{"id":61,"date":"2023-07-19T15:20:46","date_gmt":"2023-07-19T15:20:46","guid":{"rendered":"https:\/\/dev-cofc-gravity-forms.pantheonsite.io\/diversity\/?page_id=61"},"modified":"2023-07-27T16:21:53","modified_gmt":"2023-07-27T16:21:53","slug":"youth-program-director-verification-form-page-2","status":"publish","type":"page","link":"https:\/\/forms.charleston.edu\/diversity\/youth-program-director-verification-form-page-2\/","title":{"rendered":"Youth Program Director Verification Form"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_5' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_5'  action='\/diversity\/wp-json\/wp\/v2\/pages\/61' data-formid='5' novalidate>\n        <div id='gf_progressbar_wrapper_5' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>7<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_14' style='width:14%;'><span>14%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_5_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_5' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_5_3\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><img decoding=\"async\" style=\"max-width: 100%\" src=\"https:\/\/forms.charleston.edu\/diversity\/wp-content\/uploads\/sites\/25\/2025\/04\/CofC-Block-C-horizontal-M.png\" alt=\"Logos\" \/>\n\n<p>Thank you for submitting your registration request for your youth program at the College of Charleston (CofC). To demonstrate the College's commitment to the protection of minors, important requirements must be met and documented. This verification form serves as evidence that these requirements have been fulfilled.\n<\/p>\n<p>\nPlease complete this form in its entirety (including attachments), submit, and wait for email confirmation that your documents have been approved (not just received) prior to starting your program. Confirmation may take up to 5 business days. Once approved, your program is registered and deemed to have met requirements necessary to operate. <\/p>\n\n\n\n<\/div><div id=\"field_5_4\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_4'>Youth Program Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_4'>Please enter the name of the Youth Program. <\/div><div class='ginput_container ginput_container_text'><input name='input_4' id='input_5_4' type='text' value='' class='large'  aria-describedby=\"gfield_description_5_4\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_5_5\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Type of Youth Program<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_5_5'>What type of youth program is this?<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_5'>\n\t\t\t<div class='gchoice gchoice_5_5_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Internal - operated by a CofC entity, regardless of location'  id='choice_5_5_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_5_5\"   \/>\n\t\t\t\t\t<label for='choice_5_5_0' id='label_5_5_0' class='gform-field-label gform-field-label--type-inline'>Internal - operated by a CofC entity, regardless of location<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_5_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='External - operated by a non-CofC entity using CofC facilities'  id='choice_5_5_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_5_1' id='label_5_5_1' class='gform-field-label gform-field-label--type-inline'>External - operated by a non-CofC entity using CofC facilities<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_8\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Youth Program Director Information<\/h3><\/div><fieldset id=\"field_5_6\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Director Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name 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_5_6'>\n                            \n                            <span id='input_5_6_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_5_6_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_6.3' id='input_5_6_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_5_6_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_5_6_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_6.6' id='input_5_6_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_5_10\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_10'>Director Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_10' id='input_5_10' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_5_7\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_7'>Director Organization<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_7' id='input_5_7' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_9'>Director Position<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_5_9' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Youth Program Co-Director Information<\/h3><\/div><fieldset id=\"field_5_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there a co-director for the youth program?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_12'>\n\t\t\t<div class='gchoice gchoice_5_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Yes'  id='choice_5_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_12_0' id='label_5_12_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='No'  id='choice_5_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_12_1' id='label_5_12_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_15\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Co-Director Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name 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_5_15'>\n                            \n                            <span id='input_5_15_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_5_15_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_15.3' id='input_5_15_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_5_15_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_5_15_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_15.6' id='input_5_15_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_5_16\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_16'>Co-Director Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_16' id='input_5_16' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_5_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_13'>Co-Director Organization<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_5_13' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_14\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_14'>Co-Director Position<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_5_14' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_17\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">College Sponsor Information<\/h3><\/div><div id=\"field_5_18\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Each youth program is expected to have a College Sponsor. <\/p>\n\n<p><strong>\nEvery College Sponsor must be pre-authorized by the appropriate Dean or Executive Vice President.\n<\/strong><\/p>\n\n<p>\nFor <strong>internal programs<\/strong>, the College Sponsor is the College of Charleston <strong>department or unit<\/strong> operating or hosting the program.  \n<\/p>\n\n<p>\nFor <strong>external programs<\/strong>, the College Sponsor is the College of Charleston <strong>employee, department, or unit<\/strong> serving as the liaison between the program and the College.