{"id":34135,"date":"2023-12-20T16:45:56","date_gmt":"2023-12-20T21:45:56","guid":{"rendered":"http:\/\/localhost:10037\/%e1%93%84%e1%93%87%e1%92%83%e1%91%b0%e1%95%88%e1%91%8e%e1%95%90%e1%94%aa%e1%90%8a%e1%93%82%e1%91%a6-%e1%90%85%e1%96%81%e1%92%aa%e1%90%83%e1%91%a6%e1%91%90%e1%93%95%e1%95%86%e1%94%be%e1%94%aa%e1%91%8e\/"},"modified":"2023-12-20T16:45:56","modified_gmt":"2023-12-20T21:45:56","slug":"%e1%93%84%e1%93%87%e1%92%83%e1%91%b0%e1%95%88%e1%91%8e%e1%95%90%e1%94%aa%e1%90%8a%e1%93%82%e1%91%a6-%e1%90%85%e1%96%81%e1%92%aa%e1%90%83%e1%91%a6%e1%91%90%e1%93%95%e1%95%86%e1%94%be%e1%94%aa%e1%91%8e","status":"publish","type":"page","link":"https:\/\/www.qia.ca\/iu\/applications\/%e1%93%84%e1%93%87%e1%92%83%e1%91%b0%e1%95%88%e1%91%8e%e1%95%90%e1%94%aa%e1%90%8a%e1%93%82%e1%91%a6-%e1%90%85%e1%96%81%e1%92%aa%e1%90%83%e1%91%a6%e1%91%90%e1%93%95%e1%95%86%e1%94%be%e1%94%aa%e1%91%8e\/","title":{"rendered":"\u14c4\u14c7\u1483\u1470\u1548\u144e\u1550\u152a\u140a\u14c2\u1466 \u1405\u1581\u14aa\u1403\u1466\u1450\u14d5\u1546\u153e\u152a\u144e\u14c2\u1466 \u140a\u1581\u144e\u1405\u14c2\u1550\u14a5\u1483"},"content":{"rendered":"<div class=\"application-page\">\n<div class=\"text-block website-grid\">\n<p>\u1450\u154c\u1490\u14ea\u14d7\u140a\u1455\u14d6\u1466 \u157f\u146d\u1585\u1455\u14c2\u2212\u1472\u1450\u153e\u1528\u1583\u144e\u148c\u148d\u1455\u1405\u152a\u14a5 \u140a\u14a5\u14f1\u1548\u1483\u1472\u14d0\u14c2\u1581\u14ea\u14d7\u148b\u1466 \u1403\u14c4\u1403\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1550\u1438\u1466\u1450\u1466 \u157f\u146d\u1585\u1455\u14c2 \u14f4\u14c7\u1555\u1405\u1559\u1466\u1450\u14c2\u1466 \u14f2\u14d7\u1550 \u1405\u152d\u154b\u14d0\u14c2\u140a\u1550\u1555\u14bb\u14a5. \u157f\u146d\u1585\u1455\u14c2\u2212\u1472\u1450\u153e\u1528\u1583\u144e\u148c\u148d\u1455\u1405\u152a\u1585 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585\u1456\u1548\u1455\u1405\u1583\u1466\u1455\u14c2\u140a\u1585\u1450\u14c2\u1466 \u140a\u14bb\u14aa\u14d7 \u140a\u14ef\u158f\u14d0\u14c4\u1466 \u140a\u1450\u1585\u1455\u1405\u152a\u14d0\u14c7\u1585\u1450\u14c2\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u144e\u1466\u144e\u1559\u1466\u1450\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u144e\u1466\u144e\u148d\u144e\u148b\u1559\u1466\u1455\u158f\u144e\u148d\u1466 \u1403\u14c4\u14d0\u14c2\u1466 \u14c4\u14c7\u14d5\u14d0\u14c2\u1466 \u157f\u146d\u1585\u1455\u14c2. <\/p>\n<p>\u157f\u146d\u1585\u1455\u14c2\u2212\u1472\u1450\u153e\u1528\u1583\u144e\u148c\u148d\u1455\u1405\u152a\u1585 \u1431\u1593\u14f2\u152a\u1585\u1450\u14c2\u1466\u2212\u1431\u14c7\u14f1\u140a\u1548\u14ef\u1550\u14c2\u1466 \u14c4\u14c7\u1483\u1470\u1548\u144e\u1550\u152a\u140a\u14c2\u1466 \u140a\u1581\u144e\u1405\u14c2\u1550\u14a5\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u144e\u1466\u144e\u1583\u1466\u1455\u14f2\u1466 \u14a7\u140a\u1546\u1505\u1558\u1483, \u140b\u14d0\u144e\u1405\u1546\u1405\u14a5. \u1456\u14d0\u14c7 \u1403\u14d5\u14d0\u14c2\u140a\u1548\u1455\u1405\u14f2\u1585 \u1431\u152d\u1547\u1550\u14ef\u14ef\u14aa\u152a\u14c4\u1466 \u1431\u1559\u14ea\u14d5\u140a\u148d\u1455\u1405\u152a\u14d0\u14c7\u1438\u14bb\u14aa\u1466 \u140a\u1451\u144e\u14d5\u14d0\u14c2\u1466 \u1403\u1585\u1472\u14c7\u1403\u152e\u1583\u1550\u14c2\u1550\u14a5\u1483 \u1405\u152d\u154b\u14d0\u14c2\u140a\u1550\u1555\u14d0\u14c2\u1466 \u1405\u155d\u1559\u14d8\u14d0\u14c3\u1466 \u1403\u1585\u1472\u14c7\u1403\u152e\u1585\u1456\u1548\u1455\u1405\u14f2\u1591\u14ea\u14d7\u14c2 \u14c4\u14c7\u158f\u14d0\u14c2. <\/p>\n<p>\u1456\u14d0\u14c7 \u1431\u152d\u1547\u1466\u144e\u140a\u1550\u14c2\u140a\u154b\u1555\u1405\u1483 \u1431\u14c7\u14f2\u144f\u1466, \u1431\u152d\u1547\u1550\u14ef\u14ef\u14aa\u148b\u140a\u1583\u1585\u1450\u144e\u1466 \u1403\u1585\u1472\u14c7\u1403\u152e\u1585\u1456\u154b\u14f2\u144e\u14d0\u14c2\u1483 \u140a\u14bb\u14aa\u14d7 \u1431\u154b\u152d\u14da\u1405\u1550\u14ef\u14aa\u14bb\u14aa\u1594\u1550\u1431\u1466 \u1583\u1405\u1528\u14f4\u1585\u1455\u1405\u153e\u152a\u144e\u1583\u1546\u140a\u1583\u154b\u152d\u1585\u1450\u144e\u1466.<\/p>\n<p>\u1450\u146d\u14ef\u1483\u1472\u14d0\u14c2\u1548\u14aa\u148d\u1505\u14ef:<\/p>\n<p><a href=\"http:\/\/www.qia.ca\/what-we-do\/training-and-jobs\/#qstep\" target=\"_blank\" rel=\"noopener\">\u157f\u146d\u1585\u1455\u14c2 \u1431\u14d5\u14bb\u14aa\u1505\u14f4\u1403\u14c2\u1550\u14a7\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u144e\u1466\u144e\u14c2\u1550\u14a7\u14ea\u14d7 \u1403\u1585\u1472\u14c7\u1403\u152e\u1505\u14f4\u14c4\u1466 \u1472\u1450\u153e\u1528\u1583\u144e\u148c\u148d\u1455\u1405\u152a\u1585<\/a><\/p>\n<p>\u1450\u146d\u14ef\u148b\u140a\u1550\u14d7\u14ef \u1405\u1557\u1593 <a href=\"http:\/\/tuttarvik.qia.flywheelsites.com\/\" onclick=\"javascript:window.open('http:\/\/tuttarvik.qia.flywheelsites.com\/', '_blank', 'noopener'); return false;\">Tuttarvik.qia.flywheelsites.com<\/a><\/p>\n<p>\u1403\u1550\u1590\u14c8\u1585\u1455\u1405\u1456 <a href=\"mailto:tuttarvik@qia.flywheelsites.com\" target=\"_blank\" rel=\"noopener\">tuttarvik@qia.flywheelsites.com<\/a><\/p>\n<\/p><\/div>\n<div class=\"form-section\">\n<div class=\"website-grid\"><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 gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_32' style='display:none'><div id='gf_32' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Q-STEP - Heavy Equipment<\/h3>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_32'  action='\/iu\/wp-json\/wp\/v2\/pages\/34135#gf_32' data-formid='32' novalidate>\n        <div id='gf_progressbar_wrapper_32' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>5<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_20' style='width:20%;'><span>20%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_32_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_32' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_32_290\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_290'><span class='gform-field-label__text'>Facebook<\/span><\/label><div class='ginput_container'><input name='input_290' id='input_32_290' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_32_290'>This field is for validation purposes and should be left unchanged.<\/div><\/li><li id=\"field_32_95\" class=\"gfield gfield--type-section gsection nhsp-page-title field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Personal Information \/ \u1403\u155d\u1555\u1466 \u14a5\u1505\u14f5\u14c4\u1466 \u1450\u146d\u14ef\u1405\u14aa\u153e\u152a\u144e\u1505\u14f4\u1466<\/h2><div class='gsection_description' id='gfield_description_32_95'>All fields with * are required \/ \u144e\u144e\u1585\u14ef\u14aa\u152a\u14d5\u14ab\u1466 \u1405\u14ea\u14d7\u1546\u140a\u1550\u1591\u140a\u14d5\u1595\u14a5 * \u1455\u1455\u144e\u1585\u1455\u1405\u148b\u140a\u1583\u1585\u1450\u1466<\/div><\/li><li id=\"field_32_35\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Please enter your name \/ \u140a\u144f\u1466 \u144e\u144e\u154b\u1673\u140a\u1455\u1550\u14ef\u14d0\u14c7\u1548\u1483<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_32_35'>\n                            \n                            <span id='input_32_35_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_35.3' id='input_32_35_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_32_35_3' class='gform-field-label gform-field-label--type-sub '>First Name \/ \u140a\u144f\u1466<\/label>\n                                                <\/span>\n                            \n                            <span id='input_32_35_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_35.6' id='input_32_35_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_32_35_6' class='gform-field-label gform-field-label--type-sub '>Last Name \/ \u140a\u144e\u1548\u14f0\u1466<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_32_212\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Gender \/ \u140a\u1550\u14c7\u1405\u1555\u1466\/\u140a\u1591\u1455\u1405\u1555\u14ea\u14d8\u14d0\u14c3\u1466<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_212'>\n\t\t\t<li class='gchoice gchoice_32_212_0'>\n\t\t\t\t<input name='input_212' type='radio' value='Male \/ \u140a\u1591\u144f\u1466'  id='choice_32_212_0'    \/>\n\t\t\t\t<label for='choice_32_212_0' id='label_32_212_0' class='gform-field-label gform-field-label--type-inline'>Male \/ \u140a\u1591\u144f\u1466<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_212_1'>\n\t\t\t\t<input name='input_212' type='radio' value='Female \/ \u140a\u1550\u14c7\u1403\u1466'  id='choice_32_212_1'    \/>\n\t\t\t\t<label for='choice_32_212_1' id='label_32_212_1' class='gform-field-label gform-field-label--type-inline'>Female \/ \u140a\u1550\u14c7\u1403\u1466<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_212_2'>\n\t\t\t\t<input name='input_212' type='radio' value='Other \/ \u140a\u1403\u1449\u1439'  id='choice_32_212_2'    \/>\n\t\t\t\t<label for='choice_32_212_2' id='label_32_212_2' class='gform-field-label gform-field-label--type-inline'>Other \/ \u140a\u1403\u1449\u1439<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_236\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p style=\"font-size:20px; font-weight:700;\">Date of Birth \/ \u144e\u144e\u1550\u14ef\u1555\u148b\u14d7\u148d \u1405\u146d\u1405\u144e\u1466 \u14c7\u14db\u14c3\u155d\u1555\u158f\u1466<\/p><\/li><li id=\"field_32_237\" class=\"gfield gfield--type-select gfield--width-full gf_left_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_237'><span class='gform-field-label__text'>Day \/ \u1405\u14ea\u14d7\u1585<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_237' id='input_32_237' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Day \/ \u1405\u14ea\u14d7\u1585<\/option><option value='1st' >1st<\/option><option value='2nd' >2nd<\/option><option value='3rd' >3rd<\/option><option value='4th' >4th<\/option><option value='5th' >5th<\/option><option value='6th' >6th<\/option><option value='7th' >7th<\/option><option value='8th' >8th<\/option><option value='9th' >9th<\/option><option value='10th' >10th<\/option><option value='11th' >11th<\/option><option value='12th' >12th<\/option><option value='13th' >13th<\/option><option value='14th' >14th<\/option><option value='15th' >15th<\/option><option value='16th' >16th<\/option><option value='17th' >17th<\/option><option value='18th' >18th<\/option><option value='19th' >19th<\/option><option value='20th' >20th<\/option><option value='21st' >21st<\/option><option value='22nd' >22nd<\/option><option value='23rd' >23rd<\/option><option value='24th' >24th<\/option><option value='25th' >25th<\/option><option value='26th' >26th<\/option><option value='27th' >27th<\/option><option value='28th' >28th<\/option><option value='29th' >29th<\/option><option value='30th' >30th<\/option><option value='31st' >31st<\/option><\/select><\/div><\/li><li id=\"field_32_239\" class=\"gfield gfield--type-select gfield--width-full gf_middle_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_239'><span class='gform-field-label__text'>Month \/ \u1455\u1585\u146d\u1585<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_239' id='input_32_239' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Month \/ \u1455\u1585\u146d\u1585<\/option><option value='January \/ \u152e\u14d0\u14c4\u140a\u1546' >January \/ \u152e\u14d0\u14c4\u140a\u1546<\/option><option value='February \/ \u1556\u155d\u1557\u140a\u1546' >February \/ \u1556\u155d\u1557\u140a\u1546<\/option><option value='March \/ \u14aa\u153e\u1528' >March \/ \u14aa\u153e\u1528<\/option><option value='April \/ \u1404\u1433\u14ea' >April \/ \u1404\u1433\u14ea<\/option><option value='May \/ \u14aa\u1403' >May \/ \u14aa\u1403<\/option><option value='June \/ \u152a\u14c2' >June \/ \u152a\u14c2<\/option><option value='July \/ \u152a\u14da\u1403' >July \/ \u152a\u14da\u1403<\/option><option value='August \/ \u140a\u14a1\u148c\u14ef' >August \/ \u140a\u14a1\u148c\u14ef<\/option><option value='September \/ \u14ef\u144e\u1431\u1546' >September \/ \u14ef\u144e\u1431\u1546<\/option><option value='October \/ \u1405\u1450\u1431\u1546' >October \/ \u1405\u1450\u1431\u1546<\/option><option value='November \/ \u14c4\u1556\u155d\u1559' >November \/ \u14c4\u1556\u155d\u1559<\/option><option value='December \/ \u144e\u14ef\u1431\u1546' >December \/ \u144e\u14ef\u1431\u1546<\/option><\/select><\/div><\/li><li id=\"field_32_238\" class=\"gfield gfield--type-select gfield--width-full gf_right_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_238'><span class='gform-field-label__text'>Year \/ \u140a\u1550\u154c\u148d<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_238' id='input_32_238' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Year \/ \u140a\u1550\u154c\u148d<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><option value='1919' >1919<\/option><option value='1918' >1918<\/option><option value='1917' >1917<\/option><option value='1916' >1916<\/option><option value='1915' >1915<\/option><option value='1914' >1914<\/option><option value='1913' >1913<\/option><option value='1912' >1912<\/option><option value='1911' >1911<\/option><option value='1910' >1910<\/option><option value='1909' >1909<\/option><option value='1908' >1908<\/option><option value='1907' >1907<\/option><option value='1906' >1906<\/option><option value='1905' >1905<\/option><option value='1904' >1904<\/option><option value='1903' >1903<\/option><option value='1902' >1902<\/option><option value='1901' >1901<\/option><option value='1900' >1900<\/option><\/select><\/div><\/li><li id=\"field_32_213\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_213'><span class='gform-field-label__text'>Select your community \/ \u14c2\u1548\u140a\u1546\u1466 \u14c4\u14c7\u1583\u1550\u1555\u14d0\u14c2\u1483<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_213' id='input_32_213' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Select \/ \u14c2\u1548\u140a\u1550\u14d7\u144e\u1466<\/option><option value='Arctic Bay \/ \u1403\u1483\u1431\u140a\u1550\u152a\u1483' >Arctic Bay \/ \u1403\u1483\u1431\u140a\u1550\u152a\u1483<\/option><option value='Clyde River \/ \u1472\u158f\u1585\u1450\u1491\u1431\u1483' >Clyde River \/ \u1472\u158f\u1585\u1450\u1491\u1431\u1483<\/option><option value='Grise Fiord \/ \u140a\u1405\u14f1\u1403\u1466\u1450\u1585' >Grise Fiord \/ \u140a\u1405\u14f1\u1403\u1466\u1450\u1585<\/option><option value='Igloolik \/ \u1403\u14a1\u14d7\u14d5\u1483' >Igloolik \/ \u1403\u14a1\u14d7\u14d5\u1483<\/option><option value='Iqaluit \/ \u1403\u1583\u14d7\u1403\u1466' >Iqaluit \/ \u1403\u1583\u14d7\u1403\u1466<\/option><option value='Kimmirut \/ \u146d\u14bb\u14a5\u1548\u1466' >Kimmirut \/ \u146d\u14bb\u14a5\u1548\u1466<\/option><option value='Kinngait \/ \u146d\u1675\u1403\u1466' >Kinngait \/ \u146d\u1675\u1403\u1466<\/option><option value='Pangnirtung \/ \u1438\u14d0\u14c2\u1585\u1451\u1585' >Pangnirtung \/ \u1438\u14d0\u14c2\u1585\u1451\u1585<\/option><option value='Pond Inlet \/ \u14a5\u1466\u144e\u14aa\u1455\u14d5\u1483' >Pond Inlet \/ \u14a5\u1466\u144e\u14aa\u1455\u14d5\u1483<\/option><option value='Qikiqtarjuaq \/ \u157f\u146d\u1585\u1455\u1550\u152a\u140a\u1585' >Qikiqtarjuaq \/ \u157f\u146d\u1585\u1455\u1550\u152a\u140a\u1585<\/option><option value='Resolute Bay \/ \u1583\u1405\u14f1\u1403\u1466\u1450\u1585' >Resolute Bay \/ \u1583\u1405\u14f1\u1403\u1466\u1450\u1585<\/option><option value='Sanikiluaq \/ \u14f4\u14c2\u146d\u14d7\u140a\u1585' >Sanikiluaq \/ \u14f4\u14c2\u146d\u14d7\u140a\u1585<\/option><option value='Sanirajak \/ \u14f4\u14c2\u154b\u152d\u1483' >Sanirajak \/ \u14f4\u14c2\u154b\u152d\u1483<\/option><\/select><\/div><\/li><li id=\"field_32_92\" class=\"gfield gfield--type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_92'><span class='gform-field-label__text'>NTI number \/ \u14c4\u14c7\u1557\u1466 \u1450\u1675\u1555\u1483\u146f\u14d0\u14c2\u1466 \u1403\u14da\u148b\u152d\u1405\u153e\u152a\u144f\u1466 \u14c8\u14f4\u1405\u1456<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_32_92'><strong>Do not include dashes or spaces with your NTI number \/ \u1431\u1583\u14ef\u1405\u153e\u1528\u1466\u1455\u1403\u14d5\u148b\u1466 \u144e\u144e\u1585\u14ef\u14aa\u152a\u14c2\u1466 \u14c8\u14f4\u1405\u144e\u1405\u1671\u1466\u1450\u14c2\u1466 \u140a\u14bb\u14aa\u14d7 \u1472\u144e\u1675\u144e\u1466\u1455\u1403\u14d0\u14c7\u1546\u14d7\u148b\u1466 \u14c4\u14c7\u1557\u1466 \u1450\u1675\u1555\u1483 \u144e\u14a5\u1593\u14c4\u1466 \u14c8\u14f4\u1405\u144e\u1546\u152d\u144e\u1466<\/strong><\/div><div class='ginput_container ginput_container_number'><input name='input_92' id='input_32_92' type='number' step='any' min='999999999' max='10000000000' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_32_92\" \/><\/div><\/li><li id=\"field_32_281\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_281'><span class='gform-field-label__text'>SIN Number \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1585\u1450\u1550\u14ef\u1405\u1466 \u14c8\u14f4\u1405\u144f\u1466<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_281' id='input_32_281' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_10\" class=\"gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Mailing Address \/ \u144e\u144e\u1585\u1472\u14c2\u140a\u1550\u1555\u1483\u146f\u1466 \u1450\u154c\u1548\u1456<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_32_10' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_32_10_1_container' >\n                                        <input type='text' name='input_10.1' id='input_32_10_1' value=''    aria-required='true'    \/>\n                                        <label for='input_32_10_1' id='input_32_10_1_label' class='gform-field-label gform-field-label--type-sub '>PO Box \/ \u144e\u144e\u1585\u1472\u14c2\u140a\u1550\u1555\u1483\u146f\u1466 \u1450\u154c\u1548\u1456<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_32_10_3_container' >\n                                    <input type='text' name='input_10.3' id='input_32_10_3' value=''    aria-required='true'    \/>\n                                    <label for='input_32_10_3' id='input_32_10_3_label' class='gform-field-label gform-field-label--type-sub '>Community \/ \u14c4\u14c7\u14d5\u1483<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_32_10_4_container' >\n                                        <select name='input_10.4' id='input_32_10_4'     aria-required='true'    ><option value='' ><\/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='Newfoundland and Labrador' >Newfoundland and Labrador<\/option><option value='Northwest Territories' >Northwest Territories<\/option><option value='Nova Scotia' >Nova Scotia<\/option><option value='Nunavut' selected='selected'>Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='Prince Edward Island' >Prince Edward Island<\/option><option value='Quebec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                        <label for='input_32_10_4' id='input_32_10_4_label' class='gform-field-label gform-field-label--type-sub '>Province \/ \u14c4\u14c7\u14d5\u1405\u1449 \u140a\u1555\u1483\u1450\u1585\u14ef\u14aa\u14c2\u1546\u152d\u1593<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_32_10_5_container' >\n                                    <input type='text' name='input_10.5' id='input_32_10_5' value=''    aria-required='true'    \/>\n                                    <label for='input_32_10_5' id='input_32_10_5_label' class='gform-field-label gform-field-label--type-sub '>Postal Code \/ \u144e\u144e\u1585\u1472\u14c2\u140a\u1550\u1555\u1483\u146f\u1466 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1593<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_10.6' id='input_32_10_6' value='CA' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_32_12\" class=\"gfield gfield--type-phone gfield--phone-format-standard gfield--width-full gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_12'><span class='gform-field-label__text'>Phone \/ \u1405\u1584\u14da\u1405\u1456<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_12' id='input_32_12' type='tel' value='' class='medium'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_32_11\" class=\"gfield gfield--type-email gfield--width-full gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_11'><span class='gform-field-label__text'>Email \/ \u1403\u1550\u1590\u14c8\u1585\u1455\u1405\u1456<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_11' id='input_32_11' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_32_214\" class=\"gfield gfield--type-text gfield--width-full gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_214'><span class='gform-field-label__text'>Alternate Contact \/ \u1405\u1583\u1550\u1555\u1405\u1594\u1548\u14d0\u14c7\u1585\u1450\u1585<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_214' id='input_32_214' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_215\" class=\"gfield gfield--type-phone gfield--phone-format-standard gfield--width-full gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_215'><span class='gform-field-label__text'>Alternate Contact Phone Number \/ \u1405\u1584\u14da\u1555\u1405\u1594\u1548\u14d0\u14c7\u1585\u1450\u1585 \u1405\u1584\u14da\u1405\u1456<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_215' id='input_32_215' type='tel' value='' class='large'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_32_242\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have any children\/dependents? \/ \u157f\u1450\u1550\u1593\u1583\u1585\u1432\u1466\/\u1438\u1585\u146d\u152d\u1583\u1585\u1432\u1466?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_242'>\n\t\t\t<li class='gchoice gchoice_32_242_0'>\n\t\t\t\t<input name='input_242' type='radio' value='Yes \/ \u1404'  id='choice_32_242_0'    \/>\n\t\t\t\t<label for='choice_32_242_0' id='label_32_242_0' class='gform-field-label gform-field-label--type-inline'>Yes \/ \u1404<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_242_1'>\n\t\t\t\t<input name='input_242' type='radio' value='No \/ \u140b\u14a1\u1490'  id='choice_32_242_1'    \/>\n\t\t\t\t<label for='choice_32_242_1' id='label_32_242_1' class='gform-field-label gform-field-label--type-inline'>No \/ \u140b\u14a1\u1490<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_243\" class=\"gfield gfield--type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_243'><span class='gform-field-label__text'>How many children\/dependents (under 18 years old)? \/ \u1583\u1466\u144e\u14c2\u1466 \u157f\u1450\u1550\u1593\u1583\u1585\u1431\u1466\/\u1438\u1585\u146d\u152d\u1583\u1585\u1433\u1466 (\u1405\u146d\u1405\u14d6\u1466 18 \u1450\u1594\u14c2\u14d7)?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_243' id='input_32_243' type='number' step='any'   value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_32_15' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next \/ \u140a\u1403\u1449\u1439\u14c4\u1466<\/button> <a type='button' href=\"javascript:void(0);\" id='gform_save_32_2_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary'  > Save and Continue Later<\/a>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_32_2' class='gform_page' data-js='page-field-id-15' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_32_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_32_245\" class=\"gfield gfield--type-section gsection nhsp-page-title field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Income &amp; Employment \/ \u146e\u14c7\u1405\u153e\u152d\u1483\u14f5\u1466 \u140a\u14bb\u14aa\u14d7 \u1403\u1585\u1472\u14c7\u1403\u152d\u1550\u14c3\u1466<\/h2><div class='gsection_description' id='gfield_description_32_245'>All fields with * are required \/ \u144e\u144e\u1585\u14ef\u14aa\u152a\u14d5\u14ab\u1466 \u1405\u14ea\u14d7\u1546\u140a\u1550\u1591\u140a\u14d5\u1595\u14a5 * \u1455\u1455\u144e\u1585\u1455\u1405\u148b\u140a\u1583\u1585\u1450\u1466<\/div><\/li><li id=\"field_32_246\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you claim Employment Insurance (EI)? \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1450\u1585\u14ef\u1405\u144e\u1456\u1585\u14ef\u14aa\u1556\u1466?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_246'>\n\t\t\t<li class='gchoice gchoice_32_246_0'>\n\t\t\t\t<input name='input_246' type='radio' value='Yes \/ \u1404'  id='choice_32_246_0'    \/>\n\t\t\t\t<label for='choice_32_246_0' id='label_32_246_0' class='gform-field-label gform-field-label--type-inline'>Yes \/ \u1404<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_246_1'>\n\t\t\t\t<input name='input_246' type='radio' value='No \/ \u140b\u14a1\u1490'  id='choice_32_246_1'    \/>\n\t\t\t\t<label for='choice_32_246_1' id='label_32_246_1' class='gform-field-label gform-field-label--type-inline'>No \/ \u140b\u14a1\u1490<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_247\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>What is your Employment Insurance status? \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1450\u1585\u14ef\u1405\u144e\u1456\u1583\u1466\u1455\u1585\u1450\u14a5\u14c2\u1585?