{"id":3140,"date":"2021-06-14T12:22:42","date_gmt":"2021-06-14T16:22:42","guid":{"rendered":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/?page_id=3140"},"modified":"2023-02-07T10:57:45","modified_gmt":"2023-02-07T15:57:45","slug":"become-a-volunteer","status":"publish","type":"page","link":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/en\/become-a-volunteer\/","title":{"rendered":"Become a volunteer"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_header title=&#8221;Thank you for your interest in becoming a SASMAD\/PHC volunteer !&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_image=&#8221;https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/uploads\/sites\/27\/2019\/10\/compassion.jpg&#8221; parallax=&#8221;on&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><span style=\"font-size: large\">Our staff will get in touch with you and provide the proper follow<\/span><span style=\"font-size: large\">-up to your application<\/span><\/p>\n<p>[\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar 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class='gform_description'>Form to register new volunteers to the service of spiritual accompaniment of Pastoral Home Care \/ SASMAD<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_18'  action='\/microsites\/sasmad\/wp-json\/wp\/v2\/pages\/3140' data-formid='18' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_18' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_18_1\" class=\"gfield gfield--type-name gf_scroll_text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_18_1'>\n                            \n                            <span id='input_18_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_18_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_18_1_3' class='gform-field-label gform-field-label--type-sub '>First Name<\/label>\n                                                <\/span>\n                            \n                            <span id='input_18_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_18_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_18_1_6' class='gform-field-label gform-field-label--type-sub '>Last Name<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_18_129\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_129'>E-mail<\/label><div class='ginput_container ginput_container_text'><input name='input_129' id='input_18_129' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_121\" class=\"gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Address :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_18_121' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_18_121_1_container' >\n                                        <input type='text' name='input_121.1' id='input_18_121_1' value=''    aria-required='true'    \/>\n                                        <label for='input_18_121_1' id='input_18_121_1_label' class='gform-field-label gform-field-label--type-sub '>Postal Address line 1<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_18_121_2_container' >\n                                        <input type='text' name='input_121.2' id='input_18_121_2' value=''     aria-required='false'   \/>\n                                        <label for='input_18_121_2' id='input_18_121_2_label' class='gform-field-label gform-field-label--type-sub '>Postal Address line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_18_121_3_container' >\n                                    <input type='text' name='input_121.3' id='input_18_121_3' value=''    aria-required='true'    \/>\n                                    <label for='input_18_121_3' id='input_18_121_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_18_121_4_container' >\n                                        <input type='text' name='input_121.4' id='input_18_121_4' value=''      aria-required='true'    \/>\n                                        <label for='input_18_121_4' id='input_18_121_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_18_121_5_container' >\n                                    <input type='text' name='input_121.5' id='input_18_121_5' value=''    aria-required='true'    \/>\n                                    <label for='input_18_121_5' id='input_18_121_5_label' class='gform-field-label gform-field-label--type-sub '>Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_121.6' id='input_18_121_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_18_119\" class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_119'>Telephone 1<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_119' id='input_18_119' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_122\" class=\"gfield gfield--type-phone gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_122'>Telephone 2<\/label><div class='ginput_container ginput_container_phone'><input name='input_122' id='input_18_122' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_132\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_132'>Current occupation<\/label><div class='ginput_container ginput_container_text'><input name='input_132' id='input_18_132' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_42\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_42'>Parish<\/label><div class='gfield_description' id='gfield_description_18_42'>Please indicate the territory of the Parish that you usually attend (optional)<\/div><div class='ginput_container ginput_container_text'><input name='input_42' id='input_18_42' type='text' value='' class='medium'  aria-describedby=\"gfield_description_18_42\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_131\" class=\"gfield gfield--type-select gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_131'>Sector and coordinator<\/label><div class='gfield_description' id='gfield_description_18_131'>Please indicate the sector where you live in and\/or the name of the PHC\/SASMAD coordinator you have been in touch with<\/div><div class='ginput_container ginput_container_select'><select name='input_131' id='input_18_131' class='large gfield_select'  aria-describedby=\"gfield_description_18_131\"   aria-invalid=\"false\" ><option value='Anglophone Sector - Cathie Macaulay' >Anglophone Sector - Cathie Macaulay<\/option><option value='Centre - Thalia Vaussenat' >Centre - Thalia Vaussenat<\/option><option value='East - Blanca Rodriguez' >East - Blanca Rodriguez<\/option><option value='Laval \/ Repentigny - Francine Baudelet' >Laval \/ Repentigny - Francine Baudelet<\/option><option value='West - Christiane Lemaire \/ Maria - Regina M\u00e9lo' >West - Christiane Lemaire \/ Maria - Regina M\u00e9lo<\/option><\/select><\/div><\/li><li id=\"field_18_60\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_60'>Do you have any allergies ? :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_18_60'>(cigarette smoke, cats, dogs, others) If you do not have any allergies please write \"none\".