\/option><option value='Prefer not to say' >Prefer not to say<\/option><\/select><\/div><\/div><div id=\"field_3672_20\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #ff00ff;\"><strong><span style=\"font-family: verdana, geneva, sans-serif;\">CONTACT DETAILS<\/span><\/strong><\/span><\/div><div id=\"field_3672_21\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #ff0000;\"><span style=\"color: #3366ff;\">If possible, PLEASE provide us with BOTH your home (landline) and mobile numbers. <p>\nAs this course requires the coordination of yourself and our trainers, it may become important for our team to contact you should the need arise.<\/span>\n<\/span><\/div><div id=\"field_3672_23\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third 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_3672_23'>Telephone: Mobile<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_23' id='input_3672_23' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_3672_89\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like to provide with us an alternative number?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_89'>\n\t\t\t<div class='gchoice gchoice_3672_89_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='NO' checked='checked' id='choice_3672_89_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_89_0' id='label_3672_89_0' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_89_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='YES'  id='choice_3672_89_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_89_1' id='label_3672_89_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3672_22\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_3672_22'>Telephone: Home<\/label><div class='ginput_container ginput_container_phone'><input name='input_22' id='input_3672_22' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_3672_24\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your preferred email address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_3672_24_container'>\n                                <span id='input_3672_24_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_24' id='input_3672_24' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_3672_24' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_3672_24_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_24_2' id='input_3672_24_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_3672_24_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_3672_91\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_3672_26\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #ff00ff;\"><strong><span style=\"font-family: verdana, geneva, sans-serif;\">RESIDENTIAL ADDRESS\u00a0<\/span><\/strong><\/span><\/div><fieldset id=\"field_3672_27\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_3672_27' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_3672_27_1_container' >\n                                        <input type='text' name='input_27.1' id='input_3672_27_1' value=''    aria-required='true'    \/>\n                                        <label for='input_3672_27_1' id='input_3672_27_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_3672_27_2_container' >\n                                        <input type='text' name='input_27.2' id='input_3672_27_2' value=''     aria-required='false'   \/>\n                                        <label for='input_3672_27_2' id='input_3672_27_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_3672_27_3_container' >\n                                    <input type='text' name='input_27.3' id='input_3672_27_3' value=''    aria-required='true'    \/>\n                                    <label for='input_3672_27_3' id='input_3672_27_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_3672_27_4_container' >\n                                        <input type='text' name='input_27.4' id='input_3672_27_4' value='Victoria'      aria-required='true'    \/>\n                                        <label for='input_3672_27_4' id='input_3672_27_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_3672_27_5_container' >\n                                    <input type='text' name='input_27.5' id='input_3672_27_5' value=''    aria-required='true'    \/>\n                                    <label for='input_3672_27_5' id='input_3672_27_5_label' class='gform-field-label gform-field-label--type-sub '>Post Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_3672_27_6_container' >\n                                        <select name='input_27.6' id='input_3672_27_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' selected='selected'>Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cape Verde' >Cape Verde<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_3672_27_6' id='input_3672_27_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><div class='gfield_description' id='gfield_description_3672_27'><span style=\"color: #ff0000; font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt;\"><span style=\"color: #3366ff;\">Please provide the <strong>physical address<\/strong> of where you usually reside - street number and name, <strong>not post office box.<\/strong> Do not provide any temporary address at which you reside for training, work or other purposes. If you are from a rural area, use the address from your state or territory's rural addressing or numbering system as your residential street.<\/span>\n<\/span><\/div><\/fieldset><div id=\"field_3672_28\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #ff00ff;\"><strong><span style=\"font-family: verdana, geneva, sans-serif;\">MAILING ADDRESS<\/span><\/strong><\/span><\/div><fieldset id=\"field_3672_29\" 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\"  ><legend class='gfield_label gform-field-label' >Is your mailing address the same as your residential address?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_29'>\n\t\t\t<div class='gchoice gchoice_3672_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='YES' checked='checked' id='choice_3672_29_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_29_0' id='label_3672_29_0' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='NO'  id='choice_3672_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_29_1' id='label_3672_29_1' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3672_31\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #ff0000; font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt;\"><span style=\"color: #3366ff;\">Please enter your mailing address below.