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_247'>\n\t\t\t<li class='gchoice gchoice_32_247_0'>\n\t\t\t\t<input name='input_247' type='radio' value='Employment Insurance Claimant \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1450\u1585\u14ef\u1405\u144e\u1456\u14f2\u1585'  id='choice_32_247_0'    \/>\n\t\t\t\t<label for='choice_32_247_0' id='label_32_247_0' class='gform-field-label gform-field-label--type-inline'>Employment Insurance Claimant \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1450\u1585\u14ef\u1405\u144e\u1456\u14f2\u1585<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_247_1'>\n\t\t\t\t<input name='input_247' type='radio' value='Applied for Employment Insurance \/ \u1431\u14c7\u14f1\u1483\u14ef\u14aa\u152a\u1585 \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1450\u1585\u14ef\u1405\u14c2\u144e\u1466'  id='choice_32_247_1'    \/>\n\t\t\t\t<label for='choice_32_247_1' id='label_32_247_1' class='gform-field-label gform-field-label--type-inline'>Applied for Employment Insurance \/ \u1431\u14c7\u14f1\u1483\u14ef\u14aa\u152a\u1585 \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1450\u1585\u14ef\u1405\u14c2\u144e\u1466<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_247_2'>\n\t\t\t\t<input name='input_247' type='radio' value='Received Employment Insurance in the past 3 years \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1450\u1585\u14ef\u1405\u144e\u1456\u1585\u14ef\u14aa\u152a\u1585 \u1431\u1593\u14f1\u1466 \u140a\u1550\u154c\u148e\u14da\u1405\u1585\u1450\u14c2\u1466'  id='choice_32_247_2'    \/>\n\t\t\t\t<label for='choice_32_247_2' id='label_32_247_2' class='gform-field-label gform-field-label--type-inline'>Received Employment Insurance in the past 3 years \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1450\u1585\u14ef\u1405\u144e\u1456\u1585\u14ef\u14aa\u152a\u1585 \u1431\u1593\u14f1\u1466 \u140a\u1550\u154c\u148e\u14da\u1405\u1585\u1450\u14c2\u1466<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_247_3'>\n\t\t\t\t<input name='input_247' type='radio' value='Employment Insurance Maternal or Paternal in the past 5 years \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1450\u1585\u14ef\u1405\u144e\u1456\u1585\u14ef\u14aa\u152a\u1585 \u140a\u14c8\u14c7\u148b\u152d\u1405\u152a\u1466 \u140a\u1456\u1455\u148b\u152d\u1405\u152a\u14ea\u14d8\u14d0\u14c3\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1472\u1403\u14d0\u14c7\u1585\u144e\u14ea\u14d7\u148b\u1466 \u157f\u1450\u1550\u1593\u1585\u1456\u1585\u1450\u14a5\u14c2\u1405\u14c2\u158f\u1595\u14c4\u1483 \u1455\u14ea\u14d5\u14aa\u1466 \u140a\u1550\u154c\u148d\u14da\u1405\u1585\u1450\u14c2\u1466'  id='choice_32_247_3'    \/>\n\t\t\t\t<label for='choice_32_247_3' id='label_32_247_3' class='gform-field-label gform-field-label--type-inline'>Employment Insurance Maternal or Paternal in the past 5 years \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1450\u1585\u14ef\u1405\u144e\u1456\u1585\u14ef\u14aa\u152a\u1585 \u140a\u14c8\u14c7\u148b\u152d\u1405\u152a\u1466 \u140a\u1456\u1455\u148b\u152d\u1405\u152a\u14ea\u14d8\u14d0\u14c3\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1472\u1403\u14d0\u14c7\u1585\u144e\u14ea\u14d7\u148b\u1466 \u157f\u1450\u1550\u1593\u1585\u1456\u1585\u1450\u14a5\u14c2\u1405\u14c2\u158f\u1595\u14c4\u1483 \u1455\u14ea\u14d5\u14aa\u1466 \u140a\u1550\u154c\u148d\u14da\u1405\u1585\u1450\u14c2\u1466<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_247_4'>\n\t\t\t\t<input name='input_247' type='radio' value='Receiving Income Assistance \/ \u146e\u14c7\u1405\u152d\u14c2\u1466 \u1403\u1472\u152b\u14ef\u140a\u1585\u1456\u14f2\u1585'  id='choice_32_247_4'    \/>\n\t\t\t\t<label for='choice_32_247_4' id='label_32_247_4' class='gform-field-label gform-field-label--type-inline'>Receiving Income Assistance \/ \u146e\u14c7\u1405\u152d\u14c2\u1466 \u1403\u1472\u152b\u14ef\u140a\u1585\u1456\u14f2\u1585<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_248\" class=\"gfield gfield--type-number gfield--width-full gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_248'><span class='gform-field-label__text'>Gross weekly rate of Employment Insurance \/ \u1456\u1483\u14ef\u1505 \u1432\u152d\u1585\u1455\u1405\u14da\u1405\u1671\u1466\u144e\u14ea\u14d7\u148b\u1466 \u1431\u14c7\u14f1\u140a\u1548\u14ef\u1455\u14ab\u1466 \u146e\u14c7\u1405\u153e\u152d\u1483\u14f4\u144e\u1466<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_248' id='input_32_248' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_32_249\" class=\"gfield gfield--type-number gfield--width-full gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_249'><span class='gform-field-label__text'>Numbers of weeks entitled \/ \u140a\u14a5\u14f2\u14c2\u158f\u1466 \u1431\u14c7\u14f1\u140a\u1548\u14f0\u1466 \u146e\u14c7\u1405\u152d\u1585\u1456\u1548\u144e\u148b\u1583\u1466\u1455\u14c2\u140a\u1585\u1455\u144e\u1466<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_249' id='input_32_249' type='number' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_32_250\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Are you a Social Assistance Recipient? \/ \u146e\u14c7\u1405\u152d\u14c2\u1466 \u1403\u1472\u152b\u14ef\u140a\u1585\u1456\u1583\u1466\u1455\u1585\u1450\u1585?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_250'>\n\t\t\t<li class='gchoice gchoice_32_250_0'>\n\t\t\t\t<input name='input_250' type='radio' value='Yes \/ \u1404'  id='choice_32_250_0'    \/>\n\t\t\t\t<label for='choice_32_250_0' id='label_32_250_0' class='gform-field-label gform-field-label--type-inline'>Yes \/ \u1404<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_250_1'>\n\t\t\t\t<input name='input_250' type='radio' value='No \/ \u140b\u14a1\u1490'  id='choice_32_250_1'    \/>\n\t\t\t\t<label for='choice_32_250_1' id='label_32_250_1' class='gform-field-label gform-field-label--type-inline'>No \/ \u140b\u14a1\u1490<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_252\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Barriers to employment (select all that apply) \/ \u140a\u155d\u1555\u140a\u1548\u144f\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1550\u14c2\u1550\u14a7\u1466 (\u14c2\u1548\u140a\u1550\u14d7\u148b\u1466 \u1403\u14d5\u1595\u14c4\u1466 \u1450\u154c\u1593\u152a\u14d5\u14ab\u1466)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_32_252'><li class='gchoice gchoice_32_252_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.1' type='checkbox'  value='None \/ \u1431\u1455\u1583\u1671\u1466\u1450\u1585'  id='choice_32_252_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_1' id='label_32_252_1' class='gform-field-label gform-field-label--type-inline'>None \/ \u1431\u1455\u1583\u1671\u1466\u1450\u1585<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.2' type='checkbox'  value='Lack of labour force attachment \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1585\u1438\u1466\u1450\u14c4\u1466 \u1403\u14da\u148b\u152d\u1405\u1671\u14d7\u140a\u14a7\u1466'  id='choice_32_252_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_2' id='label_32_252_2' class='gform-field-label gform-field-label--type-inline'>Lack of labour force attachment \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1585\u1438\u1466\u1450\u14c4\u1466 \u1403\u14da\u148b\u152d\u1405\u1671\u14d7\u140a\u14a7\u1466<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.3' type='checkbox'  value='Lack of work experience \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u14da\u1405\u1585\u14ef\u14aa\u1671\u14d0\u14c2\u14bb\u14c4\u1466'  id='choice_32_252_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_3' id='label_32_252_3' class='gform-field-label gform-field-label--type-inline'>Lack of work experience \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u14da\u1405\u1585\u14ef\u14aa\u1671\u14d0\u14c2\u14bb\u14c4\u1466<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.4' type='checkbox'  value='Lack of transportation \/ \u1403\u158f\u1550\u154b\u153e\u152a\u144e\u1583\u1671\u14d7\u140a\u14a7\u1466'  id='choice_32_252_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_4' id='label_32_252_4' class='gform-field-label gform-field-label--type-inline'>Lack of transportation \/ \u1403\u158f\u1550\u154b\u153e\u152a\u144e\u1583\u1671\u14d7\u140a\u14a7\u1466<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.5' type='checkbox'  value='Remoteness \/ \u1405\u1593\u14ef\u1483\u1450\u14a6\u14d7\u140a\u14a7\u1466'  id='choice_32_252_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_5' id='label_32_252_5' class='gform-field-label gform-field-label--type-inline'>Remoteness \/ \u1405\u1593\u14ef\u1483\u1450\u14a6\u14d7\u140a\u14a7\u1466<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.6' type='checkbox'  value='Language \/ \u1405\u1583\u1405\u14ef\u1585 \u1431\u14ea\u14d7\u148d'  id='choice_32_252_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_6' id='label_32_252_6' class='gform-field-label gform-field-label--type-inline'>Language \/ \u1405\u1583\u1405\u14ef\u1585 \u1431\u14ea\u14d7\u148d<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.7' type='checkbox'  value='Education \/ \u1403\u14d5\u14d0\u14c2\u140a\u1585\u14ef\u14aa\u1671\u14d7\u140a\u1585\u1450\u1585'  id='choice_32_252_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_7' id='label_32_252_7' class='gform-field-label gform-field-label--type-inline'>Education \/ \u1403\u14d5\u14d0\u14c2\u140a\u1585\u14ef\u14aa\u1671\u14d7\u140a\u1585\u1450\u1585<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.8' type='checkbox'  value='Economic \/ \u146e\u14c7\u1405\u152d\u14d5\u1405\u154b\u14f1\u140a\u1550\u14c2\u1550\u14a7\u1466'  id='choice_32_252_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_8' id='label_32_252_8' class='gform-field-label gform-field-label--type-inline'>Economic \/ \u146e\u14c7\u1405\u152d\u14d5\u1405\u154b\u14f1\u140a\u1550\u14c2\u1550\u14a7\u1466<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.9' type='checkbox'  value='Dependent care \/ \u1438\u1585\u146d\u1466\u144e\u152d\u1546\u140a\u1583\u1550\u14c2\u1550\u14a7\u1466'  id='choice_32_252_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_9' id='label_32_252_9' class='gform-field-label gform-field-label--type-inline'>Dependent care \/ \u1438\u1585\u146d\u1466\u144e\u152d\u1546\u140a\u1583\u1550\u14c2\u1550\u14a7\u1466<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.11' type='checkbox'  value='Lack of marketable skills \/ \u140a\u152a\u14d7\u140a\u1585\u1450\u1585 \u1431\u14d5\u1546\u152a\u14d0\u14c7\u14ea\u14da\u1466\u1456\u1585\u14ef\u14aa\u152a\u14c2\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u1585\u14ef\u14aa\u1671\u14d0\u14c2\u146f\u1593\u14c4\u1466'  id='choice_32_252_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_11' id='label_32_252_11' class='gform-field-label gform-field-label--type-inline'>Lack of marketable skills \/ \u140a\u152a\u14d7\u140a\u1585\u1450\u1585 \u1431\u14d5\u1546\u152a\u14d0\u14c7\u14ea\u14da\u1466\u1456\u1585\u14ef\u14aa\u152a\u14c2\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u1585\u14ef\u14aa\u1671\u14d0\u14c2\u146f\u1593\u14c4\u1466<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.12' type='checkbox'  value='Physical, emotional or mental health \/ \u144e\u14a5\u1483\u146f\u1466, \u1403\u1449\u1431\u14d0\u14c2\u140a\u14c2\u1483\u146f\u1466 \u1405\u155d\u1559\u14d8\u14d0\u14c3\u1466 \u1403\u14f1\u14aa\u1483\u146f\u1466 \u140b\u14d0\u14c2\u140a\u1585\u1455\u1403\u14d5\u14aa\u14c2\u1550\u14a7\u1466'  id='choice_32_252_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_12' id='label_32_252_12' class='gform-field-label gform-field-label--type-inline'>Physical, emotional or mental health \/ \u144e\u14a5\u1483\u146f\u1466, \u1403\u1449\u1431\u14d0\u14c2\u140a\u14c2\u1483\u146f\u1466 \u1405\u155d\u1559\u14d8\u14d0\u14c3\u1466 \u1403\u14f1\u14aa\u1483\u146f\u1466 \u140b\u14d0\u14c2\u140a\u1585\u1455\u1403\u14d5\u14aa\u14c2\u1550\u14a7\u1466<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_252_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_252.13' type='checkbox'  value='Other \/ \u140a\u1403\u1449\u1439'  id='choice_32_252_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_252_13' id='label_32_252_13' class='gform-field-label gform-field-label--type-inline'>Other \/ \u140a\u1403\u1449\u1439<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_253\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_253'><span class='gform-field-label__text'>Please specify \/ \u14c7\u14d7\u14c7\u1403\u1550\u14ef\u1472\u1403\u14d0\u14c7\u1546\u1466<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_253' id='input_32_253' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_254\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Are you currently employed? \/ \u14ab\u14d0\u14c7 \u1403\u1585\u1472\u14c7\u1403\u152d\u1585\u1431\u1466?