<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_60' id='input_18_60' class='textarea medium'  aria-describedby=\"gfield_description_18_60\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_18_133\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Spoken Languages<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_18_133'>Please indicate all languages that you feel comfortable for accompanying<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_18_133'><li class='gchoice gchoice_18_133_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.1' type='checkbox'  value='English'  id='choice_18_133_1'   aria-describedby=\"gfield_description_18_133\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_18_133_1' id='label_18_133_1' class='gform-field-label gform-field-label--type-inline'>English<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_18_133_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.2' type='checkbox'  value='French'  id='choice_18_133_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_133_2' id='label_18_133_2' class='gform-field-label gform-field-label--type-inline'>French<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_18_133_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.3' type='checkbox'  value='Spanish'  id='choice_18_133_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_133_3' id='label_18_133_3' class='gform-field-label gform-field-label--type-inline'>Spanish<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_18_133_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.4' type='checkbox'  value='Arabic'  id='choice_18_133_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_133_4' id='label_18_133_4' class='gform-field-label gform-field-label--type-inline'>Arabic<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_18_133_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.5' type='checkbox'  value='Italian'  id='choice_18_133_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_133_5' id='label_18_133_5' class='gform-field-label gform-field-label--type-inline'>Italian<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_18_138\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_138'>Other spoken languages<\/label><div class='gfield_description' id='gfield_description_18_138'>Please indicate if you speak any other language(s)  \nin which you would feel comfortable accompanying people<\/div><div class='ginput_container ginput_container_text'><input name='input_138' id='input_18_138' type='text' value='' class='large'  aria-describedby=\"gfield_description_18_138\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_126\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_126'>Fields of interest, skills or leisure activities :<\/label><div class='gfield_description' id='gfield_description_18_126'>We will try to match you with a beneficiary who shares some of your interests<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_126' id='input_18_126' class='textarea medium'  aria-describedby=\"gfield_description_18_126\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_18_127\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_127'>Have you volunteered for other organizations?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_18_127'>If so, please describe your tasks and responsibilities.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_127' id='input_18_127' class='textarea medium'  aria-describedby=\"gfield_description_18_127\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_18_135\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_135'>How can your experiences and skills be beneficial to PHC\/SASMAD?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_135' id='input_18_135' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_18_134\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_134'>How did you hear about our Service? :<\/label><div class='ginput_container ginput_container_text'><input name='input_134' id='input_18_134' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_137\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_137'>Name of your Emergency contact and relationship to you :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_137' id='input_18_137' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_139\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_139'>Please indicate at least one telephone number of your emergency contact :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_139' id='input_18_139' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_143\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_143'>Name, relationship to you of Referral no. 1 :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_18_143'>As part of the Program of responsible pastoral services, we need to collect at least 2 positive referrals for you. Kindly, provide us with the name and one phone number of 3 people who can help us to know you better. They should be people who know you well but are not your relatives. Example : co-workers, friends, parishioners, supervisors, neighbours.