{"id":5903,"date":"2024-07-16T10:04:37","date_gmt":"2024-07-16T10:04:37","guid":{"rendered":"https:\/\/boosterclubs.org\/developerone\/?page_id=5903"},"modified":"2024-08-07T10:36:14","modified_gmt":"2024-08-07T10:36:14","slug":"covid-19-support-form","status":"publish","type":"page","link":"https:\/\/boosterclubs.org\/developerone\/covid-19-support-form\/","title":{"rendered":"Covid &#8211; 19 Support Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"5903\" class=\"elementor elementor-5903\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-61a9b2db elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"61a9b2db\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1bdb4f02\" data-id=\"1bdb4f02\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-51d0042b elementor-widget elementor-widget-pix-badge\" data-id=\"51d0042b\" data-element_type=\"widget\" data-widget_type=\"pix-badge.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"pix-element-div w-100 text-center\"><span class=\"pix-badge-element h6 d-inline-flex mr-1 \"  ><span class=\"badge font-weight-bold badge-pill bg-secondary-light  \" style=\" \"><span class=\"text-secondary\" style=\"\">Services<\/span><\/span><\/span><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1322a5f1 elementor-widget elementor-widget-pix-sliding-text\" data-id=\"1322a5f1\" data-element_type=\"widget\" data-widget_type=\"pix-sliding-text.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div id=\"el-1322a5f1\" class=\"mb-3 text-center \"><div class=\"d-inline-block\" style=\"max-width:500px;\"><h2 class=\"mb-32 pix-sliding-headline-2 animate-in font-weight-bold secondary-font \" data-anim-type=\"pix-sliding-text\" pix-anim-delay=\"500\" data-class=\"secondary-font text-heading-default\" style=\"\"><span class=\"slide-in-container \"><span class=\"pix-sliding-item secondary-font text-heading-default\" style=\"transition-delay: 0ms;\">Covid&#32;<\/span><\/span> <span class=\"slide-in-container \"><span class=\"pix-sliding-item secondary-font text-heading-default\" style=\"transition-delay: 50ms;\">-19&#32;<\/span><\/span> <span class=\"slide-in-container \"><span class=\"pix-sliding-item secondary-font text-heading-default\" style=\"transition-delay: 100ms;\">Support&#32;<\/span><\/span> <span class=\"slide-in-container \"><span class=\"pix-sliding-item secondary-font text-heading-default\" style=\"transition-delay: 150ms;\">Form&#32;<\/span><\/span> <\/h2><\/div><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1c8734bd elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1c8734bd\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-200b99ca\" data-id=\"200b99ca\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-7e93d1e4 elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7e93d1e4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-c67c9e2\" data-id=\"c67c9e2\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1a34763 elementor-widget elementor-widget-image\" data-id=\"1a34763\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.22.0 - 26-06-2024 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"640\" height=\"360\" src=\"https:\/\/boosterclubs.org\/developerone\/wp-content\/uploads\/2024\/07\/covid-19.jpg\" class=\"attachment-large size-large wp-image-5920\" alt=\"\" srcset=\"https:\/\/boosterclubs.org\/developerone\/wp-content\/uploads\/2024\/07\/covid-19.jpg 960w, https:\/\/boosterclubs.org\/developerone\/wp-content\/uploads\/2024\/07\/covid-19-300x169.jpg 300w, https:\/\/boosterclubs.org\/developerone\/wp-content\/uploads\/2024\/07\/covid-19-768x432.jpg 768w\" sizes=\"(max-width: 640px) 100vw, 640px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-2e3ad025\" data-id=\"2e3ad025\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-30db42a3 elementor-invisible elementor-widget elementor-widget-pix-text\" data-id=\"30db42a3\" data-element_type=\"widget\" data-widget_type=\"pix-text.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"pix-el-text w-100 text-left \" ><p class=\"resp-option text-left \"><div class=\" animate-in d-inline-block\" data-anim-delay=\"400\" data-anim-type=\"fade-in-up\"><p>Fill out the following support form and one of our highly trained staff will personally respond.<br \/><br \/><\/p><p>If your Booster Club is facing challenges caused from Covid-19, we are here to help. Complete the form below and we will send you the special Booster Club and Covid-19 sheet.