<\/span>\n<\/span><\/div><fieldset id=\"field_3672_32\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please enter your mailing address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_3672_32' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_3672_32_1_container' >\n                                        <input type='text' name='input_32.1' id='input_3672_32_1' value=''    aria-required='true'    \/>\n                                        <label for='input_3672_32_1' id='input_3672_32_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_3672_32_2_container' >\n                                        <input type='text' name='input_32.2' id='input_3672_32_2' value=''     aria-required='false'   \/>\n                                        <label for='input_3672_32_2' id='input_3672_32_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_3672_32_3_container' >\n                                    <input type='text' name='input_32.3' id='input_3672_32_3' value=''    aria-required='true'    \/>\n                                    <label for='input_3672_32_3' id='input_3672_32_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_3672_32_4_container' >\n                                        <input type='text' name='input_32.4' id='input_3672_32_4' value='Victoria'      aria-required='true'    \/>\n                                        <label for='input_3672_32_4' id='input_3672_32_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_3672_32_5_container' >\n                                    <input type='text' name='input_32.5' id='input_3672_32_5' value=''    aria-required='true'    \/>\n                                    <label for='input_3672_32_5' id='input_3672_32_5_label' class='gform-field-label gform-field-label--type-sub '>Post Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_3672_32_6_container' >\n                                        <select name='input_32.6' id='input_3672_32_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' selected='selected'>Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cape Verde' >Cape Verde<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' >United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_3672_32_6' id='input_3672_32_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><div class='gfield_description' id='gfield_description_3672_32'><span style=\"color: #ff0000; font-family: tahoma, arial, helvetica, sans-serif; font-size: 12pt;\"><span style=\"color: #3366ff;\">NOTE: This will be the address our team will send out your Certificate should you choose to have a printed copy sent to you<\/span>\n<\/span><\/div><\/fieldset><div id=\"field_3672_90\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_3672_34\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you completing this course as part of a requirement for a Sports Club or Team<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_34'>\n\t\t\t<div class='gchoice gchoice_3672_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='NO, Self-interest only' checked='checked' id='choice_3672_34_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_34_0' id='label_3672_34_0' class='gform-field-label gform-field-label--type-inline'>NO, Self-interest only<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='YES'  id='choice_3672_34_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_34_1' id='label_3672_34_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3672_35\" 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_3672_35'>Which club do you belong to?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_3672_35' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_3672_37' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_3672_37' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3672_3' class='gform_page' data-js='page-field-id-37' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_3672_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3672_38\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_38'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION D - EMERGENCY CONTACT DETAILS<\/span><\/h2><\/div><\/div><div id=\"field_3672_42\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"color: #000000; font-family: verdana, geneva, sans-serif; font-size: 12pt;\">This course may require you to participate in classroom activities, which may or may not involve outdoor training activities. In the unlikely event of a medical emergency such as a heart attack, asthma or anaphylaxis attack, or any other major or minor emergency, we would like to know who in your family or circle of friends to contact so that we may gather some background medical information on you. This information may be shared with the emergency services team. You are not obligated to provide us with this information; however:<\/span>\n<p>\n<span style=\"color: #ff0000;\"><strong><span style=\"font-family: verdana, geneva, sans-serif;\">PLEASE NOTE - <\/span><\/strong><\/span><span style=\"color: #ff0000;\"><strong><span style=\"font-family: verdana, geneva, sans-serif;\">If you choose not to provide us with your emergency contact details, be aware that in the event of a medical emergency, regardless of how minor, our staff are instructed to call 000 for the emergency services. Any and all associated costs will be at your expense.<\/span><\/strong><\/span><\/div><fieldset id=\"field_3672_41\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like to provide us with your preferred emergency contact?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_3672_41'>\n\t\t\t<div class='gchoice gchoice_3672_41_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='NO' checked='checked' id='choice_3672_41_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_41_0' id='label_3672_41_0' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_3672_41_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_41' type='radio' value='YES'  id='choice_3672_41_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_3672_41_1' id='label_3672_41_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_3672_39\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">Please ensure that the person you nominate below is aware of your medical history and will be available to contact on the day of your training.