{"id":14,"date":"2020-08-12T20:54:25","date_gmt":"2020-08-12T20:54:25","guid":{"rendered":"http:\/\/matrixhelp.org\/?page_id=14"},"modified":"2021-01-07T19:43:55","modified_gmt":"2021-01-07T19:43:55","slug":"form","status":"publish","type":"page","link":"https:\/\/matrixhelp.org\/","title":{"rendered":"Matrix Community Outreach Center Assistance Form"},"content":{"rendered":"\n\n\t<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_chrome gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_2' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/wp-json\/wp\/v2\/pages\/14' data-formid='2' >\n                        <div class='gform-body gform_body'><ul id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_2_123\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_123\"><label class='gfield_label gform-field-label' for='input_2_123' >What assistance are you requesting (your most immediate need)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_123' id='input_2_123' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose One<\/option><option value='Clothing' >Clothing<\/option><option value='Food' >Food<\/option><option value='Food stamps\/Medicaid' >Food stamps\/Medicaid<\/option><option value='Gas\/Fuel' >Gas\/Fuel<\/option><option value='Household Items' >Household Items<\/option><option value='Housing' >Housing<\/option><option value='Rental\/Mortgage' >Rental\/Mortgage<\/option><option value='Transportation' >Transportation<\/option><option value='Utilities' >Utilities<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_2_124\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_124\"><label class='gfield_label gform-field-label' for='input_2_124' >Explain Other<\/label><div class='ginput_container ginput_container_text'><input name='input_124' id='input_2_124' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_137\"  class=\"gfield gfield--type-select field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_137\"><label class='gfield_label gform-field-label' for='input_2_137' >Number of Children<\/label><div class='ginput_container ginput_container_select'><select name='input_137' id='input_2_137' class='medium gfield_select'  aria-describedby=\"gfield_description_2_137\"   aria-invalid=\"false\" ><option value='None' >None<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_2_137'>Each child must be listed with first name, last name, gender, and age.<\/div><\/li><li id=\"field_2_34\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_34\"><label class='gfield_label gform-field-label' for='input_2_34' >Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_34' id='input_2_34' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_34_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_34_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_34' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_1\"  class=\"gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_1\"><label class='gfield_label gform-field-label' for='input_2_1' >Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_2_1' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_67\"  class=\"gfield gfield--type-text gf_left_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_67\"><label class='gfield_label gform-field-label' for='input_2_67' >First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_67' id='input_2_67' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_25\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_25\"><label class='gfield_label gform-field-label' for='input_2_25' >Maiden\/MI<\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_2_25' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_125\"  class=\"gfield gfield--type-email field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_125\"><label class='gfield_label gform-field-label' for='input_2_125' >Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_125' id='input_2_125' type='text' value='' class='medium'     aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_2_33\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_33\"><label class='gfield_label gform-field-label' for='input_2_33' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_33' id='input_2_33' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_33_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_33_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_33' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_35\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_35\"><label class='gfield_label gform-field-label' for='input_2_35' >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_35' id='input_2_35' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Female' selected='selected'>Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_2_30\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_30\"><label class='gfield_label gform-field-label' for='input_2_30' >Family Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_30' id='input_2_30' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Married' >Married<\/option><option value='Never Married' >Never Married<\/option><option value='Widowed' >Widowed<\/option><option value='Divorced' >Divorced<\/option><option value='Separated' >Separated<\/option><\/select><\/div><\/li><li id=\"field_2_36\"  class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_36\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_2_36' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_2_36_1_container' >\n                                        <input type='text' name='input_36.1' id='input_2_36_1' value=''    aria-required='true'    \/>\n                                        <label for='input_2_36_1' id='input_2_36_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_2_36_2_container' >\n                                        <input type='text' name='input_36.2' id='input_2_36_2' value=''     aria-required='false'   \/>\n                                        <label for='input_2_36_2' id='input_2_36_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_2_36_3_container' >\n                                    <input type='text' name='input_36.3' id='input_2_36_3' value=''    aria-required='true'    \/>\n                                    <label for='input_2_36_3' id='input_2_36_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_2_36_4_container' >\n                                        <select name='input_36.4' id='input_2_36_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' selected='selected'>Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_2_36_4' id='input_2_36_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_2_36_5_container' >\n                                    <input type='text' name='input_36.5' id='input_2_36_5' value=''    aria-required='true'    \/>\n                                    <label