<\/p><\/div><\/p><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t<div class=\"elementor-element elementor-element-64481654 e-flex e-con-boxed e-con e-parent\" data-id=\"64481654\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-17f32435 elementor-widget elementor-widget-shortcode\" data-id=\"17f32435\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1719-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/developerone\/wp-json\/wp\/v2\/pages\/5903#wpcf7-f1719-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1719\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.9.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1719-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<input type=\"hidden\" name=\"_uacf7_hidden_conditional_fields\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/div>\n<div class=\"pix-contact7-form\"><div class=\"uacf7-form-1719\"><div class=\"uacf7-row\"><div class=\"uacf7-col-4\"> <label> Contact Type: (required)\n<span class=\"wpcf7-form-control-wrap\" data-name=\"contact_type\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"contact_type\"><option value=\"\">Select a Contact Type<\/option><option value=\"I&#039;m a Booster Club Officer\">I&#039;m a Booster Club Officer<\/option><option value=\"I&#039;m a Booster Club Member\">I&#039;m a Booster Club Member<\/option><option value=\"I&#039;m a Concerned Parent\">I&#039;m a Concerned Parent<\/option><option value=\"I&#039;m a Coach\">I&#039;m a Coach<\/option><option value=\"I&#039;m a School Official\">I&#039;m a School Official<\/option><option value=\"I&#039;m a Business Executive\">I&#039;m a Business Executive<\/option><option value=\"Other\">Other<\/option><\/select><\/span> <\/label> <\/div><div class=\"uacf7-col-4\"> \n<label> First Name: (required)\n<span class=\"wpcf7-form-control-wrap\" data-name=\"first_name\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first_name\" \/><\/span> <\/label> <\/div><div class=\"uacf7-col-4\"> \n<label> Last Name: (required)\n<span class=\"wpcf7-form-control-wrap\" data-name=\"last_name\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last_name\" \/><\/span> <\/label> <\/div><\/div>\n\n\n<div class=\"uacf7-row\"><div class=\"uacf7-col-6\"> <label> Email: (required)\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your_email\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your_email\" \/><\/span> <\/label> <\/div><div class=\"uacf7-col-6\"> <label> Phone: \n<span class=\"wpcf7-form-control-wrap\" data-name=\"phone\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"phone\" \/><\/span> <\/label> <\/div><\/div>\n\n\n\n<div class=\"uacf7-row\"><div class=\"uacf7-col-6\"> <label> Group Name: \n<span class=\"wpcf7-form-control-wrap\" data-name=\"group_name\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"group_name\" \/><\/span> <\/label> <\/div><div class=\"uacf7-col-6\"> \n<label> City: (required)\n<span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span> <\/label> <\/div><\/div>\n\n<div class=\"uacf7-row\"><div class=\"uacf7-col-6\"> <label> State: \n<span class=\"wpcf7-form-control-wrap\" data-name=\"state\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"state\"><option value=\"Select One\">Select One<\/option><option value=\"Washington\">Washington<\/option><option value=\"Alabama\">Alabama<\/option><option value=\"Alaska\">Alaska<\/option><option value=\"Arizona\">Arizona<\/option><option value=\"Arkansas\">Arkansas<\/option><option value=\"California\">California<\/option><option value=\"Colorado\">Colorado<\/option><option value=\"Connecticut\">Connecticut<\/option><option value=\"Delaware\">Delaware<\/option><option value=\"Florida\">Florida<\/option><option value=\"Georgia\">Georgia<\/option><option value=\"Hawaii\">Hawaii<\/option><option value=\"Idaho\">Idaho<\/option><option value=\"Illinois\">Illinois<\/option><option value=\"Indiana\">Indiana<\/option><option value=\"Iowa\">Iowa<\/option><option value=\"Kansas\">Kansas<\/option><option value=\"Kentucky\">Kentucky<\/option><option value=\"Louisiana\">Louisiana<\/option><option value=\"Maine\">Maine<\/option><option value=\"Maryland\">Maryland<\/option><option value=\"Massachusetts\">Massachusetts<\/option><option value=\"Michigan\">Michigan<\/option><option value=\"Minnesota\">Minnesota<\/option><option value=\"Mississippi\">Mississippi<\/option><option value=\"Missouri\">Missouri<\/option><option value=\"Montana\">Montana<\/option><option value=\"Nebraska\">Nebraska<\/option><option value=\"Nevada\">Nevada<\/option><option value=\"New Hampshire\">New Hampshire<\/option><option value=\"New Jersey\">New Jersey<\/option><option value=\"New Mexico\">New Mexico<\/option><option value=\"New York\">New York<\/option><option value=\"North Carolina\">North Carolina<\/option><option value=\"North Dakota\">North Dakota<\/option><option