<\/span>\n<p>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">Who would you like us to contact in the unlikely event of an emergency?<\/span><\/div><fieldset id=\"field_3672_40\" 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\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Emergency Contact Full Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name has_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_3672_40'>\n                            <span id='input_3672_40_2_container' class='name_prefix name_prefix_select gform-grid-col gform-grid-col--size-auto' >\n                                                    <select name='input_40.2' id='input_3672_40_2'    aria-required='false'   >\n                          <option value=''><\/option><option value='Dr.' >Dr.<\/option><option value='Miss' >Miss<\/option><option value='Mr.' >Mr.<\/option><option value='Mrs.' >Mrs.<\/option><option value='Ms.' >Ms.<\/option><option value='Prof.' >Prof.<\/option><option value='Rev.' >Rev.<\/option>\n                      <\/select>\n                                                    <label for='input_3672_40_2' class='gform-field-label gform-field-label--type-sub '>Prefix<\/label>\n                                                  <\/span>\n                            <span id='input_3672_40_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_40.3' id='input_3672_40_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_3672_40_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_3672_40_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_40.6' id='input_3672_40_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_3672_40_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_3672_44' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_3672_44' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3672_4' class='gform_page' data-js='page-field-id-44' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_3672_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><fieldset id=\"field_3672_51\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Sporting Club<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 ginput_container_address gform-grid-row' id='input_3672_51' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_3672_51_1_container' >\n                                        <input type='text' name='input_51.1' id='input_3672_51_1' value=''    aria-required='false'    \/>\n                                        <label for='input_3672_51_1' id='input_3672_51_1_label' class='gform-field-label gform-field-label--type-sub '>Contact Person<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_3672_51_2_container' >\n                                        <input type='text' name='input_51.2' id='input_3672_51_2' value=''     aria-required='false'   \/>\n                                        <label for='input_3672_51_2' id='input_3672_51_2_label' class='gform-field-label gform-field-label--type-sub '>Email Address<\/label>\n                                    <\/span><input type='hidden' class='gform_hidden' name='input_51.4' id='input_3672_51_4' value=''\/><input type='hidden' class='gform_hidden' name='input_51.6' id='input_3672_51_6' value='Australia' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_3672_92' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_3672_92' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_3672_5' class='gform_page' data-js='page-field-id-92' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_3672_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_3672_54\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_54'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION F - ENROLMENT PRIVACY NOTICE & TERMS AND CONDITIONS<\/span><\/h2><\/div><\/div><div id=\"field_3672_55\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\"><strong>PRIVACY NOTICE (VERSION 2) 2020 UPDATE<\/strong><\/span>\n<p>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">Your personal information, which includes the personal information contained within is registration form, may be used or disclosed by Intelligent Training Solutions for statistical, administrative, regulatory and research purposes. Intelligent Training Solutions may disclose your personal information for these purposes to:<\/span>\n<ul>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">Australian Football League (AFL)<\/span><\/li>\n<\/ul>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">Personal information that has been disclosed to the AFL may be used or disclosed by AFL for the following purposes:<\/span>\n<ul>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">populating authenticated transcripts;<\/span><\/li>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">facilitating statistics and research relating to AFL and club related activities, including surveys and data linkage;<\/span><\/li>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">pre-populating AFL registration \/ enrolment forms;<\/span><\/li>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">understanding how the AFL market operates, for policy, workforce planning and consumer information; and<\/span><\/li>\n \t<li><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">administering AFL, including program administration, regulation, monitoring and evaluation.<\/span><\/li>\n<\/ul>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">You may receive a student survey which may be administrated by an Australian Football League (AFL) employee, agent or third-party contractor or other authorised agencies. Please note you may opt-out of the survey at the time of being contacted.