for='input_2_36_5' id='input_2_36_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_36.6' id='input_2_36_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_2_37\"  class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_37\"><label class='gfield_label gform-field-label' for='input_2_37' >Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_37' id='input_2_37' type='text' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_38\"  class=\"gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_38\"><label class='gfield_label gform-field-label' for='input_2_38' >Alternative Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_38' id='input_2_38' type='text' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_39\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_39\"><label class='gfield_label gform-field-label' for='input_2_39' >Ethnicity<\/label><div class='ginput_container ginput_container_select'><select name='input_39' id='input_2_39' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Black' >Black<\/option><option value='Hispanic' >Hispanic<\/option><option value='Native American' >Native American<\/option><option value='White' >White<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><li id=\"field_2_41\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_41\"><label class='gfield_label gform-field-label' for='input_2_41' >Additional Persons in Household<\/label><div class='ginput_container ginput_container_select'><select name='input_41' id='input_2_41' class='medium gfield_select'     aria-invalid=\"false\" ><option value='None' >None<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><\/select><\/div><\/li><li id=\"field_2_49\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_49\">Additional person 1<\/li><li id=\"field_2_66\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_66\"><label class='gfield_label gform-field-label' for='input_2_66' >Person 1-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_66' id='input_2_66' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_147\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_147\"><label class='gfield_label gform-field-label' for='input_2_147' >Child 1-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_147' id='input_2_147' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_76\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_76\"><label class='gfield_label gform-field-label' for='input_2_76' >Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_76' id='input_2_76' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_148\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_148\"><label class='gfield_label gform-field-label' for='input_2_148' >Child 1-Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_148' id='input_2_148' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_85\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_85\"><label class='gfield_label gform-field-label' for='input_2_85' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_85' id='input_2_85' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_85_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_85_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_85' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_103\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_103\"><label class='gfield_label gform-field-label' for='input_2_103' >Gender<\/label><div class='ginput_container ginput_container_select'><select name='input_103' id='input_2_103' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_2_104\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_104\"><label class='gfield_label gform-field-label' for='input_2_104' >Grade<\/label><div class='ginput_container ginput_container_text'><input name='input_104' id='input_2_104' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_112\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_112\"><label class='gfield_label gform-field-label' for='input_2_112' >Relationship<\/label><div class='ginput_container ginput_container_text'><input name='input_112' id='input_2_112' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_138\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_138\"><label class='gfield_label gform-field-label' for='input_2_138' >Items of interest<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_138' id='input_2_138' class='textarea medium'  aria-describedby=\"gfield_description_2_138\" maxlength='140'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_2_138'>Please give us three areas of interest for the child.  Sports, Hunting, Fishing, Bicycling, Gators, Seminoles.  This is information we will use when matching gifts.<\/div><\/li><li id=\"field_2_122\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_122\">Additional person 2<\/li><li id=\"field_2_68\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_68\"><label class='gfield_label gform-field-label' for='input_2_68' >Person 2-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_68' id='input_2_68' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_149\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_149\"><label class='gfield_label gform-field-label' for='input_2_149' >Child 2-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_149' id='input_2_149' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_77\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_77\"><label class='gfield_label gform-field-label' for='input_2_77' >Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_77' id='input_2_77' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_150\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_150\"><label class='gfield_label gform-field-label' for='input_2_150' >Child 2-Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_150' id='input_2_150' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_86\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_86\"><label class='gfield_label gform-field-label' for='input_2_86' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_86' id='input_2_86' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_86_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_86_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_86' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_101\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_101\"><label class='gfield_label gform-field-label' for='input_2_101' >Gender<\/label><div class='ginput_container ginput_container_select'><select name='input_101' id='input_2_101' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_2_106\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_106\"><label class='gfield_label gform-field-label' for='input_2_106' >Grade<\/label><div class='ginput_container ginput_container_text'><input name='input_106' id='input_2_106' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_113\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_113\"><label class='gfield_label gform-field-label' for='input_2_113' >Relationship<\/label><div class='ginput_container ginput_container_text'><input name='input_113' id='input_2_113' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_139\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_139\"><label class='gfield_label gform-field-label' for='input_2_139' >Items of interest<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_139' id='input_2_139' class='textarea medium'  aria-describedby=\"gfield_description_2_139\" maxlength='140'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_2_139'>Please give us three areas of interest for the child.  