\n<\/p>\n\n<p>\nFor the purposes of protection of minors, a College Sponsor is not assumed to have a financial commitment to the program. \n<\/p><\/div><fieldset id=\"field_5_19\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >College Sponsor Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name 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_5_19'>\n                            \n                            <span id='input_5_19_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_5_19_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_19.3' id='input_5_19_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_5_19_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_5_19_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_19.6' id='input_5_19_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_5_20\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_20'>College Sponsor CofC Email Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_20' id='input_5_20' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_5_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_22'>Start Date of Youth Program<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_5_22' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_5_24' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_5_2_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Resume Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_5_2' class='gform_page' data-js='page-field-id-24' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_5_2' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_5_23\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Program Staff\/Volunteers<\/h3><\/div><div id=\"field_5_25\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_25'>Complete Current Program Roster<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_25'>Upload a complete current roster of the youth program staff, including volunteers. The roster should include only first name, last name, and position\/title in the program. (example: Kim Smith, Counselor). Please do not include any other personal information.<\/div><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1536000' \/><input name='input_25' id='input_5_25' type='file' class='large' aria-describedby=\"gfield_upload_rules_5_25 gfield_description_5_25\" onchange='javascript:gformValidateFileSize( this, 1536000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_5_25'>Max. file size: 1 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_5_25'><\/div> <\/div><\/div><fieldset id=\"field_5_26\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Background Check Verification<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_26.1' id='input_5_26_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_26_1' >Each program staff member and volunteer has undergone an appropriate background check which includes both a criminal history and sexual offender registry check and review within the last thirty-six (36) months.<\/label><input type='hidden' name='input_26.2' value='Each program staff member and volunteer has undergone an appropriate background check which includes both a criminal history and sexual offender registry check and review within the last thirty-six (36) months.' class='gform_hidden' \/><input type='hidden' name='input_26.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_27\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Check Verifications Provided to College Sponsor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_27.1' id='input_5_27_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_27_1' >Verification that a background check which includes both a criminal history check and sexual offender registry check was conducted for each program staff and volunteer within the last thirty-six (36) months has been provided to the college sponsor.<\/label><input type='hidden' name='input_27.2' value='Verification that a background check which includes both a criminal history check and sexual offender registry check was conducted for each program staff and volunteer within the last thirty-six (36) months has been provided to the college sponsor.' class='gform_hidden' \/><input type='hidden' name='input_27.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_30\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Child Sexual Abuse Prevention Training<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_30.1' id='input_5_30_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_30_1' >Each program staff and volunteer has completed child sexual abuse prevention training that addresses, at a minimum, how to prevent, recognize, and react responsibly to child sexual abuse.<\/label><input type='hidden' name='input_30.2' value='Each program staff and volunteer has completed child sexual abuse prevention training that addresses, at a minimum, how to prevent, recognize, and react responsibly to child sexual abuse.' class='gform_hidden' \/><input type='hidden' name='input_30.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_31\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Training Completion Verifications Provided to College Sponsor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_31.1' id='input_5_31_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_31_1' >Verification that each program staff and volunteer has completed appropriate child sexual abuse prevention training has been provided to the program's College Sponsor.<\/label><input type='hidden' name='input_31.2' value='Verification that each program staff and volunteer has completed appropriate child sexual abuse prevention training has been provided to the program&#039;s College Sponsor.' class='gform_hidden' \/><input type='hidden' name='input_31.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_32\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Statement of Acknowledgement and Agreement for Working with Minors<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_32.1' id='input_5_32_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_32_1' >Each program staff and volunteer has signed a Statement of Acknowledgement and Agreement for Working with Minors.<\/label><input type='hidden' name='input_32.2' value='Each program staff and volunteer has signed a Statement of Acknowledgement and Agreement for Working with Minors.' class='gform_hidden' \/><input type='hidden' name='input_32.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_33\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Signed Statements Provided to College Sponsor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_33.1' id='input_5_33_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_33_1' >A signed Statement of Acknowledgement and Agreement for Working with Minors from each program staff and volunteer has been provided to the program's College Sponsor.<\/label><input type='hidden' name='input_33.2' value='A signed Statement of Acknowledgement and Agreement for Working with Minors from each program staff and volunteer has been provided to the program&#039;s College Sponsor.' class='gform_hidden' \/><input type='hidden' name='input_33.