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_254'>\n\t\t\t<li class='gchoice gchoice_32_254_0'>\n\t\t\t\t<input name='input_254' type='radio' value='Yes \/ \u1404'  id='choice_32_254_0'    \/>\n\t\t\t\t<label for='choice_32_254_0' id='label_32_254_0' class='gform-field-label gform-field-label--type-inline'>Yes \/ \u1404<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_254_1'>\n\t\t\t\t<input name='input_254' type='radio' value='No \/ \u140b\u14a1\u1490'  id='choice_32_254_1'    \/>\n\t\t\t\t<label for='choice_32_254_1' id='label_32_254_1' class='gform-field-label gform-field-label--type-inline'>No \/ \u140b\u14a1\u1490<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_255\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_255'><span class='gform-field-label__text'>If employed, name of current employer \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1585\u1450\u1585, \u1405\u14ea\u14d7\u14a5\u1405\u152a\u1585 \u140a\u144e\u1593 \u1403\u1585\u1472\u14c7\u1403\u152d\u1550\u1555\u1555\u1466<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_255' id='input_32_255' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_257\" class=\"gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Employer Address \/ \u144e\u144e\u1585\u1472\u14c2\u140a\u1550\u1555\u1483\u146f\u1466 \u1450\u154c\u1548\u1456<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_32_257' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_32_257_1_container' >\n                                        <input type='text' name='input_257.1' id='input_32_257_1' value=''    aria-required='true'    \/>\n                                        <label for='input_32_257_1' id='input_32_257_1_label' class='gform-field-label gform-field-label--type-sub '>PO Box \/ \u144e\u144e\u1585\u1472\u14c2\u140a\u1550\u1555\u1483\u146f\u1466 \u1450\u154c\u1548\u1456<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_32_257_3_container' >\n                                    <input type='text' name='input_257.3' id='input_32_257_3' value=''    aria-required='true'    \/>\n                                    <label for='input_32_257_3' id='input_32_257_3_label' class='gform-field-label gform-field-label--type-sub '>Community \/ \u14c4\u14c7\u14d5\u1483<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_32_257_4_container' >\n                                        <select name='input_257.4' id='input_32_257_4'     aria-required='true'    ><option value='' ><\/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='Newfoundland and Labrador' >Newfoundland and Labrador<\/option><option value='Northwest Territories' >Northwest Territories<\/option><option value='Nova Scotia' >Nova Scotia<\/option><option value='Nunavut' selected='selected'>Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='Prince Edward Island' >Prince Edward Island<\/option><option value='Quebec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                        <label for='input_32_257_4' id='input_32_257_4_label' class='gform-field-label gform-field-label--type-sub '>Province \/ \u14c4\u14c7\u14d5\u1405\u1449 \u140a\u1555\u1483\u1450\u1585\u14ef\u14aa\u14c2\u1546\u152d\u1593<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_32_257_5_container' >\n                                    <input type='text' name='input_257.5' id='input_32_257_5' value=''    aria-required='true'    \/>\n                                    <label for='input_32_257_5' id='input_32_257_5_label' class='gform-field-label gform-field-label--type-sub '>Postal Code \/ \u144e\u144e\u1585\u1472\u14c2\u140a\u1550\u1555\u1483\u146f\u1466 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1593<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_257.6' id='input_32_257_6' value='CA' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_32_258\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_258'><span class='gform-field-label__text'>Job title \/ \u1403\u1585\u1472\u14c7\u1403\u152e\u1449 \u1455\u1403\u152d\u1405\u14c2\u1593<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_258' id='input_32_258' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_259\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_259'><span class='gform-field-label__text'>Name of supervisor and\/or contact number \/ \u140a\u144e\u1593 \u1405\u140a\u1466\u144e\u1528\u1555\u1466 \u140a\u14bb\u14aa\u14d7\/\u1405\u155d\u1559\u14d8\u14d0\u14c3\u1466 \u1405\u1584\u14da\u1405\u144e\u1593<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_259' id='input_32_259' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_260\" class=\"gfield gfield--type-html gfield--width-full qia_gf_fieldtitle gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p style=\"font-size:20px; font-weight:700;\">Start Date \/ \u1405\u14ea\u14d7\u1585 \u1431\u148b\u140a\u1585\u1455\u14a5\u14c3\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1546\u140a\u14ef\u14d7\u144e\u1466<\/p><\/li><li id=\"field_32_261\" class=\"gfield gfield--type-select gfield--width-full gf_left_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_261'><span class='gform-field-label__text'>Day \/ \u1405\u14ea\u14d7\u1585<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_261' id='input_32_261' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Day \/ \u1405\u14ea\u14d7\u1585<\/option><option value='1st' >1st<\/option><option value='2nd' >2nd<\/option><option value='3rd' >3rd<\/option><option value='4th' >4th<\/option><option value='5th' >5th<\/option><option value='6th' >6th<\/option><option value='7th' >7th<\/option><option value='8th' >8th<\/option><option value='9th' >9th<\/option><option value='10th' >10th<\/option><option value='11th' >11th<\/option><option value='12th' >12th<\/option><option value='13th' >13th<\/option><option value='14th' >14th<\/option><option value='15th' >15th<\/option><option value='16th' >16th<\/option><option value='17th' >17th<\/option><option value='18th' >18th<\/option><option value='19th' >19th<\/option><option value='20th' >20th<\/option><option value='21st' >21st<\/option><option value='22nd' >22nd<\/option><option value='23rd' >23rd<\/option><option value='24th' >24th<\/option><option value='25th' >25th<\/option><option value='26th' >26th<\/option><option value='27th' >27th<\/option><option value='28th' >28th<\/option><option value='29th' >29th<\/option><option value='30th' >30th<\/option><option value='31st' >31st<\/option><\/select><\/div><\/li><li id=\"field_32_262\" class=\"gfield gfield--type-select gfield--width-full gf_middle_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_262'><span class='gform-field-label__text'>Month \/ \u1455\u1585\u146d\u1585<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_262' id='input_32_262' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Month \/ \u1455\u1585\u146d\u1585<\/option><option value='January \/ \u152e\u14d0\u14c4\u140a\u1546' >January \/ \u152e\u14d0\u14c4\u140a\u1546<\/option><option value='February \/ \u1556\u155d\u1557\u140a\u1546' >February \/ \u1556\u155d\u1557\u140a\u1546<\/option><option value='March \/ \u14aa\u153e\u1528' >March \/ \u14aa\u153e\u1528<\/option><option value='April \/ \u1404\u1433\u14ea' >April \/ \u1404\u1433\u14ea<\/option><option value='May \/ \u14aa\u1403' >May \/ \u14aa\u1403<\/option><option value='June \/ \u152a\u14c2' >June \/ \u152a\u14c2<\/option><option value='July \/ \u152a\u14da\u1403' >July \/ \u152a\u14da\u1403<\/option><option value='August \/ \u140a\u14a1\u148c\u14ef' >August \/ \u140a\u14a1\u148c\u14ef<\/option><option value='September \/ \u14ef\u144e\u1431\u1546' >September \/ \u14ef\u144e\u1431\u1546<\/option><option value='October \/ \u1405\u1450\u1431\u1546' >October \/ \u1405\u1450\u1431\u1546<\/option><option value='November \/ \u14c4\u1556\u155d\u1559' >November \/ \u14c4\u1556\u155d\u1559<\/option><option value='December \/ \u144e\u14ef\u1431\u1546' >December \/ \u144e\u14ef\u1431\u1546<\/option><\/select><\/div><\/li><li id=\"field_32_263\" class=\"gfield gfield--type-select gfield--width-full gf_right_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_263'><span class='gform-field-label__text'>Year \/ \u140a\u1550\u154c\u148d<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_263' id='input_32_263' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Year \/ \u140a\u1550\u154c\u148d<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><option value='1919' >1919<\/option><option value='1918' >1918<\/option><option value='1917' >1917<\/option><option value='1916' >1916<\/option><option value='1915' >1915<\/option><option value='1914' >1914<\/option><option value='1913' >1913<\/option><option value='1912' >1912<\/option><option value='1911' >1911<\/option><option value='1910' >1910<\/option><option value='1909' >1909<\/option><option value='1908' >1908<\/option><option value='1907' >1907<\/option><option value='1906' >1906<\/option><option value='1905' >1905<\/option><option value='1904' >1904<\/option><option value='1903' >1903<\/option><option value='1902' >1902<\/option><option value='1901' >1901<\/option><option value='1900' >1900<\/option><\/select><\/div><\/li><li id=\"field_32_264\" class=\"gfield gfield--type-list gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Previous work experience \/ \u1405\u140a\u1466\u144e\u140a\u1548 \u1403\u1585\u1472\u14c7\u1403\u152d\u1550\u1555\u148b\u14da\u1405\u1585\u14ef\u14aa\u152d\u144e\u1466<\/span><\/label><style type=\"text\/css\">\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons {\n\t\t\t\t\t\t\tvertical-align: middle !important;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons img {\n\t\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t\t\tbackground-position: 0 0;\n\t\t\t\t\t\t\tbackground-size: 16px 16px !important;\n\t\t\t\t\t\t\tbackground-repeat: no-repeat;\n\t\t\t\t\t\t\tborder: none !important;\n\t\t\t\t\t\t\twidth: 16px !important;\n\t\t\t\t\t\t\theight: 16px !important;\n\t\t\t\t\t\t\topacity: 0.5;\n\t\t\t\t\t\t\ttransition: opacity .5s ease-out;\n\t\t\t\t\t\t    -moz-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -webkit-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -o-transition: opacity .5s ease-out;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons a:hover img {\n\t\t\t\t\t\t\topacity: 1.0;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\t<\/style><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_264_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_264_col_2' class='gfield_list_col_even' \/><col id='gfield_list_264_col_3' class='gfield_list_col_odd' \/><\/colgroup><thead><tr><th scope=\"col\">Job title \/ \u1403\u1585\u1472\u14c7\u1403\u152e\u1449 \u1455\u1403\u152d\u1405\u14c2\u1593<\/th><th scope=\"col\">Reason for leaving \/ \u1431\u153e\u152a\u144f\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1548\u14d0\u14c3\u1585\u1450\u14a5\u14c2\u1405\u14c2\u1550\u14c4\u1466<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_264_cell1' data-label='Job title \/ \u1403\u1585\u1472\u14c7\u1403\u152e\u1449 \u1455\u1403\u152d\u1405\u14c2\u1593'><input aria-invalid='false'  aria-describedby=\"gfield_description_32_264\" aria-label='Job title \/ \u1403\u1585\u1472\u14c7\u1403\u152e\u1449 \u1455\u1403\u152d\u1405\u14c2\u1593, Row 1' data-aria-label-template='Job title \/ \u1403\u1585\u1472\u14c7\u1403\u152e\u1449 \u1455\u1403\u152d\u1405\u14c2\u1593, Row {0}' type='text' name='input_264[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_264_cell2' data-label='Reason for leaving \/ \u1431\u153e\u152a\u144f\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1548\u14d0\u14c3\u1585\u1450\u14a5\u14c2\u1405\u14c2\u1550\u14c4\u1466'><input aria-invalid='false'  aria-describedby=\"gfield_description_32_264\" aria-label='Reason for leaving \/ \u1431\u153e\u152a\u144f\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1548\u14d0\u14c3\u1585\u1450\u14a5\u14c2\u1405\u14c2\u1550\u14c4\u1466, Row 1' data-aria-label-template='Reason for leaving \/ \u1431\u153e\u152a\u144f\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1548\u14d0\u14c3\u1585\u1450\u14a5\u14c2\u1405\u14c2\u1550\u14c4\u1466, Row {0}' type='text' name='input_264[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/www.qia.ca\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/www.qia.ca\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><div class='gfield_description' id='gfield_description_32_264'>Click the + to add more lines \/ \u14c7\u157f\u14ea\u14d7\u148d \u14f4\u14c2\u1593\u152a\u14d5\u1673\u140a\u1585 + \u1403\u14da\u14ef\u148b\u140a\u1583\u1548\u1555\u1466<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_32_244' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous \/ \u14ef\u1557\u14ea\u14d5\u1405\u154b\u1456\u1585\u1450\u14a7\u1466<\/button> <button type='button' id='gform_next_button_32_244' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next \/ \u140a\u1403\u1449\u1439\u14c4\u1466<\/button> <a type='button' href=\"javascript:void(0);\" id='gform_save_32_3_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary'  > Save and Continue Later<\/a>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_32_3' class='gform_page' data-js='page-field-id-244' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_32_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_32_93\" class=\"gfield gfield--type-section gsection nhsp-page-title field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Education &amp; Childcare \/ \u1403\u14d5\u14d0\u14c2\u140a\u1585\u14ef\u14aa\u14c3\u1466 \u140a\u14bb\u14aa\u14d7 \u1438\u1403\u1546\u1528\u1583\u1546\u140a\u1583\u1550\u14c3\u1466<\/h2><div class='gsection_description' id='gfield_description_32_93'>All fields with * are required \/ \u144e\u144e\u1585\u14ef\u14aa\u152a\u14d5\u14ab\u1466 \u1405\u14ea\u14d7\u1546\u140a\u1550\u1591\u140a\u14d5\u1595\u14a5 * \u1455\u1455\u144e\u1585\u1455\u1405\u148b\u140a\u1583\u1585\u1450\u1466<\/div><\/li><li id=\"field_32_267\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Please select the education level you have completed \/ \u14c2\u1548\u140a\u1550\u14d7\u144e\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u1547\u1585\u1455\u14a5\u14c2\u1585\u1431\u1466 \u1431\u152d\u1547\u1585\u14ef\u14aa\u152d\u1555\u1466 \u14c7\u14d5\u14a7\u14d0\u14c2\u1593\u14c2\u1483<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_267'>\n\t\t\t<li class='gchoice gchoice_32_267_0'>\n\t\t\t\t<input name='input_267' type='radio' value='No formal education \/ \u1403\u14d5\u14d0\u14c2\u140a\u1585\u14ef\u14aa\u1671\u1466\u1450\u1585'  id='choice_32_267_0'    \/>\n\t\t\t\t<label for='choice_32_267_0' id='label_32_267_0' class='gform-field-label gform-field-label--type-inline'>No formal education \/ \u1403\u14d5\u14d0\u14c2\u140a\u1585\u14ef\u14aa\u1671\u1466\u1450\u1585<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_267_1'>\n\t\t\t\t<input name='input_267' type='radio' value='Grade (7-8) \/ \u1581\u1466\u144e\u14d0\u14c2\u14d5\u1483 7-8'  id='choice_32_267_1'    \/>\n\t\t\t\t<label for='choice_32_267_1' id='label_32_267_1' class='gform-field-label gform-field-label--type-inline'>Grade (7-8) \/ \u1581\u1466\u144e\u14d0\u14c2\u14d5\u1483 7-8<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_267_2'>\n\t\t\t\t<input name='input_267' type='radio' value='Grade (9-10) \/ \u1581\u1466\u144e\u14d0\u14c2\u14d5\u1483 9-10'  id='choice_32_267_2'    \/>\n\t\t\t\t<label for='choice_32_267_2' id='label_32_267_2' class='gform-field-label gform-field-label--type-inline'>Grade (9-10) \/ \u1581\u1466\u144e\u14d0\u14c2\u14d5\u1483 9-10<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_267_3'>\n\t\t\t\t<input name='input_267' type='radio' value='Grade (11-12) \/ \u1581\u1466\u144e\u14d0\u14c2\u14d5\u1483 11-12'  id='choice_32_267_3'    \/>\n\t\t\t\t<label for='choice_32_267_3' id='label_32_267_3' class='gform-field-label gform-field-label--type-inline'>Grade (11-12) \/ \u1581\u1466\u144e\u14d0\u14c2\u14d5\u1483 11-12<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_267_4'>\n\t\t\t\t<input name='input_267' type='radio' value='High School Diploma or GED \/ \u1581\u1466\u144e\u14c2\u1585\u1439\u1550\u14a5\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u1547\u1585\u1450\u1466 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1593 \u1405\u155d\u1559\u14d8\u14d0\u14c3\u1466 \u14c7\u14d5\u14a7\u14d0\u14c2\u1593'  id='choice_32_267_4'    \/>\n\t\t\t\t<label for='choice_32_267_4' id='label_32_267_4' class='gform-field-label gform-field-label--type-inline'>High School Diploma or GED \/ \u1581\u1466\u144e\u14c2\u1585\u1439\u1550\u14a5\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u1547\u1585\u1450\u1466 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1593 \u1405\u155d\u1559\u14d8\u14d0\u14c3\u1466 \u14c7\u14d5\u14a7\u14d0\u14c2\u1593<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_268\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_268'><span class='gform-field-label__text'>Which province or territory did you complete your education in? \/ \u14c7\u14d5\u140a\u14d0\u14c2 \u1472\u14c7\u1455\u1449 \u1405\u146d\u1405\u1585\u1455\u1585\u1450\u1593\u1455 \u140a\u1555\u1466\u1450\u1585\u14ef\u14aa\u152a\u1593\u14c2\/\u1472\u14c7\u1455\u1449 \u140a\u1555\u1466\u1450\u1585\u14ef\u14aa\u14c2\u1593\u14c2\u1483<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_268' id='input_32_268' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_269\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Please select if you have attended: \/ \u14c2\u1548\u140a\u1550\u14d7\u144e\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u1546\u140a\u1583\u1466\u1455\u14da\u1405\u1585\u14ef\u14aa\u148d\u1555\u1466<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_32_269'><li class='gchoice gchoice_32_269_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_269.1' type='checkbox'  value='College \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1483'  id='choice_32_269_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_269_1' id='label_32_269_1' class='gform-field-label gform-field-label--type-inline'>College \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1483<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_269_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_269.2' type='checkbox'  value='University \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1550\u152a\u140a\u1585'  id='choice_32_269_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_269_2' id='label_32_269_2' class='gform-field-label gform-field-label--type-inline'>University \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1550\u152a\u140a\u1585<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_32_269_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_269.3' type='checkbox'  value='Apprenticeship \/ \u14f4\u14c7\u1528\u1405\u14c2\u1550\u14a7\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u14ef\u14d0\u14c8\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1585\u1450\u1585'  id='choice_32_269_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_269_3' id='label_32_269_3' class='gform-field-label gform-field-label--type-inline'>Apprenticeship \/ \u14f4\u14c7\u1528\u1405\u14c2\u1550\u14a7\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u14ef\u14d0\u14c8\u1466 \u1403\u1585\u1472\u14c7\u1403\u152d\u1585\u1450\u1585<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_270\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>At college, you received \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u14bb\u14a5 \u1431\u152d\u14a5\u14c3\u1466:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_270'>\n\t\t\t<li class='gchoice gchoice_32_270_0'>\n\t\t\t\t<input name='input_270' type='radio' value='Certificate \/ \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585'  id='choice_32_270_0'    \/>\n\t\t\t\t<label for='choice_32_270_0' id='label_32_270_0' class='gform-field-label gform-field-label--type-inline'>Certificate \/ \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_270_1'>\n\t\t\t\t<input name='input_270' type='radio' value='Diploma \/ \u14aa\u1550\u1549\u1595\u14c4\u1483 \u140a\u1550\u154c\u148e\u1595\u14c4\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u1547\u1585\u1450\u14a5\u14c2\u1405\u14c2\u1593\u14c4\u1466 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585'  id='choice_32_270_1'    \/>\n\t\t\t\t<label for='choice_32_270_1' id='label_32_270_1' class='gform-field-label gform-field-label--type-inline'>Diploma \/ \u14aa\u1550\u1549\u1595\u14c4\u1483 \u140a\u1550\u154c\u148e\u1595\u14c4\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u1547\u1585\u1450\u14a5\u14c2\u1405\u14c2\u1593\u14c4\u1466 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_271\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_271'><span class='gform-field-label__text'>Name of Program \/ \u140a\u144e\u1593 \u1403\u14d5\u14d0\u14c2\u140a\u1490\u1483\u14f4\u1449 \u1431\u14d5\u1546\u140a\u1449<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_271' id='input_32_271' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_272\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_272'><span class='gform-field-label__text'>Which province or territory did you complete your education in? \/ \u14c7\u14d5\u140a\u14d0\u14c2 \u1472\u14c7\u1455\u1449 \u1405\u146d\u1405\u1585\u1455\u1585\u1450\u1593\u1455 \u140a\u1555\u1466\u1450\u1585\u14ef\u14aa\u152a\u1593\u14c2\/\u1472\u14c7\u1455\u1449 \u140a\u1555\u1466\u1450\u1585\u14ef\u14aa\u14c2\u1593\u14c2\u1483<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_272' id='input_32_272' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_273\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>At university, you received \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1550\u152a\u140a\u1550\u14a5 \u1431\u152d\u14a5\u14c3\u1466:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_273'>\n\t\t\t<li class='gchoice gchoice_32_273_0'>\n\t\t\t\t<input name='input_273' type='radio' value='Certificate \/ \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585'  id='choice_32_273_0'    \/>\n\t\t\t\t<label for='choice_32_273_0' id='label_32_273_0' class='gform-field-label gform-field-label--type-inline'>Certificate \/ \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_273_1'>\n\t\t\t\t<input name='input_273' type='radio' value='Diploma \/ Degree \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1550\u152a\u140a\u1550\u14a5 \u1431\u148b\u140a\u1675\u1548\u144e\u1593\u14c2\u1483 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585'  id='choice_32_273_1'    \/>\n\t\t\t\t<label for='choice_32_273_1' id='label_32_273_1' class='gform-field-label gform-field-label--type-inline'>Diploma \/ Degree \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1550\u152a\u140a\u1550\u14a5 \u1431\u148b\u140a\u1675\u1548\u144e\u1593\u14c2\u1483 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_273_2'>\n\t\t\t\t<input name='input_273' type='radio' value='Masters \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1550\u152a\u140a\u1550\u14a5 \u140a\u146f\u14d0\u14c2\u1593\u14c2\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u1490\u1483\u14f4\u14a5\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u1547\u1585\u14ef\u14aa\u152a\u1585 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585'  id='choice_32_273_2'    \/>\n\t\t\t\t<label for='choice_32_273_2' id='label_32_273_2' class='gform-field-label gform-field-label--type-inline'>Masters \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1550\u152a\u140a\u1550\u14a5 \u140a\u146f\u14d0\u14c2\u1593\u14c2\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u1490\u1483\u14f4\u14a5\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u1547\u1585\u14ef\u14aa\u152a\u1585 \u14c7\u14d7\u14c7\u1403\u1483\u146f\u1455\u1585<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_273_3'>\n\t\t\t\t<input name='input_273' type='radio' value='Doctorate \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1550\u152a\u140a\u1449 \u1581\u1466\u144e\u14c2\u1585\u1439\u1593\u14c2\u1483 \u1431\u152d\u1547\u1585\u14ef\u14aa\u152a\u1585'  id='choice_32_273_3'    \/>\n\t\t\t\t<label for='choice_32_273_3' id='label_32_273_3' class='gform-field-label gform-field-label--type-inline'>Doctorate \/ \u14ef\u14da\u1466\u1450\u1585\u14f4\u1550\u1555\u1550\u152a\u140a\u1449 \u1581\u1466\u144e\u14c2\u1585\u1439\u1593\u14c2\u1483 \u1431\u152d\u1547\u1585\u14ef\u14aa\u152a\u1585<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_274\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_274'><span class='gform-field-label__text'>Name of Program \/ \u140a\u144e\u1593 \u1403\u14d5\u14d0\u14c2\u140a\u1490\u1483\u14f4\u1449 \u1431\u14d5\u1546\u140a\u1449<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_274' id='input_32_274' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_275\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_275'><span class='gform-field-label__text'>Which province or territory did you complete your education in? \/ \u14c7\u14d5\u140a\u14d0\u14c2 \u1472\u14c7\u1455\u1449 \u1405\u146d\u1405\u1585\u1455\u1585\u1450\u1593\u1455 \u140a\u1555\u1466\u1450\u1585\u14ef\u14aa\u152a\u1593\u14c2\/\u1472\u14c7\u1455\u1449 \u140a\u1555\u1466\u1450\u1585\u14ef\u14aa\u14c2\u1593\u14c2\u1483<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_275' id='input_32_275' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_276\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_276'><span class='gform-field-label__text'>Name of Apprenticeship Program \/ \u140a\u144e\u1593 \u1403\u14d5\u14d0\u14c2\u140a\u1490\u1483\u14f4\u1449 \u1431\u14d5\u1546\u140a\u1449<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_276' id='input_32_276' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_277\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_277'><span class='gform-field-label__text'>Which province or territory did you complete your apprenticeship in? \/ \u14c7\u14d5\u140a\u14d0\u14c2 \u1472\u14c7\u1455\u1449 \u1405\u146d\u1405\u1585\u1455\u1585\u1450\u1593\u1455 \u140a\u1555\u1466\u1450\u1585\u14ef\u14aa\u152a\u1593\u14c2\/\u1472\u14c7\u1455\u1449 \u140a\u1555\u1466\u1450\u1585\u14ef\u14aa\u14c2\u1593\u14c2\u1483<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_277' id='input_32_277' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_278\" class=\"gfield gfield--type-list gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Please specify any other training taken: \/ \u14c7\u14d7\u14c7\u1403\u152d\u1550\u14d7\u148b\u1466 \u14c7\u14d5\u140a\u1450\u1403\u14d0\u14c7\u1466 \u140a\u14ef\u158f\u1466 \u1431\u14d5\u14bb\u14aa\u1483\u14f4\u14da\u1405\u1585\u14ef\u14aa\u152d\u144e\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u1548\u144e\u148b\u14ea\u14d7\u148b\u1466<\/span><\/label><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_278_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_278_col_2' class='gfield_list_col_even' \/><col id='gfield_list_278_col_3' class='gfield_list_col_odd' \/><col id='gfield_list_278_col_4' class='gfield_list_col_even' \/><\/colgroup><thead><tr><th scope=\"col\">Training \/ Course \/ \u1431\u14d5\u14bb\u14aa\u1483\u14f4\u1585\u1455\u14a5\u14c3\u1466 \/ \u1403\u14d5\u14d0\u14c2\u140a\u1490\u1483\u14f4\u1585 \u1403\u14d5\u14d0\u14c2\u140a\u1585\u1455\u14a5\u14c3\u1466<\/th><th scope=\"col\">Length \/ \u140a\u146f\u14c2\u1405\u14c2\u1593<\/th><th scope=\"col\">Year Completed \/ \u140a\u1550\u154c\u148d \u1431\u152d\u1547\u1585\u1455\u14a5\u14c3\u1466<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_278_cell1' data-label='Training \/ Course \/ \u1431\u14d5\u14bb\u14aa\u1483\u14f4\u1585\u1455\u14a5\u14c3\u1466 \/ \u1403\u14d5\u14d0\u14c2\u140a\u1490\u1483\u14f4\u1585 \u1403\u14d5\u14d0\u14c2\u140a\u1585\u1455\u14a5\u14c3\u1466'><input aria-invalid='false'  aria-describedby=\"gfield_description_32_278\" aria-label='Training \/ Course \/ \u1431\u14d5\u14bb\u14aa\u1483\u14f4\u1585\u1455\u14a5\u14c3\u1466 \/ \u1403\u14d5\u14d0\u14c2\u140a\u1490\u1483\u14f4\u1585 \u1403\u14d5\u14d0\u14c2\u140a\u1585\u1455\u14a5\u14c3\u1466, Row 1' data-aria-label-template='Training \/ Course \/ \u1431\u14d5\u14bb\u14aa\u1483\u14f4\u1585\u1455\u14a5\u14c3\u1466 \/ \u1403\u14d5\u14d0\u14c2\u140a\u1490\u1483\u14f4\u1585 \u1403\u14d5\u14d0\u14c2\u140a\u1585\u1455\u14a5\u14c3\u1466, Row {0}' type='text' name='input_278[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_278_cell2' data-label='Length \/ \u140a\u146f\u14c2\u1405\u14c2\u1593'><input aria-invalid='false'  aria-describedby=\"gfield_description_32_278\" aria-label='Length \/ \u140a\u146f\u14c2\u1405\u14c2\u1593, Row 1' data-aria-label-template='Length \/ \u140a\u146f\u14c2\u1405\u14c2\u1593, Row {0}' type='text' name='input_278[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_278_cell3' data-label='Year Completed \/ \u140a\u1550\u154c\u148d \u1431\u152d\u1547\u1585\u1455\u14a5\u14c3\u1466'><input aria-invalid='false'  aria-describedby=\"gfield_description_32_278\" aria-label='Year Completed \/ \u140a\u1550\u154c\u148d \u1431\u152d\u1547\u1585\u1455\u14a5\u14c3\u1466, Row 1' data-aria-label-template='Year Completed \/ \u140a\u1550\u154c\u148d \u1431\u152d\u1547\u1585\u1455\u14a5\u14c3\u1466, Row {0}' type='text' name='input_278[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)' onkeypress='gformAddListItem(this, 0)'><img src='https:\/\/www.qia.ca\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 0)' onkeypress='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\"><img src='https:\/\/www.qia.ca\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><div class='gfield_description' id='gfield_description_32_278'>Click the + to add more lines \/ \u14c7\u157f\u14ea\u14d7\u148d \u14f4\u14c2\u1593\u152a\u14d5\u1673\u140a\u1585 + \u1403\u14da\u14ef\u148b\u140a\u1583\u1548\u1555\u1466<\/div><\/li><li id=\"field_32_279\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you need childcare? \/ \u1438\u1403\u1546\u1528\u1583\u1546\u140a\u1583\u1585\u1432\u1466 \u157f\u1450\u1550\u1593\u1595\u14c4\u1466?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_279'>\n\t\t\t<li class='gchoice gchoice_32_279_0'>\n\t\t\t\t<input name='input_279' type='radio' value='Yes \/ \u1404'  id='choice_32_279_0'    \/>\n\t\t\t\t<label for='choice_32_279_0' id='label_32_279_0' class='gform-field-label gform-field-label--type-inline'>Yes \/ \u1404<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_279_1'>\n\t\t\t\t<input name='input_279' type='radio' value='No \/ \u140b\u14a1\u1490'  id='choice_32_279_1'    \/>\n\t\t\t\t<label for='choice_32_279_1' id='label_32_279_1' class='gform-field-label gform-field-label--type-inline'>No \/ \u140b\u14a1\u1490<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_280\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Choose type of support \/ \u14c2\u1548\u140a\u1550\u14d7\u148d \u1583\u14c4\u1403\u1466\u1451\u14c2\u1593 \u1403\u1472\u152a\u1585\u1450\u1585\u1455\u1405\u153e\u152a\u144f\u1466 (\u1403\u1472\u152b\u14ef\u140a\u1583\u1466\u1455\u1548\u1555\u1466)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_280'>\n\t\t\t<li class='gchoice gchoice_32_280_0'>\n\t\t\t\t<input name='input_280' type='radio' value='First Nation &amp; Inuit Childcare Initiative \/ \u140a\u14ea\u14da\u1403\u1466 \u140a\u14bb\u14aa\u14d7 \u1403\u14c4\u1403\u1466 \u14c4\u1455\u1585\u1472\u1466 \u1438\u1585\u146d\u152d\u1405\u14c2\u158f\u1595\u14c4\u1466 \u1431\u14d5\u1546\u140a\u1585'  id='choice_32_280_0'    \/>\n\t\t\t\t<label for='choice_32_280_0' id='label_32_280_0' class='gform-field-label gform-field-label--type-inline'>First Nation &amp; Inuit Childcare Initiative \/ \u140a\u14ea\u14da\u1403\u1466 \u140a\u14bb\u14aa\u14d7 \u1403\u14c4\u1403\u1466 \u14c4\u1455\u1585\u1472\u1466 \u1438\u1585\u146d\u152d\u1405\u14c2\u158f\u1595\u14c4\u1466 \u1431\u14d5\u1546\u140a\u1585<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_280_1'>\n\t\t\t\t<input name='input_280' type='radio' value='Employment Insurance Childcare Benefits \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1450\u1585\u14ef\u1405\u144e\u1456\u1550\u14c2\u1585 \u1438\u1403\u1546\u1528\u14c4\u1466 \u1403\u1472\u152b\u14ef\u140a\u1585\u1456\u1548\u144f\u1466'  id='choice_32_280_1'    \/>\n\t\t\t\t<label for='choice_32_280_1' id='label_32_280_1' class='gform-field-label gform-field-label--type-inline'>Employment Insurance Childcare Benefits \/ \u1403\u1585\u1472\u14c7\u1403\u152d\u1671\u1450\u1585\u14ef\u1405\u144e\u1456\u1550\u14c2\u1585 \u1438\u1403\u1546\u1528\u14c4\u1466 \u1403\u1472\u152b\u14ef\u140a\u1585\u1456\u1548\u144f\u1466<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_280_2'>\n\t\t\t\t<input name='input_280' type='radio' value='Provincial funding or subsidy \/ \u1472\u14c7\u1455\u14a5 \u140a\u1555\u1466\u1450\u1585\u14ef\u14aa\u152a\u14a5 \u146e\u14c7\u1405\u152d\u1585\u1456\u1546\u152d\u1405\u14f2\u1466 \u1405\u155d\u1559\u14d8\u14d0\u14c3\u1466 \u1403\u1472\u152b\u14ef\u140a\u1585\u1456\u1546\u152d\u1405\u14f2\u1466'  id='choice_32_280_2'    \/>\n\t\t\t\t<label for='choice_32_280_2' id='label_32_280_2' class='gform-field-label gform-field-label--type-inline'>Provincial funding or subsidy \/ \u1472\u14c7\u1455\u14a5 \u140a\u1555\u1466\u1450\u1585\u14ef\u14aa\u152a\u14a5 \u146e\u14c7\u1405\u152d\u1585\u1456\u1546\u152d\u1405\u14f2\u1466 \u1405\u155d\u1559\u14d8\u14d0\u14c3\u1466 \u1403\u1472\u152b\u14ef\u140a\u1585\u1456\u1546\u152d\u1405\u14f2\u1466<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_280_3'>\n\t\t\t\t<input name='input_280' type='radio' value='No funding received \/ \u146e\u14c7\u1405\u152d\u14c2\u1466 \u1431\u14da\u1405\u1585\u14ef\u14aa\u1671\u1466\u1450\u1585'  id='choice_32_280_3'    \/>\n\t\t\t\t<label for='choice_32_280_3' id='label_32_280_3' class='gform-field-label gform-field-label--type-inline'>No funding received \/ \u146e\u14c7\u1405\u152d\u14c2\u1466 \u1431\u14da\u1405\u1585\u14ef\u14aa\u1671\u1466\u1450\u1585<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_280_4'>\n\t\t\t\t<input name='input_280' type='radio' value='Daycare space not available \/ \u1438\u1403\u1546\u1555\u14bb\u14a5 \u1403\u14c2\u1483\u14f4\u1583\u1671\u1466\u1450\u1585'  id='choice_32_280_4'    \/>\n\t\t\t\t<label for='choice_32_280_4' id='label_32_280_4' class='gform-field-label gform-field-label--type-inline'>Daycare space not available \/ \u1438\u1403\u1546\u1555\u14bb\u14a5 \u1403\u14c2\u1483\u14f4\u1583\u1671\u1466\u1450\u1585<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_280_5'>\n\t\t\t\t<input name='input_280' type='radio' value='Assisted by family\/self-funded \/ \u1403\u1472\u152a\u1585\u1455\u1405\u152a\u1585 \u1403\u14da\u148b\u152d\u1405\u152a\u14a7\u1466 \/ \u14c7\u1595\u14a5\u14c2\u1585 \u146e\u14c7\u1405\u152d\u1583\u1585\u144e\u1466\u1450\u1585'  id='choice_32_280_5'    \/>\n\t\t\t\t<label for='choice_32_280_5' id='label_32_280_5' class='gform-field-label gform-field-label--type-inline'>Assisted by family\/self-funded \/ \u1403\u1472\u152a\u1585\u1455\u1405\u152a\u1585 \u1403\u14da\u148b\u152d\u1405\u152a\u14a7\u1466 \/ \u14c7\u1595\u14a5\u14c2\u1585 \u146e\u14c7\u1405\u152d\u1583\u1585\u144e\u1466\u1450\u1585<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_32_265' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous \/ \u14ef\u1557\u14ea\u14d5\u1405\u154b\u1456\u1585\u1450\u14a7\u1466<\/button> <button type='button' id='gform_next_button_32_265' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next \/ \u140a\u1403\u1449\u1439\u14c4\u1466<\/button> <a type='button' href=\"javascript:void(0);\" id='gform_save_32_4_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary'  > Save and Continue Later<\/a>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_32_4' class='gform_page' data-js='page-field-id-265' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_32_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_32_266\" class=\"gfield gfield--type-section gsection nhsp-page-title field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Heavy Equipment Operator Training \/ \u14c4\u14c7\u1483\u1470\u1548\u144e\u1550\u152a\u140a\u14c2\u1466 \u1405\u1581\u14aa\u1403\u1466\u1450\u14d5\u1546\u153e\u152a\u144e\u14c2\u1466 \u140a\u1581\u144e\u1405\u14c2\u1550\u14a5\u1483&quot;;<\/h2><div class='gsection_description' id='gfield_description_32_266'>All fields with * are required \/ \u144e\u144e\u1585\u14ef\u14aa\u152a\u14d5\u14ab\u1466 \u1405\u14ea\u14d7\u1546\u140a\u1550\u1591\u140a\u14d5\u1595\u14a5 * \u1455\u1455\u144e\u1585\u1455\u1405\u148b\u140a\u1583\u1585\u1450\u1466<\/div><\/li><li id=\"field_32_216\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_216'><span class='gform-field-label__text'>Why are you interested in taking the Heavy Equipment Operator training? \/ \u14f1\u14bb\u14aa\u1466 \u1403\u14da\u148b\u152d\u1405\u152a\u14aa\u1555\u1466 \u14c4\u14c7\u1483\u1470\u1548\u144e\u1550\u152a\u140a\u14c2\u1466 \u140a\u1581\u144e\u1405\u14c2\u1550\u14a5\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u14c2\u1550\u14a5\u1483?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_216' id='input_32_216' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_32_217\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Are you prepared to be away from home for six weeks? \/ \u1405\u1438\u14d7\u1593\u1403\u1550\u14ef\u14aa\u1556\u1466 \u140a\u1405\u14ea\u14da\u1550\u14ef\u14aa\u1583\u1466\u1455\u154b\u152d\u1546\u140a\u1505\u14f4\u1585 \u1431\u1593\u14f2\u152a\u1585\u1450\u14c2\u1466 \u1431\u14c7\u14f1\u140a\u1548\u14ef\u1550\u14c2\u1466?