Sports, Hunting, Fishing, Bicycling, Gators, Seminoles.  This is information we will use when matching gifts.<\/div><\/li><li id=\"field_2_58\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_58\">Additional person 3<\/li><li id=\"field_2_69\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_69\"><label class='gfield_label gform-field-label' for='input_2_69' >Person 3-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_69' id='input_2_69' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_151\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_151\"><label class='gfield_label gform-field-label' for='input_2_151' >Child 3-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_151' id='input_2_151' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_78\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_78\"><label class='gfield_label gform-field-label' for='input_2_78' >Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_2_78' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_152\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_152\"><label class='gfield_label gform-field-label' for='input_2_152' >Child 3-Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_152' id='input_2_152' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_87\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_87\"><label class='gfield_label gform-field-label' for='input_2_87' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_87' id='input_2_87' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_87_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_87_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_87' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_100\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_100\"><label class='gfield_label gform-field-label' for='input_2_100' >Gender<\/label><div class='ginput_container ginput_container_select'><select name='input_100' id='input_2_100' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_2_105\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_105\"><label class='gfield_label gform-field-label' for='input_2_105' >Grade<\/label><div class='ginput_container ginput_container_text'><input name='input_105' id='input_2_105' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_114\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_114\"><label class='gfield_label gform-field-label' for='input_2_114' >Relationship<\/label><div class='ginput_container ginput_container_text'><input name='input_114' id='input_2_114' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_140\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_140\"><label class='gfield_label gform-field-label' for='input_2_140' >Items of interest<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_140' id='input_2_140' class='textarea medium'  aria-describedby=\"gfield_description_2_140\" maxlength='140'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_2_140'>Please give us three areas of interest for the child.  Sports, Hunting, Fishing, Bicycling, Gators, Seminoles.  This is information we will use when matching gifts.<\/div><\/li><li id=\"field_2_57\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_57\">Additional person 4<\/li><li id=\"field_2_71\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_71\"><label class='gfield_label gform-field-label' for='input_2_71' >Person 4-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_71' id='input_2_71' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_153\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_153\"><label class='gfield_label gform-field-label' for='input_2_153' >Child 4-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_153' id='input_2_153' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_79\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_79\"><label class='gfield_label gform-field-label' for='input_2_79' >Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_2_79' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_154\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_154\"><label class='gfield_label gform-field-label' for='input_2_154' >Child 4-Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_154' id='input_2_154' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_88\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_88\"><label class='gfield_label gform-field-label' for='input_2_88' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_88' id='input_2_88' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_88_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_88_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_88' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_98\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_98\"><label class='gfield_label gform-field-label' for='input_2_98' >Gender<\/label><div class='ginput_container ginput_container_select'><select name='input_98' id='input_2_98' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_2_116\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_116\"><label class='gfield_label gform-field-label' for='input_2_116' >Grade<\/label><div class='ginput_container ginput_container_text'><input name='input_116' id='input_2_116' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_115\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_115\"><label class='gfield_label gform-field-label' for='input_2_115' >Relationship<\/label><div class='ginput_container ginput_container_text'><input name='input_115' id='input_2_115' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_141\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_141\"><label class='gfield_label gform-field-label' for='input_2_141' >Items of interest<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_141' id='input_2_141' class='textarea medium'  aria-describedby=\"gfield_description_2_141\" maxlength='140'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_2_141'>Please give us three areas of interest for the child.  Sports, Hunting, Fishing, Bicycling, Gators, Seminoles.  This is information we will use when matching gifts.