{"id":3164,"date":"2021-07-08T22:10:30","date_gmt":"2021-07-09T02:10:30","guid":{"rendered":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/?page_id=3164"},"modified":"2021-11-03T14:28:37","modified_gmt":"2021-11-03T18:28:37","slug":"registration-beneficiary","status":"publish","type":"page","link":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/en\/registration-beneficiary\/","title":{"rendered":"Registration Beneficiary"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; _builder_version=&#8221;4.6.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_header title=&#8221;Register a beneficiary&#8221; _builder_version=&#8221;4.6.0&#8243; _module_preset=&#8221;default&#8221; content_font_size=&#8221;18px&#8221; background_image=&#8221;https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/uploads\/sites\/27\/2020\/09\/thomas-willmott-JwbRlo52UFU-unsplash-scaled.jpg&#8221; custom_padding=&#8221;103px||132px|||&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>One of our coordinators<\/p>\n<p>will get in touch with you\u00a0in order to do the<\/p>\n<p>appropriate\u00a0follow-up.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>We look forward to responding to \u00a0your application<\/p>\n<p>as quickly \u00a0as possible<\/p>\n<p>depending on the availability of our volunteers.<\/p>\n<p>[\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.9.10&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.9.10&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.9.10&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text admin_label=&#8221;Text&#8221; _builder_version=&#8221;4.11.4&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\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 gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_11' >\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Register a Beneficiary<\/h3>\n                            <p class='gform_description'>Form to register new beneficiaries to the service of spiritual accompaniment of Pastoral Home Care \/ SASMAD<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11'  action='\/microsites\/sasmad\/wp-json\/wp\/v2\/pages\/3164' data-formid='11' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_11_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_11_1'>\n                            \n                            <span id='input_11_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_11_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_1_3' class='gform-field-label gform-field-label--type-sub '>First Name<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_11_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_1_6' class='gform-field-label gform-field-label--type-sub '>Last Name<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_11_118\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon 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_11_118'>Date of birth<\/label><div class='gfield_description' id='gfield_description_11_118'>Date of birth of the beneficiary <\/div><div class='ginput_container ginput_container_date'>\n                            <input name='input_118' id='input_11_118' type='text' value='' class='datepicker gform-datepicker ymd_dash datepicker_no_icon gdatepicker-no-icon'   placeholder='aaaa-mm-jj' aria-describedby=\"input_11_118_date_format gfield_description_11_118\" aria-invalid=\"false\" \/>\n                            <span id='input_11_118_date_format' class='screen-reader-text'>AAAA - MM - JJ<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_11_118' class='gform_hidden' value='https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_11_104\" class=\"gfield gfield--type-select 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_11_104'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_104'>Choose if the person to be accompanied is male or female. <\/div><div class='ginput_container ginput_container_select'><select name='input_104' id='input_11_104' class='medium gfield_select'  aria-describedby=\"gfield_description_11_104\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_11_117\" class=\"gfield gfield--type-email 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_11_117'>E-mail of the person filling out this form<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_117' id='input_11_117' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_11_129\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon 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_11_129'>Date of registration<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_129'>Date when the new registration was received or is being created (today's date)<\/div><div class='ginput_container ginput_container_date'>\n                            <input name='input_129' id='input_11_129' type='text' value='' class='datepicker gform-datepicker ymd_dash datepicker_no_icon gdatepicker-no-icon'   placeholder='aaaa-mm-jj' aria-describedby=\"input_11_129_date_format gfield_description_11_129\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_11_129_date_format' class='screen-reader-text'>AAAA - MM - JJ<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_11_129' class='gform_hidden' value='https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_11_120\" 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_11_120'>Living environment (At home\/ Private Residence\/ Public establishment) :<\/label><div class='ginput_container ginput_container_text'><input name='input_120' id='input_11_120' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_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' >Addresse<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_11_121' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_11_121_1_container' >\n                                        <input type='text' name='input_121.1' id='input_11_121_1' value=''    aria-required='true'    \/>\n                                        <label for='input_11_121_1' id='input_11_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_11_121_2_container' >\n                                        <input type='text' name='input_121.2' id='input_11_121_2' value=''     aria-required='false'   \/>\n                                        <label for='input_11_121_2' id='input_11_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_11_121_3_container' >\n                                    <input type='text' name='input_121.3' id='input_11_121_3' value=''    aria-required='true'    \/>\n                                    <label for='input_11_121_3' id='input_11_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_11_121_4_container' >\n                                        <input type='text' name='input_121.4' id='input_11_121_4' value=''      aria-required='true'    \/>\n                                        <label for='input_11_121_4' id='input_11_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_11_121_5_container' >\n                                    <input type='text' name='input_121.5' id='input_11_121_5' value=''    aria-required='true'    \/>\n                                    <label for='input_11_121_5' id='input_11_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_11_121_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_11_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_11_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_11_119' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_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_11_122'>Telephone 2<\/label><div class='ginput_container ginput_container_phone'><input name='input_122' id='input_11_122' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_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_11_42'>Parish<\/label><div class='gfield_description' id='gfield_description_11_42'>Please indicate the territory of the Parish where  the beneficiary resides (optional)<\/div><div class='ginput_container ginput_container_text'><input name='input_42' id='input_11_42' type='text' value='' class='medium'  aria-describedby=\"gfield_description_11_42\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_123\" 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_11_123'>Sector<\/label><div class='gfield_description' id='gfield_description_11_123'>(Laval\/ Repentigny, Centre, East, West, Anglophone)<\/div><div class='ginput_container ginput_container_text'><input name='input_123' id='input_11_123' type='text' value='' class='medium'  aria-describedby=\"gfield_description_11_123\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_124\" 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_11_124'>Spoken Languages :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_124'>Please indicate all languages that the beneficiary are able to speak<\/div><div class='ginput_container ginput_container_text'><input name='input_124' id='input_11_124' type='text' value='' class='large'  aria-describedby=\"gfield_description_11_124\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_125\" 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_11_125'>Language  for the accompaniment :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_125'>Specify the language for the accompaniment<\/div><div class='ginput_container ginput_container_text'><input name='input_125' id='input_11_125' type='text' value='' class='large'  aria-describedby=\"gfield_description_11_125\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_60\" 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_11_60'>Health Status :<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_60' id='input_11_60' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_11_112\" 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' >Reasons or needs :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_112'>Please indicate all that are applicable<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_11_112'><li class='gchoice gchoice_11_112_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.1' type='checkbox'  value='I would like to talk to a priest'  id='choice_11_112_1'   aria-describedby=\"gfield_description_11_112\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_11_112_1' id='label_11_112_1' class='gform-field-label gform-field-label--type-inline'>I would like to talk to a priest<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_112_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.2' type='checkbox'  value='I would like to receive the sacraments of Confession and Communion'  id='choice_11_112_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_112_2' id='label_11_112_2' class='gform-field-label gform-field-label--type-inline'>I would like to receive the sacraments of Confession and Communion<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_112_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.3' type='checkbox'  value='I would like to be visited by a  volunteer and have somebody to talk to'  id='choice_11_112_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_112_3' id='label_11_112_3' class='gform-field-label gform-field-label--type-inline'>I would like to be visited by a  volunteer and have somebody to talk to<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_112_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.4' type='checkbox'  value='Other (please explain on the here below space)'  id='choice_11_112_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_112_4' id='label_11_112_4' class='gform-field-label gform-field-label--type-inline'>Other (please explain on the here below space)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_11_126\" 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_11_126'>Other reasons or needs :<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_126' id='input_11_126' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_11_127\" 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_11_127'>Beneficiary referred by (Full name \/ Title or relationship \/ Telephone\/ Specific Requests)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_127' id='input_11_127' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_11_128\" 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_11_128'>Family references (Full name \/  Relationship to the beneficiary \/ Telephone and other contacts if applicable)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_128' id='input_11_128' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_11_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_11_101'>Message or additional comments (optional) :<\/label><div class='ginput_container ginput_container_text'><input name='input_101' id='input_11_101' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_116\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Thank you so much for your registration !