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_217'>\n\t\t\t<li class='gchoice gchoice_32_217_0'>\n\t\t\t\t<input name='input_217' type='radio' value='Yes \/ \u1404'  id='choice_32_217_0'    \/>\n\t\t\t\t<label for='choice_32_217_0' id='label_32_217_0' class='gform-field-label gform-field-label--type-inline'>Yes \/ \u1404<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_217_1'>\n\t\t\t\t<input name='input_217' type='radio' value='No \/ \u140b\u14a1\u1490'  id='choice_32_217_1'    \/>\n\t\t\t\t<label for='choice_32_217_1' id='label_32_217_1' class='gform-field-label gform-field-label--type-inline'>No \/ \u140b\u14a1\u1490<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_218\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_218'><span class='gform-field-label__text'>Please explain \/ \u14c7\u14d7\u14c7\u1403\u1550\u14ef\u1472\u1403\u14d0\u14c7\u1546\u1466<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_218' id='input_32_218' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_32_219\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Have you been away from home for six weeks or more before? \/ \u140a\u1405\u14ea\u14da\u1550\u14ef\u14aa\u14da\u1405\u1550\u14ef\u14aa\u1556\u1466 \u1431\u14c7\u14f1\u140a\u1548\u14ef\u1550\u14c2\u1466 \u1431\u1593\u14f2\u152a\u1585\u1450\u14c2\u1466 \u1405\u1593\u1456\u14c2\u14d8\u14d0\u14c3\u1466 \u1405\u140a\u1466\u144e\u140a\u1548?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_219'>\n\t\t\t<li class='gchoice gchoice_32_219_0'>\n\t\t\t\t<input name='input_219' type='radio' value='Yes \/ \u1404'  id='choice_32_219_0'    \/>\n\t\t\t\t<label for='choice_32_219_0' id='label_32_219_0' class='gform-field-label gform-field-label--type-inline'>Yes \/ \u1404<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_219_1'>\n\t\t\t\t<input name='input_219' type='radio' value='No \/ \u140b\u14a1\u1490'  id='choice_32_219_1'    \/>\n\t\t\t\t<label for='choice_32_219_1' id='label_32_219_1' class='gform-field-label gform-field-label--type-inline'>No \/ \u140b\u14a1\u1490<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_222\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_222'><span class='gform-field-label__text'>What do you know about the Heavy Equipment Operator training? \/ \u1583\u14c4\u1585 \u1583\u1405\u1528\u14aa\u1555\u1466 \u14c4\u14c7\u1483\u1470\u1548\u144e\u1550\u152a\u140a\u14c2\u1466 \u140a\u1581\u144e\u1405\u14c2\u1550\u14a5\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u1550\u14c2\u1405\u1449 \u14a5\u1505\u14f5\u14c4\u1466?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_222' id='input_32_222' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_32_223\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_223'><span class='gform-field-label__text'>What class Driver\u2019s license do you have? \/ \u140a\u1581\u1466\u1450\u1550\u14ef\u1405\u144f\u1466 \u14c4\u14c7\u14ef\u1405\u144e\u14c2\u1466 \u14c7\u14ea\u14d5\u140a\u14d0\u14c2\u1466 \u1581\u155d\u1559\u14ef\u14d0\u14c2\u1583\u1585\u1472?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_223' id='input_32_223' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_32_224\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_224'><span class='gform-field-label__text'>What barriers (if any) do you think you will encounter during your training in Morrisburg? \/ \u1583\u14c4\u1403\u1466\u1450\u14c2\u1466 \u1431\u14c7\u1403\u14d7\u1455\u1583\u154b\u152d\u1585\u1450\u148b\u1555\u1466 (\u1431\u1455\u1583\u1585\u1472\u14c2\u14db\u1483) \u1403\u14d5\u14d0\u14c2\u140a\u14c2\u1550\u14c2 \u14a7\u140a\u1546\u1505\u1558\u14a1\u14a5?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_224' id='input_32_224' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_32_225\" class=\"gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_225'><span class='gform-field-label__text'>How can QIA support you to ensure you successfully complete the training? \/ \u1583\u14c4\u1585 \u157f\u146d\u1585\u1455\u14c2\u1483\u146f\u1466 \u1403\u1472\u152a\u1548\u14d0\u14c7\u1585\u1472\u1466 \u1403\u14d5\u14d0\u14c2\u1483 \u1431\u152d\u1547\u1550\u14ef\u1466\u144e\u140a\u1548\u14d0\u14c7\u1581\u14ea\u14d7\u144e\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u1455\u1550\u14c2\u1483?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_225' id='input_32_225' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_32_226\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>During the training, there will be an allowance provided. Do you have a bank account? \/ \u1403\u14d5\u14d0\u14c2\u140a\u14c2\u1550\u14c2, \u140a\u146d\u14d5\u1550\u14f1\u1585\u1455\u1405\u1583\u1466\u1455\u154b\u152d\u154b\u1555\u1466. \u146e\u14c7\u1405\u152d\u1483\u146f\u1555\u14bb\u14a5 \u146e\u14c7\u1405\u152d\u1483\u146f\u1555\u1583\u1585\u146d\u1466?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_226'>\n\t\t\t<li class='gchoice gchoice_32_226_0'>\n\t\t\t\t<input name='input_226' type='radio' value='Yes \/ \u1404'  id='choice_32_226_0'    \/>\n\t\t\t\t<label for='choice_32_226_0' id='label_32_226_0' class='gform-field-label gform-field-label--type-inline'>Yes \/ \u1404<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_226_1'>\n\t\t\t\t<input name='input_226' type='radio' value='No \/ \u140b\u14a1\u1490'  id='choice_32_226_1'    \/>\n\t\t\t\t<label for='choice_32_226_1' id='label_32_226_1' class='gform-field-label gform-field-label--type-inline'>No \/ \u140b\u14a1\u1490<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_227\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>If you complete the Heavy Equipment Operator training, you may receive an opportunity to work at Baffinland\u2019s Mary River mine site and receive more training. Are you interested in working for Baffinland once training is completed? \/ \u1431\u152d\u1547\u1548\u1555\u1466 \u14c4\u14c7\u1483\u1470\u1548\u144e\u1550\u152a\u140a\u14c2\u1466 \u140a\u1581\u144e\u1405\u14c2\u1550\u14a5\u1483 \u1403\u14d5\u14d0\u14c2\u140a\u14c2\u1550\u14a5, \u1403\u1585\u1472\u14c7\u1403\u152d\u1548\u14d0\u14c7\u1550\u14ef\u1490\u152d\u1585\u1450\u1505\u14f4\u1405\u1490\u1555\u1466 \u1439\u1555\u14d0\u14db\u14d0\u146f\u1466 \u14c4\u14d8\u152d\u14d0\u14c2 \u1405\u152d\u154b\u14d0\u14c2\u140a\u1550\u1555\u1593\u14d0\u14c2 \u140a\u14bb\u14aa\u14d7 \u1403\u14d5\u14d0\u14c2\u140a\u1585\u144e\u1455\u1405\u1483\u1472\u14d0\u14c2\u154b\u152d\u1585\u1450\u144e\u1466. \u1403\u1585\u1472\u14c7\u1403\u152d\u1548\u14aa\u1490\u152d\u1585\u146e\u1466 \u1439\u1555\u14d0\u14db\u14d0\u146f\u14d0\u14c4\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u1455\u1550\u14c2\u1483 \u1431\u152d\u1547\u1550\u14ef\u148d\u1555\u1466?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_227'>\n\t\t\t<li class='gchoice gchoice_32_227_0'>\n\t\t\t\t<input name='input_227' type='radio' value='Yes \/ \u1404'  id='choice_32_227_0'    \/>\n\t\t\t\t<label for='choice_32_227_0' id='label_32_227_0' class='gform-field-label gform-field-label--type-inline'>Yes \/ \u1404<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_227_1'>\n\t\t\t\t<input name='input_227' type='radio' value='No \/ \u140b\u14a1\u1490'  id='choice_32_227_1'    \/>\n\t\t\t\t<label for='choice_32_227_1' id='label_32_227_1' class='gform-field-label gform-field-label--type-inline'>No \/ \u140b\u14a1\u1490<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_228\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_228'><span class='gform-field-label__text'>Please explain \/ \u14c7\u14d7\u14c7\u1403\u1550\u14ef\u1472\u1403\u14d0\u14c7\u1546\u1466<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_228' id='input_32_228' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_32_229\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_229'><span class='gform-field-label__text'>Is there anything else you would like to add? \/ \u140a\u14ef\u158f\u14d0\u14c2\u1483 \u1405\u1583\u1405\u14ef\u1505\u14f4\u1583\u1585\u146e\u1466?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_229' id='input_32_229' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_32_230\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Have you registered on Tutttarvik? \/ \u140a\u144e\u14d5\u1405\u1550\u14ef\u14aa\u1556\u1466 \u1450\u1466\u1455\u1550\u1555\u14bb\u14a7\u1466 \u1583\u154b\u14f4\u1405\u152d\u1483\u146f\u1466 \u1450\u146d\u14ef\u1405\u14aa\u153e\u152a\u144e\u1505\u14f4\u1583\u1550\u1555\u1466\u144e\u148d\u1466?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_230'>\n\t\t\t<li class='gchoice gchoice_32_230_0'>\n\t\t\t\t<input name='input_230' type='radio' value='Yes \/ \u1404'  id='choice_32_230_0'    \/>\n\t\t\t\t<label for='choice_32_230_0' id='label_32_230_0' class='gform-field-label gform-field-label--type-inline'>Yes \/ \u1404<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_230_1'>\n\t\t\t\t<input name='input_230' type='radio' value='No \/ \u140b\u14a1\u1490'  id='choice_32_230_1'    \/>\n\t\t\t\t<label for='choice_32_230_1' id='label_32_230_1' class='gform-field-label gform-field-label--type-inline'>No \/ \u140b\u14a1\u1490<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_231\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><a href=\"https:\/\/play.google.com\/store\/apps\/details?id=ca.qia.tuttarvik&pli=1\" target=\"_blank\">Tuttarvik on Google Play Store \/ \u1450\u1466\u1455\u1550\u1555\u1483\u146f\u1466 \u148e\u148d\u14ea \u1431\u1673\u140a\u1548\u144e\u14c2\u1466 \u14c2\u1405\u1555\u1550\u1555\u1483<\/a> <\/p>\n<p><a href=\"https:\/\/apps.apple.com\/ca\/app\/tuttarvik\/id1612288420\" target=\"_blank\">Tuttarvik on Apple App Store \/ \u1450\u1466\u1455\u1550\u1555\u1483\u146f\u1466 \u140b\u1433\u14ea \u14c2\u1405\u1555\u1550\u1555\u1483<\/a> <\/p><\/li><li id=\"field_32_232\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How would you like to submit your resume and criminal record check: \/ \u1583\u14c4\u1585 \u1450\u14c2\u152a\u14aa\u14c2\u140a\u1585\u146d\u1405\u1483 \u1403\u1585\u1472\u14c7\u1403\u152e\u1585\u1456\u154b\u14f2\u144f\u1466 \u140a\u14bb\u14aa\u14d7 \u1431\u154b\u152d\u14da\u1405\u1550\u14ef\u14aa\u14bb\u14aa\u1594\u1550\u1431\u1466 \u1583\u1405\u1528\u14f4\u1585\u1455\u1405\u153e\u152a\u144e\u14a5\u14c3\u1466:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_32_232'>\n\t\t\t<li class='gchoice gchoice_32_232_0'>\n\t\t\t\t<input name='input_232' type='radio' value='Upload \/ \u1583\u154b\u14f4\u1405\u152d\u1483\u1470\u1585\u144e\u14ea\u14d7\u148b\u1466'  id='choice_32_232_0'    \/>\n\t\t\t\t<label for='choice_32_232_0' id='label_32_232_0' class='gform-field-label gform-field-label--type-inline'>Upload \/ \u1583\u154b\u14f4\u1405\u152d\u1483\u1470\u1585\u144e\u14ea\u14d7\u148b\u1466<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_232_1'>\n\t\t\t\t<input name='input_232' type='radio' value='Email \/ \u1403\u1550\u1590\u14c8\u1585\u1455\u1405\u144e\u1483\u146f\u1466 \u14c7\u1505\u14ef\u1405\u144e\u14d7\u148b\u1466'  id='choice_32_232_1'    \/>\n\t\t\t\t<label for='choice_32_232_1' id='label_32_232_1' class='gform-field-label gform-field-label--type-inline'>Email \/ \u1403\u1550\u1590\u14c8\u1585\u1455\u1405\u144e\u1483\u146f\u1466 \u14c7\u1505\u14ef\u1405\u144e\u14d7\u148b\u1466<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_232_2'>\n\t\t\t\t<input name='input_232' type='radio' value='Fax \/ \u14f1\u1483\u1472\u152a\u1483\u146f\u1466 \u14c7\u1505\u14ef\u1405\u144e\u14d7\u148b\u1466'  id='choice_32_232_2'    \/>\n\t\t\t\t<label for='choice_32_232_2' id='label_32_232_2' class='gform-field-label gform-field-label--type-inline'>Fax \/ \u14f1\u1483\u1472\u152a\u1483\u146f\u1466 \u14c7\u1505\u14ef\u1405\u144e\u14d7\u148b\u1466<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_32_232_3'>\n\t\t\t\t<input name='input_232' type='radio' value='Tuttarvik \/ \u1450\u1466\u1455\u1550\u1555\u1483\u146f\u1466'  id='choice_32_232_3'    \/>\n\t\t\t\t<label for='choice_32_232_3' id='label_32_232_3' class='gform-field-label gform-field-label--type-inline'>Tuttarvik \/ \u1450\u1466\u1455\u1550\u1555\u1483\u146f\u1466<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_233\" class=\"gfield gfield--type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_32_233'><span class='gform-field-label__text'>Upload \/ \ufeff\u1583\u154b\u14f4\u1405\u152d\u1550\u14a8\u1585\u1472\u1550\u14d7\u148b\u1466<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_32_233' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_32_233&quot;,&quot;container&quot;:&quot;gform_multifile_upload_32_233&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_32_233&quot;,&quot;filelist&quot;:&quot;gform_preview_32_233&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/www.qia.ca\\\/?gf_page=5209e82ff5e1725&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/www.qia.ca\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/www.qia.ca\\\/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;314572800b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:32,&quot;field_id&quot;:233,&quot;_gform_file_upload_nonce_32_233&quot;:&quot;8516ff44fc&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_32_233&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_32_233' 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_32_233' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_32_233 gfield_description_32_233\"  >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_32_233'>Max. file size: 300 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_32_233'><\/ul> <div id='gform_preview_32_233' class='ginput_preview_list'><\/div><\/div><div class='gfield_description' id='gfield_description_32_233'>If you need to upload your resume and\/or criminal record check later, click \u2018Save and Continue Later\u2019 below to save your application. Criminal record checks can be emailed to <a href=\"mailto:tuttarvik@qia.ca\">tuttarvik@qia.ca<\/a> at a later date \/ \u1583\u1546\u14f4\u1405\u152d\u1550\u14a8\u1546\u140a\u1583\u1548\u1555\u1405\u1483 \u1403\u1585\u1472\u14c7\u1403\u152e\u1546\u152d\u1405\u14ef\u14aa\u152a\u14c2\u1466 \u14c7\u14d5\u1585\u1472\u144e\u1466 \u140a\u14bb\u14aa\u14d7\/\u1405\u155d\u1559\u14d8\u14d0\u14c3\u1466 \u1431\u154b\u152d\u1483\u14ef\u14aa\u1671\u1483\u1472\u14d7\u140a\u1550\u14aa\u1594\u1585\u1432\u1466 \u1583\u1405\u1528\u14f4\u1585\u1455\u1405\u153e\u152a\u144e\u14a5\u1483, \u14c7\u157f\u14ea\u14d7\u148d \u201c\u1438\u1438\u1466\u144e\u14c2\u1593 \u140a\u14bb\u14aa\u14d7 \u1472\u152a\u14ef\u14d7\u148d \u14ef\u140a\u1548\u1483\u1472\u14d0\u14c2\u1585 \u2019 \u140a\u1456\u14c3\u1466\u1450\u14a5\u1483 \u1456\u14d0\u14c7 \u140b\u1585\u146d\u1483\u14f1\u1585\u1455\u1403\u1466 \u1438\u1438\u1455\u1405\u14c2\u140a\u1550\u14aa\u1466.  \u1431\u154b\u152d\u1483\u14ef\u14aa\u1671\u1483\u1472\u14d7\u140a\u1550\u14aa\u1594\u1585\u1432\u1466 \u1583\u1405\u1528\u14f4\u1548\u144e\u1466 \u1403\u1550\u1590\u14d0\u14c8\u1548\u144e\u144e\u148d\u1466 \u14c7\u1483\u14ef\u1405\u153e\u152d\u1405\u152a\u14d0\u14c7\u1585\u1450\u1466 \u1405\u1557\u1593 <a href=\"mailto:tuttarvik@qia.ca\">tuttarvik@qia.ca<\/a>\u1583\u1593\u1483\u1472\u14d0\u14c2\u1405\u14d5\u1585\u1438\u1466.<\/div><\/li><li id=\"field_32_234\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Email your documents to <a href=\"mailto:tuttarvik@qia.ca\">tuttarvik@qia.ca<\/a> \/ \u1583\u154b\u14f4\u1405\u152d\u1483\u146f\u1466 \u14c7\u14d5\u1585\u1472\u144e\u1466 \u1403\u1550\u1590\u14c8\u1585\u1455\u1405\u144e\u1483\u146f\u1466 \u14c7\u1505\u14ef\u1405\u144e\u14d7\u148b\u1466 \u1405\u1557\u1593 <a href=\"mailto:tuttarvik@qia.ca\">tuttarvik@qia.ca<\/a><\/li><li id=\"field_32_235\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Fax your documents to 867\u2022979\u20223238 \/ \u14f1\u1483\u1472\u152a\u1483\u146f\u1466 \u14c7\u14d5\u1585\u1472\u144e\u1466 \u14c7\u1505\u14ef\u1405\u144e\u14d7\u148b\u1466 \u1405\u1557\u1593 867\u2022979\u20223238<\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_32_282' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous \/ \u14ef\u1557\u14ea\u14d5\u1405\u154b\u1456\u1585\u1450\u14a7\u1466<\/button> <button type='button' id='gform_next_button_32_282' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Next \/ \u140a\u1403\u1449\u1439\u14c4\u1466<\/button> <a type='button' href=\"javascript:void(0);\" id='gform_save_32_5_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary'  > Save and Continue Later<\/a>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_32_5' class='gform_page' data-js='page-field-id-282' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_32_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_32_283\" class=\"gfield gfield--type-section gsection nhsp-page-title field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Declaration and authorization to release information \/  \u14c7\u14d7\u14c7\u1403\u1585\u14ef\u153e\u152a\u144e \u140a\u14bb\u14aa\u14d7 \u1431\u152a\u14d0\u14c7\u1405\u144e\u1466\u144e\u153e\u152a\u144e \u14f4\u1483\u146f\u1455\u1405\u1581\u14ea\u14d7\u148b\u1466 \u1450\u146d\u14ef\u148b\u140a\u1548\u144f\u1466<\/h2><div class='gsection_description' id='gfield_description_32_283'>All fields with * are required \/ \u144e\u144e\u1585\u14ef\u14aa\u152a\u14d5\u14ab\u1466 \u1405\u14ea\u14d7\u1546\u140a\u1550\u1591\u140a\u14d5\u1595\u14a5 * \u1455\u1455\u144e\u1585\u1455\u1405\u148b\u140a\u1583\u1585\u1450\u1466<\/div><\/li><li id=\"field_32_284\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>I, the undersigned, give my consent for Qikiqtani Inuit Association to release the information contained in this form regarding my participation in the Heavy Equipment Operator training. I acknowledge that the information is collected and administered in accordance with the Privacy Act and applicable to privacy laws, and that it may be used to determine my eligibility for the Heavy Equipment Operator training. \/ \u1405\u1559\u1593, \u140a\u144e\u14d5\u1405\u1585\u144e\u1405\u14ea\u14d7\u1593 \u140a\u14ea\u14d5\u1550\u14a5, \u140a\u158f\u1585\u1433\u1593 \u157f\u146d\u1585\u1455\u14c2 \u1403\u14c4\u1403\u1466 \u1472\u1450\u153e\u1528\u1583\u144e\u148c\u158f\u1466 \u14f4\u1483\u146f\u1403\u148d\u14d0\u14c7\u1550\u14aa\u1455 \u1450\u146d\u14ef\u148b\u140a\u1548\u144e\u14c2\u1466 \u1455\u14a1\u1559\u14c3\u1466\u1450\u14c2\u1466 \u14c8\u144e\u1546\u140a\u14d5\u14bb\u14a5 \u1431\u153e\u152a\u144e\u14d5\u1483 \u1403\u14da\u1405\u1583\u1455\u1405\u14c2\u140a\u1550\u14c2\u154b \u1405\u1581\u14aa\u1403\u1466\u1450\u14c2\u1466 \u14c4\u14c7\u14ef\u1405\u144e\u14c2\u1466 \u140a\u1581\u148b\u1405\u1585\u14f4\u14c2\u1550\u14a7\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u154b\u152d\u1585\u1455\u14d0\u14c2\u1466. \u1403\u14d5\u14f4\u1585\u14ef\u1557\u1593 \u1450\u146d\u14ef\u148b\u140a\u1548\u144f\u1466 \u14c4\u140a\u1455\u1405\u152a\u1466 \u140a\u14bb\u14aa\u14d7 \u140a\u1405\u14da\u1455\u1405\u152a\u1466 \u14aa\u14d5\u1466\u1450\u148b\u1466 \u1472\u1673\u14c7\u1585\u1450\u14a6\u144e\u1466\u144e\u148b\u140a\u1583\u1550\u14c2\u1550\u14a7\u1466 \u1431\u1581\u152d\u1550\u14a5\u1483 \u140a\u14bb\u14aa\u14d7 \u140a\u1450\u1585\u1455\u1405\u152d\u1546\u140a\u14d6\u1466 \u1472\u1673\u14c7\u1585\u1450\u14a6\u144e\u1466\u144e\u14c2\u1550\u14a7\u1466 \u1431\u1581\u152d\u1466, \u140a\u1450\u1585\u1455\u1405\u152a\u14d0\u14c7\u154b\u152d\u1550\u14aa\u1455 \u1455\u14aa\u1483\u146f\u140a \u1403\u14f1\u14aa\u14d5\u1405\u1585\u1450\u1583\u1550\u14d7\u14c2 \u1431\u1583\u1455\u1405\u152a\u14d0\u14c7\u154b\u152d\u1550\u14c2\u14d0\u14c2 \u1405\u1581\u14aa\u1403\u1466\u1450\u14c2\u1466 \u14c4\u14c7\u14ef\u1405\u144e\u14c2\u1466 \u140a\u1581\u148b\u1405\u1585\u14f4\u14c2\u1550\u14a7\u1466 \u1403\u14d5\u14d0\u14c2\u140a\u154b\u14f1\u140a\u1548\u144e\u14d0\u14c4\u1466.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_32_284'><li class='gchoice gchoice_32_284_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_284.1' type='checkbox'  value='I agree'  id='choice_32_284_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_32_284_1' id='label_32_284_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_32_285\" class=\"gfield gfield--type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Please enter your name \/ \u140a\u144f\u1466 \u144e\u144e\u154b\u1673\u140a\u1455\u1550\u14ef\u14d0\u14c7\u1548\u1483<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_32_285'>\n                            \n                            <span id='input_32_285_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_285.3' id='input_32_285_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_32_285_3' class='gform-field-label gform-field-label--type-sub '>First Name \/ \u140a\u144f\u1466<\/label>\n                                                <\/span>\n                            \n                            <span id='input_32_285_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_285.6' id='input_32_285_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_32_285_6' class='gform-field-label gform-field-label--type-sub '>Last Name \/ \u140a\u144e\u1548\u14f0\u1466<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_32_287\" class=\"gfield gfield--type-select gfield--width-full gf_left_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_287'><span class='gform-field-label__text'>Day \/ \u1405\u14ea\u14d7\u1585<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_287' id='input_32_287' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Day \/ \u1405\u14ea\u14d7\u1585<\/option><option value='1st' >1st<\/option><option value='2nd' >2nd<\/option><option value='3rd' >3rd<\/option><option value='4th' >4th<\/option><option value='5th' >5th<\/option><option value='6th' >6th<\/option><option value='7th' >7th<\/option><option value='8th' >8th<\/option><option value='9th' >9th<\/option><option value='10th' >10th<\/option><option value='11th' >11th<\/option><option value='12th' >12th<\/option><option value='13th' >13th<\/option><option value='14th' >14th<\/option><option value='15th' >15th<\/option><option value='16th' >16th<\/option><option value='17th' >17th<\/option><option value='18th' >18th<\/option><option value='19th' >19th<\/option><option value='20th' >20th<\/option><option value='21st' >21st<\/option><option value='22nd' >22nd<\/option><option value='23rd' >23rd<\/option><option value='24th' >24th<\/option><option value='25th' >25th<\/option><option value='26th' >26th<\/option><option value='27th' >27th<\/option><option value='28th' >28th<\/option><option value='29th' >29th<\/option><option value='30th' >30th<\/option><option value='31st' >31st<\/option><\/select><\/div><\/li><li id=\"field_32_288\" class=\"gfield gfield--type-select gfield--width-full gf_middle_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_288'><span class='gform-field-label__text'>Month \/ \u1455\u1585\u146d\u1585<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_288' id='input_32_288' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Month \/ \u1455\u1585\u146d\u1585<\/option><option value='January \/ \u152e\u14d0\u14c4\u140a\u1546' >January \/ \u152e\u14d0\u14c4\u140a\u1546<\/option><option value='February \/ \u1556\u155d\u1557\u140a\u1546' >February \/ \u1556\u155d\u1557\u140a\u1546<\/option><option value='March \/ \u14aa\u153e\u1528' >March \/ \u14aa\u153e\u1528<\/option><option value='April \/ \u1404\u1433\u14ea' >April \/ \u1404\u1433\u14ea<\/option><option value='May \/ \u14aa\u1403' >May \/ \u14aa\u1403<\/option><option value='June \/ \u152a\u14c2' >June \/ \u152a\u14c2<\/option><option value='July \/ \u152a\u14da\u1403' >July \/ \u152a\u14da\u1403<\/option><option value='August \/ \u140a\u14a1\u148c\u14ef' >August \/ \u140a\u14a1\u148c\u14ef<\/option><option value='September \/ \u14ef\u144e\u1431\u1546' >September \/ \u14ef\u144e\u1431\u1546<\/option><option value='October \/ \u1405\u1450\u1431\u1546' >October \/ \u1405\u1450\u1431\u1546<\/option><option value='November \/ \u14c4\u1556\u155d\u1559' >November \/ \u14c4\u1556\u155d\u1559<\/option><option value='December \/ \u144e\u14ef\u1431\u1546' >December \/ \u144e\u14ef\u1431\u1546<\/option><\/select><\/div><\/li><li id=\"field_32_289\" class=\"gfield gfield--type-select gfield--width-full gf_right_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_32_289'><span class='gform-field-label__text'>Year \/ \u140a\u1550\u154c\u148d<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_289' id='input_32_289' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Year \/ \u140a\u1550\u154c\u148d<\/option><option value='2023' >2023<\/option><option value='2024' >2024<\/option><option value='2025' >2025<\/option><option value='2026' >2026<\/option><option value='2027' >2027<\/option><option value='2028' >2028<\/option><\/select><\/div><\/li><li id=\"field_32_286\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p style=\"font-size:20px; font-weight:700;\">Today's Date \/ \u144e\u144e\u1550\u14ef\u1555\u148b\u14d7\u148d<\/p><\/li><\/ul><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_32' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Previous<\/button> <button type='submit' id='gform_submit_button_32' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >SUBMIT APPLICATION \/ \u1450\u14c2\u14d7\u148d \u1450\u1505\u14ef\u154b\u1405\u1466<\/button> <a type='button' href=\"javascript:void(0);\" id='gform_save_32_footer_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary'  > Save and Continue Later<\/a>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_32' value='postback' \/>\n            <input type='hidden' class='gform_hidden' 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