<\/div><\/li><li id=\"field_2_56\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_56\">Additional person 5<\/li><li id=\"field_2_72\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_72\"><label class='gfield_label gform-field-label' for='input_2_72' >Person 5-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_72' id='input_2_72' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_155\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_155\"><label class='gfield_label gform-field-label' for='input_2_155' >Child 5-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_155' id='input_2_155' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_80\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_80\"><label class='gfield_label gform-field-label' for='input_2_80' >Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_2_80' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_157\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_157\"><label class='gfield_label gform-field-label' for='input_2_157' >Child 5-Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_157' id='input_2_157' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_89\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_89\"><label class='gfield_label gform-field-label' for='input_2_89' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_89' id='input_2_89' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_89_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_89_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_89' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_97\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_97\"><label class='gfield_label gform-field-label' for='input_2_97' >Gender<\/label><div class='ginput_container ginput_container_select'><select name='input_97' id='input_2_97' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_2_107\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_107\"><label class='gfield_label gform-field-label' for='input_2_107' >Grade<\/label><div class='ginput_container ginput_container_text'><input name='input_107' id='input_2_107' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_117\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_117\"><label class='gfield_label gform-field-label' for='input_2_117' >Relationship<\/label><div class='ginput_container ginput_container_text'><input name='input_117' id='input_2_117' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_142\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_142\"><label class='gfield_label gform-field-label' for='input_2_142' >Items of interest<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_142' id='input_2_142' class='textarea medium'  aria-describedby=\"gfield_description_2_142\" maxlength='140'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_2_142'>Please give us three areas of interest for the child.  Sports, Hunting, Fishing, Bicycling, Gators, Seminoles.  This is information we will use when matching gifts.<\/div><\/li><li id=\"field_2_55\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_55\">Additional person 6<\/li><li id=\"field_2_73\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_73\"><label class='gfield_label gform-field-label' for='input_2_73' >Person 6-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_73' id='input_2_73' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_158\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_158\"><label class='gfield_label gform-field-label' for='input_2_158' >Child 6-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_158' id='input_2_158' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_81\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_81\"><label class='gfield_label gform-field-label' for='input_2_81' >Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_81' id='input_2_81' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_159\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_159\"><label class='gfield_label gform-field-label' for='input_2_159' >Child 6-Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_159' id='input_2_159' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_90\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_90\"><label class='gfield_label gform-field-label' for='input_2_90' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_90' id='input_2_90' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_90_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_90_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_90' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_96\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_96\"><label class='gfield_label gform-field-label' for='input_2_96' >Gender<\/label><div class='ginput_container ginput_container_select'><select name='input_96' id='input_2_96' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_2_108\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_108\"><label class='gfield_label gform-field-label' for='input_2_108' >Grade<\/label><div class='ginput_container ginput_container_text'><input name='input_108' id='input_2_108' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_118\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_118\"><label class='gfield_label gform-field-label' for='input_2_118' >Relationship<\/label><div class='ginput_container ginput_container_text'><input name='input_118' id='input_2_118' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_143\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_143\"><label class='gfield_label gform-field-label' for='input_2_143' >Items of interest<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_143' id='input_2_143' class='textarea medium'  aria-describedby=\"gfield_description_2_143\" maxlength='140'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_2_143'>Please give us three areas of interest for the child.  Sports, Hunting, Fishing, Bicycling, Gators, Seminoles.  This is information we will use when matching gifts.