<\/div><div class='ginput_container ginput_container_text'><input name='input_143' id='input_18_143' type='text' value='' class='large'  aria-describedby=\"gfield_description_18_143\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_136\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_136'>Telephone number of Referral no. 1<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_136' id='input_18_136' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_145\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_145'>Name, relationship to you of Referral no. 2 :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_18_145'>As part of the Program of responsible pastoral services, we need to collect at least 2 positive referrals for you. Kindly, provide us with the name and one phone number of 3 people who can help us to know you better. They should be people who know you well but are not your relatives. Example : co-workers, friends, parishioners, supervisors, neighbours.<\/div><div class='ginput_container ginput_container_text'><input name='input_145' id='input_18_145' type='text' value='' class='large'  aria-describedby=\"gfield_description_18_145\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_141\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_141'>Telephone number of Referral no. 2<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_141' id='input_18_141' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_144\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_144'>Name, relationship to you of Referral no. 3 :<\/label><div class='gfield_description' id='gfield_description_18_144'>As part of the Program of responsible pastoral services, we need to collect at least 2 positive referrals for you. Kindly, provide us with the name and one phone number of 3 people who can help us to know you better. They should be people who know you well but are not your relatives. Example : co-workers, friends, parishioners, supervisors, neighbours.<\/div><div class='ginput_container ginput_container_text'><input name='input_144' id='input_18_144' type='text' value='' class='large'  aria-describedby=\"gfield_description_18_144\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_140\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_140'>Telephone number of Referral no. 3<\/label><div class='ginput_container ginput_container_text'><input name='input_140' id='input_18_140' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_101\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_101'>Message or additional comments (optional) :<\/label><div class='ginput_container ginput_container_text'><input name='input_101' id='input_18_101' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_116\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Thank you so much for your registration !<\/h2><div class='gsection_description' id='gfield_description_18_116'>Our staff will be in contact with you to confirm your application.<\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_18' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Send'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_18' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_18' id='gform_theme_18' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_18' id='gform_style_settings_18' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_18' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='18' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='CAD' value='ECdQXTq0fgH1CzC9KOcucGW1axCPJrVfAvvC\/77foFkuCkpi6b1iztlIrxLR8z7GlYpW2q8ezs0A337caY3kVopkQS6riWHkrpZNNB0PrIswbtE=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_18' value='WyJbXSIsImNjZGRiMWY4YWYyMGY4Yzc4ZjgzYzg4ZDJlNmU2MjU5Il0=' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_18' id='gform_target_page_number_18' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_18' id='gform_source_page_number_18' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"71\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><\/form>\n                        <\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 18, 'https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_18').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_18');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_18').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_18').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_18').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_18').removeClass('gform_validation_error');}setTimeout( 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{gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"18\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_18\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_18\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_18\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 18, current_page );            if ( visibilityTestDiv ) {                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class=\"gform_title\">Become a volunteer<\/h3>\n                            <p class='gform_description'>Form to register new volunteers to the service of spiritual accompaniment of Pastoral Home Care \/ SASMAD<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_18'  action='\/microsites\/sasmad\/wp-json\/wp\/v2\/pages\/3140' data-formid='18' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_18' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_18_1\" class=\"gfield gfield--type-name gf_scroll_text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_18_1'>\n                            \n                            <span id='input_18_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_18_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_18_1_3' class='gform-field-label gform-field-label--type-sub '>First Name<\/label>\n                                                <\/span>\n                            \n                            <span id='input_18_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_18_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_18_1_6' class='gform-field-label gform-field-label--type-sub '>Last Name<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_18_129\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_129'>E-mail<\/label><div class='ginput_container ginput_container_text'><input