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_5_36' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_5_36' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_5_3_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Resume Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_5_3' class='gform_page' data-js='page-field-id-36' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_5_3' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_5_35\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Parents\/Guardians<\/h3><\/div><fieldset id=\"field_5_37\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >College&#039;s Minor General Activity Releases Signed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_37.1' id='input_5_37_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_37_1' >A parent or legal guardian of each participating youth has signed the College's Minor General Activity Release.<\/label><input type='hidden' name='input_37.2' value='A parent or legal guardian of each participating youth has signed the College&#039;s Minor General Activity Release.' class='gform_hidden' \/><input type='hidden' name='input_37.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_38\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Signed Releases Provided to College Sponsor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_38.1' id='input_5_38_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_38_1' >An appropriately signed Minor General Activity Release Form for each participating youth has been provided to the program's College Sponsor.<\/label><input type='hidden' name='input_38.2' value='An appropriately signed Minor General Activity Release Form for each participating youth has been provided to the program&#039;s College Sponsor.' class='gform_hidden' \/><input type='hidden' name='input_38.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_39\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Proof of Health Insurance<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_39.1' id='input_5_39_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_39_1' >A parent or legal guardian has submitted proof of health insurance for each participating youth, in the event of a medical emergency.<\/label><input type='hidden' name='input_39.2' value='A parent or legal guardian has submitted proof of health insurance for each participating youth, in the event of a medical emergency.' class='gform_hidden' \/><input type='hidden' name='input_39.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><div id=\"field_5_41\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_5_41'>Youth Program Blank Forms<\/label><div class='gfield_description' id='gfield_description_5_41'>Upload a blank registration form, parent waiver, and other similar forms used by the youth program. If the forms are accessible on your program website, provide the link above.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_5_41' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_5_41&quot;,&quot;container&quot;:&quot;gform_multifile_upload_5_41&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_5_41&quot;,&quot;filelist&quot;:&quot;gform_preview_5_41&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/forms.charleston.edu\\\/diversity\\\/?gf_page=6ecf21b198089bb&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/forms.charleston.edu\\\/diversity\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/forms.charleston.edu\\\/diversity\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;1536000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:5,&quot;field_id&quot;:41,&quot;_gform_file_upload_nonce_5_41&quot;:&quot;02491d9a41&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_5_41&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_5_41' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_5_41' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_5_41 gfield_description_5_41\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_5_41'>Max. file size: 1 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_5_41'><\/ul> <div id='gform_preview_5_41' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_5_42\" class=\"gfield gfield--type-website gfield--input-type-website gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_42'>Youth Program Blank Form Links<\/label><div class='gfield_description' id='gfield_description_5_42'>If the forms are accessible on your program website, provide the link above.<\/div><div class='ginput_container ginput_container_website'>\n                    <input name='input_42' id='input_5_42' type='url' value='' class='large'  aria-describedby=\"gfield_description_5_42\"  placeholder='https:\/\/'  aria-invalid=\"false\" \/>\n                <\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_5_44' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_5_44' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_5_4_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Resume Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_5_4' class='gform_page' data-js='page-field-id-44' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_5_4' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_5_43\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Facilities and Insurance<\/h3><\/div><fieldset id=\"field_5_45\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Permission Granted to Operate Program at Program Site<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_45.1' id='input_5_45_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_45_1' >Permission has been granted by an authorized representative to operate the youth program in safe and suitable facilities at the program site.<\/label><input type='hidden' name='input_45.2' value='Permission has been granted by an authorized representative to operate the youth program in safe and suitable facilities at the program site.' class='gform_hidden' \/><input type='hidden' name='input_45.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_46\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Permission Verification Provided to College Sponsor<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_46.1' id='input_5_46_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_46_1' >Verification of permission to use facilities has been provided to the College Sponsor. If the youth program has an active Memorandum of Understanding or other agreement on file in the CofC Office of Legal Affairs, select checkbox.<\/label><input type='hidden' name='input_46.2' value='Verification of permission to use facilities has been provided to the College Sponsor. If the youth program has an active Memorandum of Understanding or other agreement on file in the CofC Office of Legal Affairs, select checkbox.' class='gform_hidden' \/><input type='hidden' name='input_46.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_47\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Insurance Coverage Is Secured<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_47.1' id='input_5_47_1' type='checkbox' value='1'   aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_47_1' >The youth program has secured appropriate liability, workers' compensation, and other insurance coverage, as determined by the College's insurance manager.<\/label><input type='hidden' name='input_47.2' value='The youth program has secured appropriate liability, workers&#039; compensation, and other insurance coverage, as determined by the College&#039;s insurance manager.' class='gform_hidden' \/><input type='hidden' name='input_47.