<\/div><\/li><li id=\"field_2_54\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_54\">Additional person 7<\/li><li id=\"field_2_74\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_74\"><label class='gfield_label gform-field-label' for='input_2_74' >Person 7-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_74' id='input_2_74' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_160\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_160\"><label class='gfield_label gform-field-label' for='input_2_160' >Child 7-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_160' id='input_2_160' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_82\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_82\"><label class='gfield_label gform-field-label' for='input_2_82' >Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_2_82' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_161\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_161\"><label class='gfield_label gform-field-label' for='input_2_161' >Child 7-Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_161' id='input_2_161' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_91\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_91\"><label class='gfield_label gform-field-label' for='input_2_91' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_91' id='input_2_91' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_91_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_91_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_91' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_95\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_95\"><label class='gfield_label gform-field-label' for='input_2_95' >Gender<\/label><div class='ginput_container ginput_container_select'><select name='input_95' id='input_2_95' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_2_109\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_109\"><label class='gfield_label gform-field-label' for='input_2_109' >Grade<\/label><div class='ginput_container ginput_container_text'><input name='input_109' id='input_2_109' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_119\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_119\"><label class='gfield_label gform-field-label' for='input_2_119' >Relationship<\/label><div class='ginput_container ginput_container_text'><input name='input_119' id='input_2_119' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_144\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_144\"><label class='gfield_label gform-field-label' for='input_2_144' >Items of interest<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_144' id='input_2_144' class='textarea medium'  aria-describedby=\"gfield_description_2_144\" maxlength='140'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_2_144'>Please give us three areas of interest for the child.  Sports, Hunting, Fishing, Bicycling, Gators, Seminoles.  This is information we will use when matching gifts.<\/div><\/li><li id=\"field_2_53\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_53\">Additional person 8<\/li><li id=\"field_2_75\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_75\"><label class='gfield_label gform-field-label' for='input_2_75' >Person 8-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_2_75' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_162\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_162\"><label class='gfield_label gform-field-label' for='input_2_162' >Child 8-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_162' id='input_2_162' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_83\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_83\"><label class='gfield_label gform-field-label' for='input_2_83' >Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_83' id='input_2_83' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_163\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_163\"><label class='gfield_label gform-field-label' for='input_2_163' >Child 8-Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_163' id='input_2_163' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_92\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_92\"><label class='gfield_label gform-field-label' for='input_2_92' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_92' id='input_2_92' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_92_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_92_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_92' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_94\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_94\"><label class='gfield_label gform-field-label' for='input_2_94' >Gender<\/label><div class='ginput_container ginput_container_select'><select name='input_94' id='input_2_94' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_2_110\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_110\"><label class='gfield_label gform-field-label' for='input_2_110' >Grade<\/label><div class='ginput_container ginput_container_text'><input name='input_110' id='input_2_110' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_120\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_120\"><label class='gfield_label gform-field-label' for='input_2_120' >Relationship<\/label><div class='ginput_container ginput_container_text'><input name='input_120' id='input_2_120' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_145\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_145\"><label class='gfield_label gform-field-label' for='input_2_145' >Items of interest<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_145' id='input_2_145' class='textarea medium'  aria-describedby=\"gfield_description_2_145\" maxlength='140'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_2_145'>Please give us three areas of interest for the child.  Sports, Hunting, Fishing, Bicycling, Gators, Seminoles.  This is information we will use when matching gifts.<\/div><\/li><li id=\"field_2_52\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_52\">Additional person 9<\/li><li id=\"field_2_43\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_43\"><label class='gfield_label gform-field-label' for='input_2_43' >Person 9-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_2_43' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_164\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_164\"><label class='gfield_label gform-field-label' for='input_2_164' >Child 9-First Name<\/label><div class='ginput_container ginput_container_text'><input name='input_164' id='input_2_164' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_42\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_42\"><label class='gfield_label gform-field-label' for='input_2_42' >Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_2_42' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_165\"  class=\"gfield gfield--type-text gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_165\"><label class='gfield_label gform-field-label' for='input_2_165' >Child 9-Last Name<\/label><div class='ginput_container ginput_container_text'><input name='input_165' id='input_2_165' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_93\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_93\"><label class='gfield_label gform-field-label' for='input_2_93' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_93' id='input_2_93' type='text' value='' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_2_93_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_2_93_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_2_93' class='gform_hidden' value='https:\/\/matrixhelp.org\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_2_45\"  