name='input_129' id='input_18_129' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_121\" class=\"gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Address :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_18_121' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_18_121_1_container' >\n                                        <input type='text' name='input_121.1' id='input_18_121_1' value=''    aria-required='true'    \/>\n                                        <label for='input_18_121_1' id='input_18_121_1_label' class='gform-field-label gform-field-label--type-sub '>Postal Address line 1<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_18_121_2_container' >\n                                        <input type='text' name='input_121.2' id='input_18_121_2' value=''     aria-required='false'   \/>\n                                        <label for='input_18_121_2' id='input_18_121_2_label' class='gform-field-label gform-field-label--type-sub '>Postal Address line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_18_121_3_container' >\n                                    <input type='text' name='input_121.3' id='input_18_121_3' value=''    aria-required='true'    \/>\n                                    <label for='input_18_121_3' id='input_18_121_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_18_121_4_container' >\n                                        <input type='text' name='input_121.4' id='input_18_121_4' value=''      aria-required='true'    \/>\n                                        <label for='input_18_121_4' id='input_18_121_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_18_121_5_container' >\n                                    <input type='text' name='input_121.5' id='input_18_121_5' value=''    aria-required='true'    \/>\n                                    <label for='input_18_121_5' id='input_18_121_5_label' class='gform-field-label gform-field-label--type-sub '>Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_121.6' id='input_18_121_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_18_119\" class=\"gfield gfield--type-phone gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_119'>Telephone 1<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_119' id='input_18_119' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_122\" class=\"gfield gfield--type-phone gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_122'>Telephone 2<\/label><div class='ginput_container ginput_container_phone'><input name='input_122' id='input_18_122' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_132\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_132'>Current occupation<\/label><div class='ginput_container ginput_container_text'><input name='input_132' id='input_18_132' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_42\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_42'>Parish<\/label><div class='gfield_description' id='gfield_description_18_42'>Please indicate the territory of the Parish that you usually attend (optional)<\/div><div class='ginput_container ginput_container_text'><input name='input_42' id='input_18_42' type='text' value='' class='medium'  aria-describedby=\"gfield_description_18_42\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_131\" class=\"gfield gfield--type-select gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_131'>Sector and coordinator<\/label><div class='gfield_description' id='gfield_description_18_131'>Please indicate the sector where you live in and\/or the name of the PHC\/SASMAD coordinator you have been in touch with<\/div><div class='ginput_container ginput_container_select'><select name='input_131' id='input_18_131' class='large gfield_select'  aria-describedby=\"gfield_description_18_131\"   aria-invalid=\"false\" ><option value='Anglophone Sector - Cathie Macaulay' >Anglophone Sector - Cathie Macaulay<\/option><option value='Centre - Thalia Vaussenat' >Centre - Thalia Vaussenat<\/option><option value='East - Blanca Rodriguez' >East - Blanca Rodriguez<\/option><option value='Laval \/ Repentigny - Francine Baudelet' >Laval \/ Repentigny - Francine Baudelet<\/option><option value='West - Christiane Lemaire \/ Maria - Regina M\u00e9lo' >West - Christiane Lemaire \/ Maria - Regina M\u00e9lo<\/option><\/select><\/div><\/li><li id=\"field_18_60\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_60'>Do you have any allergies ? :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_18_60'>(cigarette smoke, cats, dogs, others) If you do not have any allergies please write \"none\".<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_60' id='input_18_60' class='textarea medium'  aria-describedby=\"gfield_description_18_60\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_18_133\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Spoken Languages<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_18_133'>Please indicate all languages that you feel comfortable for accompanying<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_18_133'><li class='gchoice gchoice_18_133_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.1' type='checkbox'  value='English'  id='choice_18_133_1'   aria-describedby=\"gfield_description_18_133\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_18_133_1' id='label_18_133_1' class='gform-field-label gform-field-label--type-inline'>English<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_18_133_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.2' type='checkbox'  value='French'  id='choice_18_133_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_133_2' id='label_18_133_2' class='gform-field-label gform-field-label--type-inline'>French<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_18_133_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.3' type='checkbox'  value='Spanish'  id='choice_18_133_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_133_3' id='label_18_133_3' class='gform-field-label gform-field-label--type-inline'>Spanish<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_18_133_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.4' type='checkbox'  