value=\"Ohio\">Ohio<\/option><option value=\"Oklahoma\">Oklahoma<\/option><option value=\"Oregon\">Oregon<\/option><option value=\"Pennsylvania\">Pennsylvania<\/option><option value=\"Rhode Island\">Rhode Island<\/option><option value=\"South Carolina\">South Carolina<\/option><option value=\"South Dakota\">South Dakota<\/option><option value=\"Tennessee\">Tennessee<\/option><option value=\"Texas\">Texas<\/option><option value=\"Utah\">Utah<\/option><option value=\"Vermont\">Vermont<\/option><option value=\"Virginia\">Virginia<\/option><option value=\"West Virginia\">West Virginia<\/option><option value=\"Wisconsin\">Wisconsin<\/option><option value=\"Wyoming\">Wyoming<\/option><option value=\"Puerto Rico\">Puerto Rico<\/option><option value=\"Canada\">Canada<\/option><option value=\"Alberta\">Alberta<\/option><option value=\"British Columbia\">British Columbia<\/option><option value=\"Manitoba\">Manitoba<\/option><option value=\"New Brunswick\">New Brunswick<\/option><option value=\"New Foundland\">New Foundland<\/option><option value=\"N.W. Territories\">N.W. Territories<\/option><option value=\"Nova Scotia\">Nova Scotia<\/option><option value=\"Ontario\">Ontario<\/option><option value=\"Prince Edward\">Prince Edward<\/option><option value=\"Quebec\">Quebec<\/option><option value=\"Saskatchewan\">Saskatchewan<\/option><option value=\"Yukon\">Yukon<\/option><\/select><\/span> <\/label> <\/div><div class=\"uacf7-col-6\"> <label> Zip\/Postal Code: (required)\n<span class=\"wpcf7-form-control-wrap\" data-name=\"zip\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zip\" \/><\/span> <\/label> <\/div><\/div>\n\n\n\n<div class=\"uacf7-row\"><div class=\"uacf7-col-6\"> Does your Booster Club\/Group support a School or Non-School based program?\n<span class=\"wpcf7-form-control-wrap\" data-name=\"program\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"program\" value=\"School\" \/><span class=\"wpcf7-list-item-label\">School<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"program\" value=\"Non School\" \/><span class=\"wpcf7-list-item-label\">Non School<\/span><\/span><\/span><\/span>\n <\/div><div class=\"uacf7-col-6\"> Help us to properly direct your support form to the correct staff member by selecting the option that best fits:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"staff\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"staff\" value=\"General Question\" \/><span class=\"wpcf7-list-item-label\">General Question<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"staff\" value=\"Booster Club Need\" \/><span class=\"wpcf7-list-item-label\">Booster Club Need<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"staff\" value=\"Fundraising Support\" \/><span class=\"wpcf7-list-item-label\">Fundraising Support<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"staff\" value=\"Insurance Inquiry\" \/><span class=\"wpcf7-list-item-label\">Insurance Inquiry<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"staff\" value=\"Training Inquiry\" \/><span class=\"wpcf7-list-item-label\">Training Inquiry<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"staff\" value=\"Community Discount Card Inquiry\" \/><span class=\"wpcf7-list-item-label\">Community Discount Card Inquiry<\/span><\/span><\/span><\/span><\/div><\/div>\n\n \n\n<div class=\"uacf7-row\"><div class=\"uacf7-col-12\"> <label>Please provide as much detail as you feel is necessary to help us properly address your Question - Concern or Need:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"question\"><textarea cols=\"40\" rows=\"10\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"question\"><\/textarea><\/span><\/label> <\/div><\/div>\n\n\n \n\n <div class=\"uacf7-row\"><div class=\"uacf7-col-12\"> <strong>Facing Challenges caused from Covid-19?<\/strong>  Fill out the Support form below.\n<br> <\/div><\/div>\n\n\n \n\n<div class=\"uacf7-row\"><div class=\"uacf7-col-12\"> <label>If your Booster Club has been affected by, or is currently experiencing any additional challenges due to the Covid pandemic, check all of the boxes below that apply to your situation and we will send you the Booster Club Covid report. (Required)<\/label> <\/div><\/div>\n\n<div class=\"uacf7-row\"><div class=\"uacf7-col-12\"> <span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-192\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"checkbox-192[]\" value=\"Please send us  the Booster Club Covid report\" \/><span class=\"wpcf7-list-item-label\">Please send us  the Booster Club Covid report<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-192[]\" value=\"Our Booster