class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_45\"><label class='gfield_label gform-field-label' for='input_2_45' >Gender<\/label><div class='ginput_container ginput_container_select'><select name='input_45' id='input_2_45' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose<\/option><option value='Female' >Female<\/option><option value='Male' >Male<\/option><\/select><\/div><\/li><li id=\"field_2_47\"  class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_47\"><label class='gfield_label gform-field-label' for='input_2_47' >Grade<\/label><div class='ginput_container ginput_container_number'><input name='input_47' id='input_2_47' type='text'    value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_2_121\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_121\"><label class='gfield_label gform-field-label' for='input_2_121' >Relationship<\/label><div class='ginput_container ginput_container_text'><input name='input_121' id='input_2_121' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_146\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_146\"><label class='gfield_label gform-field-label' for='input_2_146' >Items of interest<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_146' id='input_2_146' class='textarea medium'  aria-describedby=\"gfield_description_2_146\" maxlength='140'   aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_2_146'>Please give us three areas of interest for the child.  Sports, Hunting, Fishing, Bicycling, Gators, Seminoles.  This is information we will use when matching gifts.<\/div><\/li><li id=\"field_2_127\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_127\"><label class='gfield_label gform-field-label' for='input_2_127' >Annual Household Income<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_127' id='input_2_127' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0-12,700' >0-12,700<\/option><option value='12,701-17,240' >12,701-17,240<\/option><option value='17,241-21,720' >17,241-21,720<\/option><option value='21,721-26,200' >21,721-26,200<\/option><option value='26,201-30,680' >26,201-30,680<\/option><option value='30,681-35,160' >30,681-35,160<\/option><option value='35161-39640' >35161-39640<\/option><option value='39641-44120' >39641-44120<\/option><\/select><\/div><\/li><li id=\"field_2_3\"  class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_3\"><label class='gfield_label gform-field-label' for='input_2_3' >NON-EXPIRED ID FOR ADULT  APPLICANT<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='26214400' \/><input name='input_3' id='input_2_3' type='file' class='medium' aria-describedby=\"gfield_upload_rules_2_3\" onchange='javascript:gformValidateFileSize( this, 26214400 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_2_3'>Max. file size: 25 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_2_3'><\/div><\/div><\/li><li id=\"field_2_167\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_167\"><label class='gfield_label gform-field-label' for='gform_browse_button_2_167' >BIRTH CERTIFICATES OR IMMUNIZATION RECORDS FOR CHILDREN<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_2_167' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_2_167&quot;,&quot;container&quot;:&quot;gform_multifile_upload_2_167&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_2_167&quot;,&quot;filelist&quot;:&quot;gform_preview_2_167&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/?gf_page=cf32a3f4b36cb04&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/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;5242880b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:2,&quot;field_id&quot;:167},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;10&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_2_167&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;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_2_167' 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_2_167' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_2_167\"  >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_2_167'>Max. file size: 5 MB, Max. files: 10.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_2_167'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_2_167' class='ginput_preview_list'><\/div><\/li><li id=\"field_2_18\"  class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_18\"><label class='gfield_label gform-field-label' for='gform_browse_button_2_18' >SOCIAL SECURITY CARDS FOR ALL IN HOUSEHOLD<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_2_18' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_2_18&quot;,&quot;container&quot;:&quot;gform_multifile_upload_2_18&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_2_18&quot;,&quot;filelist&quot;:&quot;gform_preview_2_18&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/?gf_page=cf32a3f4b36cb04&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/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;26214400b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:2,&quot;field_id&quot;:18},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_2_18&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;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_2_18' 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_2_18' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_2_18\"  >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_2_18'>Max. file size: 25 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_2_18'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_2_18' class='ginput_preview_list'><\/div><\/li><li id=\"field_2_166\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_166\"><label class='gfield_label gform-field-label' for='gform_browse_button_2_166' >CHECK STUBS FOR LAST 30 DAYS<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_2_166' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_2_166&quot;,&quot;container&quot;:&quot;gform_multifile_upload_2_166&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_2_166&quot;,&quot;filelist&quot;:&quot;gform_preview_2_166&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/?gf_page=cf32a3f4b36cb04&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/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;26214400b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:2,&quot;field_id&quot;:166},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;5&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_2_166&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;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_2_166' 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_2_166' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_2_166\"  >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_2_166'>Max. file size: 25 MB, Max. files: 5.