<\/span>\n<p>\n<p>\n<span style=\"color: #ff00ff;\"><strong><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">TERMS AND CONDITIONS FOR ENROLLING INTO THIS COURSE<\/span><\/strong><\/span>\n<p>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\"><strong>PLEASE TAKE A MOMENT TO REVIEW OUR ENROLMENT TERMS AND CONDITIONS BY CLICKING THE LINK BELOW. <\/strong><\/span>\n<p>\n<span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">You can also download, view or print a copy of our terms and conditions, including our refund policy, assessment policy and withdrawal policy to name a few, by clicking the Student Administration link below:<\/span>\n<p class=\"standout\"><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\"><a href=\"https:\/\/www.its.vic.edu.au\/enrolment-terms\/\" target=\"_blank\" rel=\"noopener\">CLICK HERE to view the Terms and Conditions associated with your enrolment<\/a><\/span><\/p>\n<p class=\"standout\"><a href=\"https:\/\/www.its.vic.edu.au\/student-administration\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-family: tahoma, arial, helvetica, sans-serif;\">CLICK HERE is visit our Student Administration section<\/span><\/a><\/p>\n&nbsp;<\/div><fieldset id=\"field_3672_57\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >TERMS AND CONDITIONS<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_57.1' id='input_3672_57_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_3672_57_1' >I have read and understood the above privacy notice and the terms and conditions related to my enrolment, including those terms and conditions related to government restrictions and lockdowns due to COVID-19 as found on https:\/\/www.its.vic.edu.au\/enrolment-terms\/.<\/label><input type='hidden' name='input_57.2' value='I have read and understood the above privacy notice and the terms and conditions related to my enrolment, including those terms and conditions related to government restrictions and lockdowns due to COVID-19 as found on https:\/\/www.its.vic.edu.au\/enrolment-terms\/.' class='gform_hidden' \/><input type='hidden' name='input_57.3' value='292' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_3672_58\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\"><\/h3><div class='gsection_description' id='gfield_description_3672_58'><hr \/>\n\n<h2><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #339966;\">SECTION G - STUDENT DECLARATION<\/span><\/h2><\/div><\/div><div id=\"field_3672_59\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><strong>PLEASE NOTE:<P>TO SUBMIT THIS ENROLMENT FORM, YOU MUST AGREE TO ALL THE TERMS AND CONDITIONS LISTED BELOW & SIGN YOUR NAME WHEN PROMPTED. <\/strong><\/div><fieldset id=\"field_3672_62\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >STUDENT DECLARATION<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox gfield_choice--select_all_enabled' id='input_3672_62'><div class='gchoice gchoice_3672_62_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.1' type='checkbox'  value='I declare that the information I have provided, to the best of my knowledge, is true and correct.'  id='choice_3672_62_1'   aria-describedby=\"gfield_description_3672_62\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_1' id='label_3672_62_1' class='gform-field-label gform-field-label--type-inline'>I declare that the information I have provided, to the best of my knowledge, is true and correct.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3672_62_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.2' type='checkbox'  value='I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice listed on the previous page.'  id='choice_3672_62_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_2' id='label_3672_62_2' class='gform-field-label gform-field-label--type-inline'>I consent to the collection, use and disclosure of my personal information in accordance with the Privacy Notice listed on the previous page.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3672_62_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.3' type='checkbox'  value='I understand the terms and conditions of this written agreement, including the refund policy. I have been advised and understand the fees involved with my enrolment and agree to be a student of Intelligent Training Solutions Pty Ltd (RTO: 22570)'  id='choice_3672_62_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_3' id='label_3672_62_3' class='gform-field-label gform-field-label--type-inline'>I understand the terms and conditions of this written agreement, including the refund policy. I have been advised and understand the fees involved with my enrolment and agree to be a student of Intelligent Training Solutions Pty Ltd (RTO: 22570)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3672_62_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.4' type='checkbox'  value='I agree to pay all the fees and charges associated with my enrolment. I understand that if I nominate a third party to make payment for this enrolment, I remain liable for all enrolment fees until such time as the nominated third party has settled the account.'  id='choice_3672_62_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_4' id='label_3672_62_4' class='gform-field-label gform-field-label--type-inline'>I agree to pay all the fees and charges associated with my enrolment. I understand that if I nominate a third party to make payment for this enrolment, I remain liable for all enrolment fees until such time as the nominated third party has settled the account.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_3672_62_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_62.5' type='checkbox'  value='I understand that I must give I.T.S 7-days notice if I cannot attend this course. Should I fail to provide 7-days notice, I understand that I am liable and must pay the FULL course fees. Failure to do so will result in my account being sent to a debt collection agency. I understand that failure to officially withdraw from a course, as stated in the refund clause, will result in a vacant position within the course and will deprive I.T.S and the course from the revenue it would provide.'  id='choice_3672_62_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_3672_62_5' id='label_3672_62_5' class='gform-field-label gform-field-label--type-inline'>I understand that I must give I.T.S 7-days notice if I cannot attend this course. Should I fail to provide 7-days notice, I understand that I am liable and must pay the FULL course fees. Failure to do so will result in my account being sent to a debt collection agency. 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