<\/h2><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_11' 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_11' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_11' id='gform_theme_11' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_11' id='gform_style_settings_11' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_11' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='11' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='CAD' value='iWod8ahKanhW1m68ZkZ6sAQ6UVaoLFakJAigSLzO3ICdYdGLufXfsL3ppw8XiJ7yljvvo7Zumd2zT3wk5L87SpY1QzIFJZZV3IDL9t7+fUpHsog=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_11' value='WyJbXSIsImNjZGRiMWY4YWYyMGY4Yzc4ZjgzYzg4ZDJlNmU2MjU5Il0=' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_11' id='gform_target_page_number_11' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_11' id='gform_source_page_number_11' 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=\"190\"\/><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( 11, 'https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_11').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_11');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_11').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_11').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_11').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_11').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_11').val();gformInitSpinner( 11, 'https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [11, current_page]);window['gf_submitting_11'] = 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_11').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [11]);window['gf_submitting_11'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_11').text());}else{jQuery('#gform_11').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"11\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_11\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_11\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_11\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 11, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} ); \n\/* ]]> *\/\n<\/script>\n\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.9.10&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; &nbsp; One of our coordinators will get in touch with you\u00a0in order to do the appropriate\u00a0follow-up. &nbsp; &nbsp; &nbsp; We look forward to responding to \u00a0your application as quickly \u00a0as possible depending on the availability of our volunteers. \n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_11' >\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Register a Beneficiary<\/h3>\n                            <p class='gform_description'>Form to register new beneficiaries to the service of spiritual accompaniment of Pastoral Home Care \/ SASMAD<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11'  action='\/microsites\/sasmad\/wp-json\/wp\/v2\/pages\/3164' data-formid='11' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_11_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_11_1'>\n                            \n                            <span id='input_11_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_11_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_1_3' class='gform-field-label gform-field-label--type-sub '>First Name<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_11_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_1_6' class='gform-field-label gform-field-label--type-sub '>Last Name<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_11_118\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon 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_11_118'>Date of birth<\/label><div class='gfield_description' id='gfield_description_11_118'>Date of birth of the beneficiary <\/div><div class='ginput_container ginput_container_date'>\n                            <input name='input_118' id='input_11_118' type='text' value='' class='datepicker gform-datepicker ymd_dash datepicker_no_icon gdatepicker-no-icon'   placeholder='aaaa-mm-jj' aria-describedby=\"input_11_118_date_format gfield_description_11_118\" aria-invalid=\"false\" \/>\n                            <span id='input_11_118_date_format' class='screen-reader-text'>AAAA - MM - JJ<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_11_118' class='gform_hidden' value='https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_11_104\" class=\"gfield gfield--type-select 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_11_104'>Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_104'>Choose if the person to be accompanied is male or female. <\/div><div class='ginput_container ginput_container_select'><select name='input_104' id='input_11_104' class='medium gfield_select'  aria-describedby=\"gfield_description_11_104\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_11_117\" class=\"gfield gfield--type-email 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_11_117'>E-mail of the person filling out this form<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_117' id='input_11_117' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_11_129\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon 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_11_129'>Date of registration<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_129'>Date when the new registration was received or is being created (today's date)<\/div><div class='ginput_container ginput_container_date'>\n                            <input name='input_129' id='input_11_129' type='text' value='' class='datepicker gform-datepicker ymd_dash datepicker_no_icon gdatepicker-no-icon'   placeholder='aaaa-mm-jj' aria-describedby=\"input_11_129_date_format gfield_description_11_129\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_11_129_date_format' class='screen-reader-text'>AAAA - MM - JJ<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_11_129' class='gform_hidden' value='https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_11_120\" 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_11_120'>Living environment (At home\/ Private Residence\/ Public establishment) :<\/label><div class='ginput_container ginput_container_text'><input