value='Arabic'  id='choice_18_133_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_133_4' id='label_18_133_4' class='gform-field-label gform-field-label--type-inline'>Arabic<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_18_133_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_133.5' type='checkbox'  value='Italian'  id='choice_18_133_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_18_133_5' id='label_18_133_5' class='gform-field-label gform-field-label--type-inline'>Italian<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_18_138\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_138'>Other spoken languages<\/label><div class='gfield_description' id='gfield_description_18_138'>Please indicate if you speak any other language(s)  \nin which you would feel comfortable accompanying people<\/div><div class='ginput_container ginput_container_text'><input name='input_138' id='input_18_138' type='text' value='' class='large'  aria-describedby=\"gfield_description_18_138\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_126\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_126'>Fields of interest, skills or leisure activities :<\/label><div class='gfield_description' id='gfield_description_18_126'>We will try to match you with a beneficiary who shares some of your interests<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_126' id='input_18_126' class='textarea medium'  aria-describedby=\"gfield_description_18_126\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_18_127\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_127'>Have you volunteered for other organizations?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_18_127'>If so, please describe your tasks and responsibilities.<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_127' id='input_18_127' class='textarea medium'  aria-describedby=\"gfield_description_18_127\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_18_135\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_135'>How can your experiences and skills be beneficial to PHC\/SASMAD?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_135' id='input_18_135' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_18_134\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_134'>How did you hear about our Service? :<\/label><div class='ginput_container ginput_container_text'><input name='input_134' id='input_18_134' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_137\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_137'>Name of your Emergency contact and relationship to you :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_137' id='input_18_137' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_139\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_139'>Please indicate at least one telephone number of your emergency contact :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_139' id='input_18_139' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_143\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_143'>Name, relationship to you of Referral no. 1 :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_18_143'>As part of the Program of responsible pastoral services, we need to collect at least 2 positive referrals for you. Kindly, provide us with the name and one phone number of 3 people who can help us to know you better. They should be people who know you well but are not your relatives. Example : co-workers, friends, parishioners, supervisors, neighbours.<\/div><div class='ginput_container ginput_container_text'><input name='input_143' id='input_18_143' type='text' value='' class='large'  aria-describedby=\"gfield_description_18_143\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_136\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_136'>Telephone number of Referral no. 1<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_136' id='input_18_136' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_145\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_145'>Name, relationship to you of Referral no. 2 :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_18_145'>As part of the Program of responsible pastoral services, we need to collect at least 2 positive referrals for you. Kindly, provide us with the name and one phone number of 3 people who can help us to know you better. They should be people who know you well but are not your relatives. Example : co-workers, friends, parishioners, supervisors, neighbours.<\/div><div class='ginput_container ginput_container_text'><input name='input_145' id='input_18_145' type='text' value='' class='large'  aria-describedby=\"gfield_description_18_145\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_141\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_141'>Telephone number of Referral no. 2<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_141' id='input_18_141' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_144\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_144'>Name, relationship to you of Referral no. 3 :<\/label><div class='gfield_description' id='gfield_description_18_144'>As part of the Program of responsible pastoral services, we need to collect at least 2 positive referrals for you. Kindly, provide us with the name and one phone number of 3 people who can help us to know you better. They should be people who know you well but are not your relatives. Example : co-workers, friends, parishioners, supervisors, neighbours.<\/div><div class='ginput_container ginput_container_text'><input name='input_144' id='input_18_144' type='text' value='' class='large'  aria-describedby=\"gfield_description_18_144\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_140\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_18_140'>Telephone number of Referral no. 3<\/label><div class='ginput_container ginput_container_text'><input name='input_140' id='input_18_140' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_18_101\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' 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