{"id":2043,"date":"2020-04-28T21:05:02","date_gmt":"2020-04-28T21:05:02","guid":{"rendered":"https:\/\/bethelstand4life.com\/?page_id=2043"},"modified":"2020-07-17T21:37:59","modified_gmt":"2020-07-17T21:37:59","slug":"application","status":"publish","type":"page","link":"https:\/\/bethelstand4life.com\/discovery\/application\/","title":{"rendered":"Application"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2043\" class=\"elementor elementor-2043\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1d18133 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1d18133\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c58a852\" data-id=\"c58a852\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4841132 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"4841132\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"New Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"2043\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"4841132\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Application\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"2043\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPartner Name \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Partner Name \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-email elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPartner Address \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Partner Address \" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-message elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-message\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCity \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[message]\" id=\"form-field-message\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"City \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_d488906 elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d488906\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tState \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_d488906]\" id=\"form-field-field_d488906\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"State \" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_15c1ffa elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_15c1ffa\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tZip Code \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_15c1ffa]\" id=\"form-field-field_15c1ffa\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Zip Code \" required=\"required\" min=\"5\" max=\"5\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_0ffbd99 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0ffbd99\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tExecutive Director \/ Pastor \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_0ffbd99]\" id=\"form-field-field_0ffbd99\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Executive Director Pastor:\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_e93411e elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e93411e\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_e93411e]\" id=\"form-field-field_e93411e\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone:\" required=\"required\" min=\"7\" max=\"7\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_ad495c9 elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ad495c9\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFax:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_ad495c9]\" id=\"form-field-field_ad495c9\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Fax:\" min=\"7\" max=\"7\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_1be700b elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_1be700b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail: \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_1be700b]\" id=\"form-field-field_1be700b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Email:\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_0cc3717 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0cc3717\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProgram Name: \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_0cc3717]\" id=\"form-field-field_0cc3717\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Program Name \" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-url elementor-field-group elementor-column elementor-field-group-field_9a0cdb1 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_9a0cdb1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSite Name:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"url\" name=\"form_fields[field_9a0cdb1]\" id=\"form-field-field_9a0cdb1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Site Name: \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_e942a6f elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e942a6f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAddress ( PO Address not accepted)\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_e942a6f]\" id=\"form-field-field_e942a6f\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_6fa0683 elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6fa0683\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCity:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_6fa0683]\" id=\"form-field-field_6fa0683\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"City: \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_96cbc02 elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_96cbc02\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tState: \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_96cbc02]\" id=\"form-field-field_96cbc02\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"State: \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_63a4ef3 elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_63a4ef3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tZip Code:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_63a4ef3]\" id=\"form-field-field_63a4ef3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Zip Code: \" min=\"5\" max=\"5\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_92a910c elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_92a910c\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tProgram Director:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_92a910c]\" id=\"form-field-field_92a910c\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Program Director: \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_3a0f8d9 elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3a0f8d9\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_3a0f8d9]\" id=\"form-field-field_3a0f8d9\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Phone: \" min=\"7\" max=\"7\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-number elementor-field-group elementor-column elementor-field-group-field_a3b0f61 elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a3b0f61\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFax:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t<input type=\"number\" name=\"form_fields[field_a3b0f61]\" id=\"form-field-field_a3b0f61\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Fax:\" min=\"7\" max=\"7\" >\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-field_4691c1b elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4691c1b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail: \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[field_4691c1b]\" id=\"form-field-field_4691c1b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Email: \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_a9313e9 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a9313e9\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tService(s) Provided:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Emergency Food pantry \" id=\"form-field-field_a9313e9-0\" name=\"form_fields[field_a9313e9][]\"> <label for=\"form-field-field_a9313e9-0\">Emergency Food pantry <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Emergency Shelter\" id=\"form-field-field_a9313e9-1\" name=\"form_fields[field_a9313e9][]\"> <label for=\"form-field-field_a9313e9-1\">Emergency Shelter<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Community Kitchen \" id=\"form-field-field_a9313e9-2\" name=\"form_fields[field_a9313e9][]\"> <label for=\"form-field-field_a9313e9-2\">Community Kitchen <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Community Residential Facility \" id=\"form-field-field_a9313e9-3\" name=\"form_fields[field_a9313e9][]\"> <label for=\"form-field-field_a9313e9-3\">Community Residential Facility <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Before and After Care Program \" id=\"form-field-field_a9313e9-4\" name=\"form_fields[field_a9313e9][]\"> <label for=\"form-field-field_a9313e9-4\">Before and After Care Program <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Day Care Center \" id=\"form-field-field_a9313e9-5\" name=\"form_fields[field_a9313e9][]\"> <label for=\"form-field-field_a9313e9-5\">Day Care Center <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Group Homes\" id=\"form-field-field_a9313e9-6\" name=\"form_fields[field_a9313e9][]\"> <label for=\"form-field-field_a9313e9-6\">Group Homes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Rehab Center \" id=\"form-field-field_a9313e9-7\" name=\"form_fields[field_a9313e9][]\"> <label for=\"form-field-field_a9313e9-7\">Rehab Center <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Transitional Shelter \" id=\"form-field-field_a9313e9-8\" name=\"form_fields[field_a9313e9][]\"> <label for=\"form-field-field_a9313e9-8\">Transitional Shelter <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Homeless Drop in Center\" id=\"form-field-field_a9313e9-9\" name=\"form_fields[field_a9313e9][]\"> <label for=\"form-field-field_a9313e9-9\">Homeless Drop in Center<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_5a95956 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5a95956\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo your program have a website?