name='input_120' id='input_11_120' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_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' >Addresse<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_11_121' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_11_121_1_container' >\n                                        <input type='text' name='input_121.1' id='input_11_121_1' value=''    aria-required='true'    \/>\n                                        <label for='input_11_121_1' id='input_11_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_11_121_2_container' >\n                                        <input type='text' name='input_121.2' id='input_11_121_2' value=''     aria-required='false'   \/>\n                                        <label for='input_11_121_2' id='input_11_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_11_121_3_container' >\n                                    <input type='text' name='input_121.3' id='input_11_121_3' value=''    aria-required='true'    \/>\n                                    <label for='input_11_121_3' id='input_11_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_11_121_4_container' >\n                                        <input type='text' name='input_121.4' id='input_11_121_4' value=''      aria-required='true'    \/>\n                                        <label for='input_11_121_4' id='input_11_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_11_121_5_container' >\n                                    <input type='text' name='input_121.5' id='input_11_121_5' value=''    aria-required='true'    \/>\n                                    <label for='input_11_121_5' id='input_11_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_11_121_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_11_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_11_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_11_119' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_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_11_122'>Telephone 2<\/label><div class='ginput_container ginput_container_phone'><input name='input_122' id='input_11_122' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_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_11_42'>Parish<\/label><div class='gfield_description' id='gfield_description_11_42'>Please indicate the territory of the Parish where  the beneficiary resides (optional)<\/div><div class='ginput_container ginput_container_text'><input name='input_42' id='input_11_42' type='text' value='' class='medium'  aria-describedby=\"gfield_description_11_42\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_123\" 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_11_123'>Sector<\/label><div class='gfield_description' id='gfield_description_11_123'>(Laval\/ Repentigny, Centre, East, West, Anglophone)<\/div><div class='ginput_container ginput_container_text'><input name='input_123' id='input_11_123' type='text' value='' class='medium'  aria-describedby=\"gfield_description_11_123\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_124\" 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_11_124'>Spoken Languages :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_124'>Please indicate all languages that the beneficiary are able to speak<\/div><div class='ginput_container ginput_container_text'><input name='input_124' id='input_11_124' type='text' value='' class='large'  aria-describedby=\"gfield_description_11_124\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_125\" 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_11_125'>Language  for the accompaniment :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_125'>Specify the language for the accompaniment<\/div><div class='ginput_container ginput_container_text'><input name='input_125' id='input_11_125' type='text' value='' class='large'  aria-describedby=\"gfield_description_11_125\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_60\" 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_11_60'>Health Status :<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_60' id='input_11_60' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_11_112\" 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' >Reasons or needs :<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_112'>Please indicate all that are applicable<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_11_112'><li class='gchoice gchoice_11_112_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.1' type='checkbox'  value='I would like to talk to a priest'  id='choice_11_112_1'   aria-describedby=\"gfield_description_11_112\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_11_112_1' id='label_11_112_1' class='gform-field-label gform-field-label--type-inline'>I would like to talk to a priest<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_112_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.2' type='checkbox'  value='I would like to receive the sacraments of Confession and Communion'  id='choice_11_112_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_112_2' id='label_11_112_2' class='gform-field-label gform-field-label--type-inline'>I would like to receive the sacraments of Confession and Communion<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_112_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.3' type='checkbox'  value='I would like to be visited by a  volunteer and have somebody to talk to'  id='choice_11_112_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_112_3' id='label_11_112_3' class='gform-field-label gform-field-label--type-inline'>I would like to be visited by a  volunteer and have somebody to talk to<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_112_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_112.4' type='checkbox'  value='Other (please explain on the here below space)'  id='choice_11_112_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_112_4' id='label_11_112_4' class='gform-field-label gform-field-label--type-inline'>Other (please explain on the here below space)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_11_126\" 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_11_126'>Other reasons or needs :<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_126' id='input_11_126' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_11_127\" 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_11_127'>Beneficiary referred by (Full name \/ Title or relationship \/ Telephone\/ Specific Requests)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_127' id='input_11_127' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_11_128\" 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_11_128'>Family references (Full name \/  Relationship to the beneficiary \/ Telephone and other contacts if applicable)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_128' id='input_11_128' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_11_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_11_101'>Message or additional comments (optional) :<\/label><div class='ginput_container ginput_container_text'><input name='input_101' id='input_11_101' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_11_116\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Thank you so much for your registration !