Club is lacking parent support\" \/><span class=\"wpcf7-list-item-label\">Our Booster Club is lacking parent support<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-192[]\" value=\"Our School is closed\" \/><span class=\"wpcf7-list-item-label\">Our School is closed<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-192[]\" value=\"We can\u2019t hold meetings or activities\" \/><span class=\"wpcf7-list-item-label\">We can\u2019t hold meetings or activities<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-192[]\" value=\"We can\u2019t conduct our traditional fundraisers\" \/><span class=\"wpcf7-list-item-label\">We can\u2019t conduct our traditional fundraisers<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-192[]\" value=\"We need to raise money and need fundraising programs that we can conduct under the current restrictions\" \/><span class=\"wpcf7-list-item-label\">We need to raise money and need fundraising programs that we can conduct under the current restrictions<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-192[]\" value=\"We are struggling to meet annual requirements outlined in our by-laws\" \/><span class=\"wpcf7-list-item-label\">We are struggling to meet annual requirements outlined in our by-laws<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-192[]\" value=\"We are losing member support\" \/><span class=\"wpcf7-list-item-label\">We are losing member support<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-192[]\" value=\"We need help determining if we are compliant with local, state and federal guidelines\" \/><span class=\"wpcf7-list-item-label\">We need help determining if we are compliant with local, state and federal guidelines<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"checkbox-192[]\" value=\"Other\" \/><span class=\"wpcf7-list-item-label\">Other<\/span><\/span><\/span><\/span> <\/div><\/div>\n\n <div class=\"uacf7-row\"><div class=\"uacf7-col-12\"> <label> Type your challenge:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"covid-other\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"covid-other\" \/><\/span> <\/label>  <\/div><\/div>\n\n \n <div class=\"uacf7-row\"><div class=\"uacf7-col-12\"> If you have spoken to one of the NBCTC representatives, please take a moment to indicate which representative. Taking the time to do so will make it easier for us to provide you with the proper assistance in the future. <\/div><\/div>\n\n <div class=\"uacf7-row\"><div class=\"uacf7-col-6\"> Were you referred by a NBCTC representative?\n<span class=\"wpcf7-form-control-wrap\" data-name=\"representative\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"representative\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"representative\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n <\/div><div class=\"uacf7-col-6\"> \n<label> NBCTC Representative Name:\n<span class=\"wpcf7-form-control-wrap\" data-name=\"representative-name\"><input size=\"40\" maxlength=\"80\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"representative-name\" \/><\/span> <\/label> <\/div><\/div>\n\n\n <div class=\"uacf7-row\"><div class=\"uacf7-col-4\">   <\/div><div class=\"uacf7-col-4\"> <input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/> <\/div><div class=\"uacf7-col-4\">  <\/div><\/div><\/div><\/div><input type='hidden' class='wpcf7-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Services Covid&#32; -19&#32; Support&#32; Form&#32; Fill out the following support form and one of our highly trained staff will personally respond. If your Booster Club is facing challenges caused from Covid-19, we are here to help. Complete the form below&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-5903","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/boosterclubs.org\/developerone\/wp-json\/wp\/v2\/pages\/5903","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/boosterclubs.org\/developerone\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/boosterclubs.org\/developerone\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/boosterclubs.org\/developerone\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/boosterclubs.org\/developerone\/wp-json\/wp\/v2\/comments?post=5903"}],"version-history":[{"count":16,"href":"https:\/\/boosterclubs.org\/developerone\/wp-json\/wp\/v2\/pages\/5903\/revisions"}],"predecessor-version":[{"id":6119,"href":"https:\/\/boosterclubs.org\/developerone\/wp-json\/wp\/v2\/pages\/5903\/revisions\/6119"}],"wp:attachment":[{"href":"https:\/\/boosterclubs.org\/developerone\/wp-json\/wp\/v2\/media?parent=5903"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}