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Yes\" id=\"form-field-field_5a95956-0\" name=\"form_fields[field_5a95956][]\"> <label for=\"form-field-field_5a95956-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"No\" id=\"form-field-field_5a95956-1\" name=\"form_fields[field_5a95956][]\"> <label for=\"form-field-field_5a95956-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_6d330b3 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6d330b3\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tWebsite Address \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_6d330b3]\" id=\"form-field-field_6d330b3\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Website Address \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_fc7a079 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_fc7a079\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo your program have a computer? \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Yes\" id=\"form-field-field_fc7a079-0\" name=\"form_fields[field_fc7a079][]\"> <label for=\"form-field-field_fc7a079-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"No\" id=\"form-field-field_fc7a079-1\" name=\"form_fields[field_fc7a079][]\"> <label for=\"form-field-field_fc7a079-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_544fd38 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_544fd38\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo your program have internet access?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Yes\" id=\"form-field-field_544fd38-0\" name=\"form_fields[field_544fd38][]\"> <label for=\"form-field-field_544fd38-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"No\" id=\"form-field-field_544fd38-1\" name=\"form_fields[field_544fd38][]\"> <label for=\"form-field-field_544fd38-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_0cb6ab4 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0cb6ab4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo your program prepare meals on site? \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Yes\" id=\"form-field-field_0cb6ab4-0\" name=\"form_fields[field_0cb6ab4][]\"> <label for=\"form-field-field_0cb6ab4-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"No\" id=\"form-field-field_0cb6ab4-1\" name=\"form_fields[field_0cb6ab4][]\"> <label for=\"form-field-field_0cb6ab4-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_539d921 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_539d921\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDo your program charge a fee to access food or services? \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Yes\" id=\"form-field-field_539d921-0\" name=\"form_fields[field_539d921][]\"> <label for=\"form-field-field_539d921-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"No\" id=\"form-field-field_539d921-1\" name=\"form_fields[field_539d921][]\"> <label for=\"form-field-field_539d921-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_3dfe3ec elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_3dfe3ec\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tIf yes please explain below: \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_3dfe3ec]\" id=\"form-field-field_3dfe3ec\" rows=\"6\" placeholder=\"Text area \"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_964309f elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_964309f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDC Sites: \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_964309f]\" id=\"form-field-field_964309f\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Ward Location \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_89ca8a4 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_89ca8a4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tNeighborhood\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_89ca8a4]\" id=\"form-field-field_89ca8a4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Neighborhood \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_75595c2 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_75595c2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMD & VA Sites \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_75595c2]\" id=\"form-field-field_75595c2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"County location: \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_01334e9 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_01334e9\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tState & Federal District: \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_01334e9]\" id=\"form-field-field_01334e9\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_d1f8bf4 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d1f8bf4\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tIndividuals shopping for your program and their affiliation \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_d1f8bf4]\" id=\"form-field-field_d1f8bf4\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_611db36 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_611db36\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAffiliation\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_611db36]\" id=\"form-field-field_611db36\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Affiliation \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_7b4f4f9 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_7b4f4f9\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_7b4f4f9]\" id=\"form-field-field_7b4f4f9\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_f7f159d elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_f7f159d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAffiliation \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_f7f159d]\" id=\"form-field-field_f7f159d\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Affiliation\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_381f436 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_381f436\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_381f436]\" id=\"form-field-field_381f436\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_94acbcb elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_94acbcb\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAffiliation\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_94acbcb]\" id=\"form-field-field_94acbcb\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Affiliation \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_8c52c44 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_8c52c44\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tName \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_8c52c44]\" id=\"form-field-field_8c52c44\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_6bc0aae elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6bc0aae\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAffiliation \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_6bc0aae]\" id=\"form-field-field_6bc0aae\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Affiliation \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_f3831e9 elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_f3831e9\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSigning below, I attest the information provided on this application is true and correct.\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_f3831e9]\" id=\"form-field-field_f3831e9\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Signature of Executive Director:\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_2ced5e9 elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2ced5e9\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_2ced5e9]\" id=\"form-field-field_2ced5e9\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" placeholder=\"Date \" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_e6f5967 elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e6f5967\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSignature of program Director: \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_e6f5967]\" id=\"form-field-field_e6f5967\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Signature of Program Director: \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_c37be81 elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_c37be81\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_c37be81]\" id=\"form-field-field_c37be81\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" placeholder=\"Date\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<input\n                    class=\"apbct_special_field apbct_email_id__elementor_form\"\n                    name=\"apbct__email_id__elementor_form\"\n                    aria-label=\"apbct__label_id__elementor_form\"\n                    type=\"text\" size=\"30\" maxlength=\"200\" autocomplete=\"off\"\n                    value=\"\"\n                \/><\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p><span class=\"more-link\"><a href=\"https:\/\/bethelstand4life.com\/discovery\/application\/\">Continue Reading<\/a><\/span><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["entry","author-adamsny","post-2043","page","type-page","status-publish"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/bethelstand4life.com\/discovery\/wp-json\/wp\/v2\/pages\/2043","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bethelstand4life.com\/discovery\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bethelstand4life.com\/discovery\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bethelstand4life.com\/discovery\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/bethelstand4life.com\/discovery\/wp-json\/wp\/v2\/comments?post=2043"}],"version-history":[{"count":0,"href":"https:\/\/bethelstand4life.com\/discovery\/wp-json\/wp\/v2\/pages\/2043\/revisions"}],"wp:attachment":[{"href":"https:\/\/bethelstand4life.com\/discovery\/wp-json\/wp\/v2\/media?parent=2043"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}