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Certificate of Insurance Provided To College<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_5_49'>A Certificate of Insurance indicating appropriate coverage during all program dates and naming the College, its Trustees, officers, and employees as co-insured has been provided to the College at least 10 days prior to the program start date. You may upload the Certificate of Insurance below.<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_49'>\n\t\t\t<div class='gchoice gchoice_5_49_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Yes - Required for External Programs'  id='choice_5_49_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_5_49\"   \/>\n\t\t\t\t\t<label for='choice_5_49_0' id='label_5_49_0' class='gform-field-label gform-field-label--type-inline'>Yes - Required for External Programs<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_49_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_49' type='radio' value='Not Applicable to Internal Programs'  id='choice_5_49_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_49_1' id='label_5_49_1' class='gform-field-label gform-field-label--type-inline'>Not Applicable to Internal Programs<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_51\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_51'>Certificate of Insurance (External Programs Only)<\/label><div class='gfield_description' id='gfield_description_5_51'>You may upload the program's Certificate of Insurance here (external programs only)<\/div><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='1536000' \/><input name='input_51' id='input_5_51' type='file' class='large' aria-describedby=\"gfield_upload_rules_5_51 gfield_description_5_51\" onchange='javascript:gformValidateFileSize( this, 1536000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_5_51'>Max. file size: 1 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_5_51'><\/div> <\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_5_59' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_5_59' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_5_5_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Resume Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_5_5' class='gform_page' data-js='page-field-id-59' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_5_5' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_5_72\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Public Safety<\/h3><\/div><div id=\"field_5_74\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>The College\u2019s nationally accredited Department of Public Safety is committed to maintaining a safe and secure environment for students, faculty, staff and visitors.  \n<\/p><\/div><fieldset id=\"field_5_75\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Evidence of coordination with campus public safety<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_5_75'>Evidence of coordination with campus public safety. Select all that apply.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_75'><div class='gchoice gchoice_5_75_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.1' type='checkbox'  value='Student pick-up\/drop-off'  id='choice_5_75_1'   aria-describedby=\"gfield_description_5_75\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_5_75_1' id='label_5_75_1' class='gform-field-label gform-field-label--type-inline'>Student pick-up\/drop-off<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_75_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.2' type='checkbox'  value='Identification of program participants while on campus'  id='choice_5_75_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_75_2' id='label_5_75_2' class='gform-field-label gform-field-label--type-inline'>Identification of program participants while on campus<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_75_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.3' type='checkbox'  value='General safety considerations'  id='choice_5_75_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_75_3' id='label_5_75_3' class='gform-field-label gform-field-label--type-inline'>General safety considerations<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_75_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_75.4' type='checkbox'  value='Other'  id='choice_5_75_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_75_4' id='label_5_75_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_76\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_76'>Other evidence<\/label><div class='gfield_description' id='gfield_description_5_76'>You selected Other for the previous question. Please explain.<\/div><div class='ginput_container ginput_container_text'><input name='input_76' id='input_5_76' type='text' value='' class='large'  aria-describedby=\"gfield_description_5_76\"    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_77\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_5_77'>Documentation<\/label><div class='gfield_description' id='gfield_description_5_77'>Upload clearly labeled documentation to verify completion of each selected additional requirement. <\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_5_77' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_5_77&quot;,&quot;container&quot;:&quot;gform_multifile_upload_5_77&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_5_77&quot;,&quot;filelist&quot;:&quot;gform_preview_5_77&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/forms.charleston.edu\\\/diversity\\\/?gf_page=6ecf21b198089bb&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/forms.charleston.edu\\\/diversity\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/forms.charleston.edu\\\/diversity\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;1536000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:5,&quot;field_id&quot;:77,&quot;_gform_file_upload_nonce_5_77&quot;:&quot;cfcdc623bf&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_5_77&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_5_77' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_5_77' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_5_77 gfield_description_5_77\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_5_77'>Max. file size: 1 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_5_77'><\/ul> <div id='gform_preview_5_77' class='ginput_preview_list'><\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_5_71' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_5_71' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_5_6_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Resume Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_5_6' class='gform_page' data-js='page-field-id-71' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_5_6' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_5_58\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Additional Requirements<\/h3><\/div><div id=\"field_5_60\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Please refer to your youth program registration follow-up email (the message that contained the link to this form) to see the list of additional requirements specific to your youth program.