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_2_166'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_2_166' class='ginput_preview_list'><\/div><\/li><li id=\"field_2_16\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_16\"><label class='gfield_label gform-field-label' for='input_2_16' >FOOD STAMPS ELIGIBILITY LETTER<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='26214400' \/><input name='input_16' id='input_2_16' type='file' class='medium' aria-describedby=\"gfield_upload_rules_2_16\" onchange='javascript:gformValidateFileSize( this, 26214400 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_2_16'>Max. file size: 25 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_2_16'><\/div><\/div><\/li><li id=\"field_2_15\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_15\"><label class='gfield_label gform-field-label' for='input_2_15' >SSI\/SSDI\/SOCIAL SECURITY STATEMENT<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='26214400' \/><input name='input_15' id='input_2_15' type='file' class='medium' aria-describedby=\"gfield_upload_rules_2_15\" onchange='javascript:gformValidateFileSize( this, 26214400 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_2_15'>Max. file size: 25 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_2_15'><\/div><\/div><\/li><li id=\"field_2_14\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_14\"><label class='gfield_label gform-field-label' for='input_2_14' >CHILD SUPPORT DOCUMENTS<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='26214400' \/><input name='input_14' id='input_2_14' type='file' class='medium' aria-describedby=\"gfield_upload_rules_2_14\" onchange='javascript:gformValidateFileSize( this, 26214400 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_2_14'>Max. file size: 25 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_2_14'><\/div><\/div><\/li><li id=\"field_2_11\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_11\"><label class='gfield_label gform-field-label' for='input_2_11' >MOST RECENT UTILITY BILL YOU NEED ASSISTANCE WITH (MUST BE DISCONNECT NOTICE SHOWING PAST DUE AMOUNT) BILL IN YOUR NAME<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='26214400' \/><input name='input_11' id='input_2_11' type='file' class='medium' aria-describedby=\"gfield_upload_rules_2_11\" onchange='javascript:gformValidateFileSize( this, 26214400 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_2_11'>Max. file size: 25 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_2_11'><\/div><\/div><\/li><li id=\"field_2_10\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_10\"><label class='gfield_label gform-field-label' for='input_2_10' >MORTGAGE\/RENTAL\/LEASE SECTION 8\/HUDIF APPLICABLE (Must have a yearly Lease)<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='26214400' \/><input name='input_10' id='input_2_10' type='file' class='medium' aria-describedby=\"gfield_upload_rules_2_10\" onchange='javascript:gformValidateFileSize( this, 26214400 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_2_10'>Max. file size: 25 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_2_10'><\/div><\/div><\/li><li id=\"field_2_8\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_8\"><label class='gfield_label gform-field-label' for='input_2_8' >FOR PRESCRIPTION ASSISTANCE MUST HAVE PRINT OUT OF PRESCRIPTION COST FR\u039f\u039c W\u0391LGR\u0395\u0395\u039dS \u03a1\u0397\u0391R\u039c\u0391C\u03a5. W\u0395 D\u039f \u039d\u039f\u03a4 \u0391SS\u0399S\u03a4 W\u0399\u03a4\u0397 \u0391\u039d\u03a5 \u039d\u0391RC\u039f\u03a4\u0399CS.<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='26214400' \/><input name='input_8' id='input_2_8' type='file' class='medium' aria-describedby=\"gfield_upload_rules_2_8\" onchange='javascript:gformValidateFileSize( this, 26214400 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_2_8'>Max. file size: 25 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_2_8'><\/div><\/div><\/li><li id=\"field_2_23\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_23\"><B>\u03a1R\u039f\u039fF \u039fF \u0397\u0391RDS\u0397\u0399\u03a1: Hardship must not be ongoing, a temporary bump in the road, and <b>MUST HAVE OCCURRED IN THE LAST 45 DAYS<\/B>\u2026 NO EXCEPTIONS!\n<br>\n<ul>\n<li>\nLETTER FROM EMPLOYER LOSS OF JOB OR NEW HIRE LETTER\n<\/li>\n<li>\nCHECK STUBS SHOWING LOSS OF HOURS\/WAGES\n<\/li>\n<li>REFERRAL LETTER FROM ANOTHER AGENCY STATING YOU NEED ASSISTANCE Etc\n<\/li>\n<li>\nDOCTOR'S NOTE STATING INABILITY TO WORK UNEMPLOYMENT PAPERWORK (CONFIRMATION PAGE, DENIAL OR APPEALS LETTER)\n<\/li>\n<\/ul>\n<\/li><li id=\"field_2_7\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_7\"><label class='gfield_label gform-field-label' for='gform_browse_button_2_7' >HARDSHIP FORMS REFER TO EXAMPLES ABOVE<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_2_7' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_2_7&quot;,&quot;container&quot;:&quot;gform_multifile_upload_2_7&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_2_7&quot;,&quot;filelist&quot;:&quot;gform_preview_2_7&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/?gf_page=cf32a3f4b36cb04&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/matrixhelp.org\\\/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;26214400b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:2,&quot;field_id&quot;:7},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_2_7&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;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_2_7' 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_2_7' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_2_7\"  >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_2_7'>Max. file size: 25 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_2_7'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_2_7' class='ginput_preview_list'><\/div><\/li><li id=\"field_2_20\"  class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_20\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Consent<\/label><div class='ginput_container ginput_container_consent'><input name='input_20.1' id='input_2_20_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_2_20\"  aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_2_20_1' >I have read and understand the above.<\/label><input type='hidden' name='input_20.2' value='I have read and understand the above.' class='gform_hidden' \/><input type='hidden' name='input_20.3' value='2' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_2_20'>The Matrix is a social service administrator, here to advocate on your behalf. We are partnered with others to maximize services available to all. We provide services based on availability which changes daily. 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