<\/h2><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_11' 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_11' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_11' id='gform_theme_11' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_11' id='gform_style_settings_11' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_11' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='11' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='CAD' value='4yXeh+i8tvWPf51uTgvhHeGJQaNqsNeNCzzfgkovouhyAHyUaLfua4LV950gxR6jkv7Toh9Fr4YoB2c3QlUD7gi4ExLedBmv3tq9AOkl7aHtK7E=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_11' value='WyJbXSIsImNjZGRiMWY4YWYyMGY4Yzc4ZjgzYzg4ZDJlNmU2MjU5Il0=' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_11' id='gform_target_page_number_11' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_11' id='gform_source_page_number_11' 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_2\" name=\"ak_js\" value=\"99\"\/><script>document.getElementById( \"ak_js_2\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><\/form>\n                        <\/div><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\n gform.initializeOnLoaded( function() {gformInitSpinner( 11, 'https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery('#gform_ajax_frame_11').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_11');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_11').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_11').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_11').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_11').removeClass('gform_validation_error');}setTimeout( function() { \/* delay the scroll by 50 milliseconds to fix a bug in chrome *\/  }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_11').val();gformInitSpinner( 11, 'https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-content\/plugins\/gravityforms\/images\/spinner.svg', true );jQuery(document).trigger('gform_page_loaded', [11, current_page]);window['gf_submitting_11'] = 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_11').replaceWith(confirmation_content);jQuery(document).trigger('gform_confirmation_loaded', [11]);window['gf_submitting_11'] = false;wp.a11y.speak(jQuery('#gform_confirmation_message_11').text());}else{jQuery('#gform_11').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger(\"gform_pre_post_render\", [{ formId: \"11\", currentPage: \"current_page\", abort: function() { this.preventDefault(); } }]);        if (event && event.defaultPrevented) {                return;        }        const gformWrapperDiv = document.getElementById( \"gform_wrapper_11\" );        if ( gformWrapperDiv ) {            const visibilitySpan = document.createElement( \"span\" );            visibilitySpan.id = \"gform_visibility_test_11\";            gformWrapperDiv.insertAdjacentElement( \"afterend\", visibilitySpan );        }        const visibilityTestDiv = document.getElementById( \"gform_visibility_test_11\" );        let postRenderFired = false;        function triggerPostRender() {            if ( postRenderFired ) {                return;            }            postRenderFired = true;            gform.core.triggerPostRenderEvents( 11, current_page );            if ( visibilityTestDiv ) {                visibilityTestDiv.parentNode.removeChild( visibilityTestDiv );            }        }        function debounce( func, wait, immediate ) {            var timeout;            return function() {                var context = this, args = arguments;                var later = function() {                    timeout = null;                    if ( !immediate ) func.apply( context, args );                };                var callNow = immediate && !timeout;                clearTimeout( timeout );                timeout = setTimeout( later, wait );                if ( callNow ) func.apply( context, args );            };        }        const debouncedTriggerPostRender = debounce( function() {            triggerPostRender();        }, 200 );        if ( visibilityTestDiv && visibilityTestDiv.offsetParent === null ) {            const observer = new MutationObserver( ( mutations ) => {                mutations.forEach( ( mutation ) => {                    if ( mutation.type === 'attributes' && visibilityTestDiv.offsetParent !== null ) {                        debouncedTriggerPostRender();                        observer.disconnect();                    }                });            });            observer.observe( document.body, {                attributes: true,                childList: false,                subtree: true,                attributeFilter: [ 'style', 'class' ],            });        } else {            triggerPostRender();        }    } );} ); \n\/* ]]> *\/\n<\/script>\n<\/p>\n","protected":false},"author":196,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-3164","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-json\/wp\/v2\/pages\/3164","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-json\/wp\/v2\/comments?post=3164"}],"version-history":[{"count":18,"href":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-json\/wp\/v2\/pages\/3164\/revisions"}],"predecessor-version":[{"id":4071,"href":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-json\/wp\/v2\/pages\/3164\/revisions\/4071"}],"wp:attachment":[{"href":"https:\/\/microsites.diocesemontreal.org\/microsites\/sasmad\/wp-json\/wp\/v2\/media?parent=3164"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}