<\/p><\/div><fieldset id=\"field_5_80\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Overnight Experience<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_5_80'>Does this program include an overnight experience?<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_80'>\n\t\t\t<div class='gchoice gchoice_5_80_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='Yes'  id='choice_5_80_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_5_80\"   \/>\n\t\t\t\t\t<label for='choice_5_80_0' id='label_5_80_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_80_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_80' type='radio' value='No'  id='choice_5_80_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_80_1' id='label_5_80_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_79\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Overnight Experience Health Plan<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_79'><div class='gchoice gchoice_5_79_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_79.1' type='checkbox'  value='Storage\/administration of medication'  id='choice_5_79_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_79_1' id='label_5_79_1' class='gform-field-label gform-field-label--type-inline'>Storage\/administration of medication<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_79_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_79.2' type='checkbox'  value='Support for management of chronic illnesses\/conditions'  id='choice_5_79_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_79_2' id='label_5_79_2' class='gform-field-label gform-field-label--type-inline'>Support for management of chronic illnesses\/conditions<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_79_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_79.3' type='checkbox'  value='Response to injuries\/medical situations'  id='choice_5_79_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_79_3' id='label_5_79_3' class='gform-field-label gform-field-label--type-inline'>Response to injuries\/medical situations<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_81\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Overnight Experience Safety Plan<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_81'><div class='gchoice gchoice_5_81_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.1' type='checkbox'  value='Coordination with public safety during move in and move out processes'  id='choice_5_81_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_81_1' id='label_5_81_1' class='gform-field-label gform-field-label--type-inline'>Coordination with public safety during move in and move out processes<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_81_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.2' type='checkbox'  value='Codes of conduct for staff\/youth'  id='choice_5_81_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_81_2' id='label_5_81_2' class='gform-field-label gform-field-label--type-inline'>Codes of conduct for staff\/youth<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_81_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.3' type='checkbox'  value='Staff to youth ratios, room visitation policies'  id='choice_5_81_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_81_3' id='label_5_81_3' class='gform-field-label gform-field-label--type-inline'>Staff to youth ratios, room visitation policies<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_81_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_81.4' type='checkbox'  value='Curfews'  id='choice_5_81_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_81_4' id='label_5_81_4' class='gform-field-label gform-field-label--type-inline'>Curfews<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_82\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Overnight Experience Agreements<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_82'><div class='gchoice gchoice_5_82_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.1' type='checkbox'  value='Lodging agreement secured (do not upload)'  id='choice_5_82_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_82_1' id='label_5_82_1' class='gform-field-label gform-field-label--type-inline'>Lodging agreement secured (do not upload)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_82_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_82.2' type='checkbox'  value='Dining agreement secured (do not upload)'  id='choice_5_82_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_82_2' id='label_5_82_2' class='gform-field-label gform-field-label--type-inline'>Dining agreement secured (do not upload)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_61\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Additional General Requirements<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_5_61'>What additional requirements were indicated for this youth program? Select all that apply.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_61'><div class='gchoice gchoice_5_61_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.1' type='checkbox'  value='Precautions for virtual interactions'  id='choice_5_61_1'   aria-describedby=\"gfield_description_5_61\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_5_61_1' id='label_5_61_1' class='gform-field-label gform-field-label--type-inline'>Precautions for virtual interactions<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_61_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.2' type='checkbox'  value='Safety for specialized settings (water, outdoors, labs, etc.)'  id='choice_5_61_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_61_2' id='label_5_61_2' class='gform-field-label gform-field-label--type-inline'>Safety for specialized settings (water, outdoors, labs, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_61_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.3' type='checkbox'  value='Safety for handling animals or specialized equipment'  id='choice_5_61_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_61_3' id='label_5_61_3' class='gform-field-label gform-field-label--type-inline'>Safety for handling animals or specialized equipment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_61_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.4' type='checkbox'  value='Meal time safety (supervision, food storage, etc.)'  id='choice_5_61_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_61_4' id='label_5_61_4' class='gform-field-label gform-field-label--type-inline'>Meal time safety (supervision, food storage, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_61_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.5' type='checkbox'  value='Field trip safety (transportation, heat\/weather, supervision, etc.)'  id='choice_5_61_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_61_5' id='label_5_61_5' class='gform-field-label gform-field-label--type-inline'>Field trip safety (transportation, heat\/weather, supervision, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_61_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.6' type='checkbox'  value='Storage\/administration of medications as needed (epi-pens, inhalers, insulin, etc.)'  id='choice_5_61_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_61_6' id='label_5_61_6' class='gform-field-label gform-field-label--type-inline'>Storage\/administration of medications as needed (epi-pens, inhalers, insulin, etc.)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_61_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.7' type='checkbox'  value='No additional requirements were indicated'  id='choice_5_61_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_61_7' id='label_5_61_7' class='gform-field-label gform-field-label--type-inline'>No additional requirements were indicated<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_61_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.8' type='checkbox'  value='Other'  id='choice_5_61_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_61_8' id='label_5_61_8' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_62\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_62'>Other Requirements<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_62'>You select Other for the Additional Requirements question. Please elaborate. <\/div><div class='ginput_container ginput_container_text'><input name='input_62' id='input_5_62' type='text' value='' class='large'  aria-describedby=\"gfield_description_5_62\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_63\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_5_63'>Requirement Satisfaction Documentation<\/label><div class='gfield_description' id='gfield_description_5_63'>Upload clearly labeled documentation to verify the completion of each additional requirement<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_5_63' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_5_63&quot;,&quot;container&quot;:&quot;gform_multifile_upload_5_63&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_5_63&quot;,&quot;filelist&quot;:&quot;gform_preview_5_63&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/forms.charleston.edu\\\/diversity\\\/?gf_page=6ecf21b198089bb&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/forms.charleston.edu\\\/diversity\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/forms.charleston.edu\\\/diversity\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;1536000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:5,&quot;field_id&quot;:63,&quot;_gform_file_upload_nonce_5_63&quot;:&quot;73e202f56e&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_5_63&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_5_63' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_5_63' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_5_63 gfield_description_5_63\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_5_63'>Max. file size: 1 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_5_63'><\/ul> <div id='gform_preview_5_63' class='ginput_preview_list'><\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_5_64' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='button' id='gform_next_button_5_64' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> <button type='button'  id='gform_save_5_7_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Resume Later<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_5_7' class='gform_page' data-js='page-field-id-64' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_5_7' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_5_65\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Certification and Submission<\/h3><\/div><fieldset id=\"field_5_66\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Certification of Accuracy<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description gfield_consent_description' id='gfield_consent_description_5_66' tabindex='0'>I certify, warrant, and assure the truthfulness and correctness of the information provided.<br \/>\n<\/div><div class='ginput_container ginput_container_consent'><input name='input_66.1' id='input_5_66_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_5_66\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_5_66_1' >I certify, warrant, and assure the truthfulness and correctness of the information provided.<\/label><input type='hidden' name='input_66.2' value='I certify, warrant, and assure the truthfulness and correctness of the information provided.' class='gform_hidden' \/><input type='hidden' name='input_66.3' value='11' class='gform_hidden' \/><\/div><\/fieldset><fieldset id=\"field_5_67\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Your Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_5_67'>Provide your name.<\/div><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_5_67'>\n                            \n                            <span id='input_5_67_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_5_67_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_67.3' id='input_5_67_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_5_67_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_5_67_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_67.6' id='input_5_67_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_5_68\" class=\"gfield gfield--type-signature gfield--input-type-signature gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_68'>Your Signature<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_68'>Please digitally sign this form. <\/div><input type='hidden' value='' name='input_68' id='input_5_68_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_5_68_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_5_68' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/forms.charleston.edu\/diversity\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_5_68_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_5_68_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_5_68_data' name='input_5_68_data' value=''><\/div><\/div><div id=\"field_5_69\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_69'>Today&#039;s Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_69'>Please enter today's date. <\/div><div class='ginput_container ginput_container_text'><input name='input_69' id='input_5_69' type='text' value='' class='large'  aria-describedby=\"gfield_description_5_69\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_5' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Previous'  \/> <input type='submit' id='gform_submit_button_5' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> <button type='button'  id='gform_save_5_footer_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save and Resume Later<\/button>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_5' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_5' id='gform_theme_5' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_5' id='gform_style_settings_5' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_5' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='5' \/>\n            <input type='hidden' class='gform_hidden' name='gform_save' id='gform_save_5' value='' \/>\n                             <input type='hidden' class='gform_hidden' name='gform_resume_token' id='gform_resume_token_5' value='' \/>\n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='y3JoadEzc3PD15T+8VvOlTsL6TcrYCV5bHLFFCDT+dKqZI6g0cr1SF3cl5Watt1zZmNAzSKpVXT4hUIVDSy\/9E4S1I7JaZDxo2GCpxjyU1iBY1U=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_5' 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